Rural engagement in primary care for optimizing weight reduction (REPOWER): A mixed methods study of patient perceptions

A systematic review of patient barriers and facilitators for implementing lifestyle interventions targeting weight loss in primary care

“…The theme of the “role of program staff” focuses on HCPs directly involved in the lifestyle intervention program, of which 15 studies reported on. Eight studies described barriers, 26,32,33,35,37,39,43,50 and 11 described facilitators 27,35,38,39,42,43,45,47,49–51 . The two most commonly reported barriers were a lack of active follow‐up and program staff being difficult to reach for participants.…”

“…Twenty‐six studies reported on the program structure of the lifestyle intervention, of which 19 reported on barriers, 27–29,31–35,37–41,43,45,46,48–50 including disliking certain aspects of the group sessions, feeling that the individual is not the target population, a lack of personalized approach, the program being too much effort, program tools are difficult to use, and the program having too much time between follow‐ups; 25 studies reported on facilitators 25–29,31–36,38–43,45–52 . The most commonly reported facilitators were a program with a personalized approach, liking certain aspects of group sessions, liking certain aspects of the program, monitoring of health and weight status, and programming tools that were seen as helpful and flexibility in scheduling the sessions.…”

“…Support as a reason for or against starting or completing a lifestyle intervention was mentioned by 21 studies, of which 15 reported barriers 26,[28][29][30][31]35,[37][38][39][40][41][42][43][44][45] and 10 reported facilitators. 25,26,30,32,33,42,43,[46][47][48] The most commonly reported barriers were lack of support from those close to the patient, lack of support from the GP, and a critical position of the family towards their change.…”

“…The theme "psychological factors" contains several factors of individuals, such as motivation, confidence, and stress. It was reported by 23 studies, of which 23 identified barriers [25][26][27][28][29][30]32,33,35,[38][39][40][41][42][43][44][45][46][47][48][49][50][51] and 12 identified facilitators. 25,[28][29][30]33,40,41,43,[46][47][48]51 These include barriers such as the motivation and self-confidence of the individual, the lack of trust in the intervention, poor knowledge of health risks associated with their weight, and stress perceived by the individual.…”

“…The role of the GP was addressed by 21 studies; 11 studies described barriers 28,35,[37][38][39][42][43][44][45]50,52 and 17 described facilitators. 26,[28][29][30]32,35,[39][40][41][42][43][45][46][47]49,50,52 The most commonly described barriers were GPs not being involved with the problem, feeling like they were wasting the GP's time, and lacking of empathy from the GP.…”