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Understanding experiences of participating in a weight loss lifestyle intervention trial: a qualitative evaluation of South Asians at high risk of diabetes.

Morrison, Zoe; Douglas, Anne; Bhopal, Raj; Sheikh, Aziz


Anne Douglas

Raj Bhopal

Aziz Sheikh


John F. Forbes
Data Collector

Jason M.R. Gill
Data Collector

Michael Lean
Data Collector

John McKnight
Data Collector

Gordon Murray
Data Collector

Naveed Sattar
Data Collector

Jaakko Tuomilehto
Data Collector

Sarah H. Wild
Data Collector


Objective: To explore the reasons for enrolling, experiences of participating and reasons for remaining in a family-based, cluster randomised controlled trial of a dietitian-delivered lifestyle modification intervention aiming to reduce obesity in South Asians at high risk of developing diabetes. Design: Qualitative study using narrative interviews of a purposive sample of trial participants following completion of the intervention. Data were thematically analysed. Setting: The intervention was conducted in Scotland and resulted in a modest decrease in weight, but did not statistically reduce the incidence of diabetes. Participants: We conducted 21 narrative interviews with 24 participants (20 trial participants and four family volunteers). Results: Many participants were motivated to participate because of: known family history of diabetes and the desire to better understand diabetes-related risks to their own and their family's health; ways to mitigate these risks and to benefit from personalised monitoring. Home-based interventions, communication in the participant's chosen language(s) and continuity in dietitians supported their continuing engagement with the trial. Adaptations in food choices were initially accommodated by participants, although social and faith-based responsibilities were reported as important barriers to persevering with agreed dietary goals. Many participants reported that increasing their level of physical activity was difficult given their long working hours, physically demanding employment and domestic commitments; this being compounded by Scotland's challenging climate and a related reluctance to exercise in the outdoors. Conclusions: Although participants had strong personal interests in participation and found the information provided by dietitians useful, they nonetheless struggled to incorporate the dietary and exercise recommendations into their daily lives. In particular, increasing levels of physical exercise was described as an additional and in some cases unachievable burden. Consideration needs to be given to strengthening and supporting lifestyle interventions with community-based approaches in order to help overcome wider social and environmental factors.


MORRISON, Z., DOUGLAS, A., BHOPAL, R. and SHEIKH, A. 2014. Understanding experiences of participating in a weight loss lifestyle intervention trial: a qualitative evaluation of South Asians at high risk of diabetes. BMJ open [online], 4(6), article ID e004736. Available from:

Journal Article Type Article
Acceptance Date May 22, 2014
Online Publication Date Jun 20, 2014
Publication Date Jun 30, 2014
Deposit Date Aug 6, 2020
Publicly Available Date Aug 6, 2020
Journal BMJ Open
Electronic ISSN 2044-6055
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 4
Issue 6
Article Number e004736
Keywords Diabetes; Family history; South Asia; Weight losss Intervention trial; Physical activity; Scotland
Public URL


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