Project Area: Health policy and systems research
Project Summary
Obesity is the most pressing current and future health challenge in Ireland. Yet, it is only recently that healthcare professionals (HCPs) are starting to acknowledge it as a chronic disease, with most still focused on willpower and self-control as solutions to this complex, multi-factorial condition. This simplistic narrative of ‘eat less, move more’ ignores decades of scientific research identifying genetic, biological, psychological, environmental and socioeconomic obesity determinants.
In 2022, the Clinical Practice Guidelines (CPGs) for the Management of Obesity in Adults in Ireland were published. These guidelines follow the science, moving away from obesity being a ‘lifestyle illness’ or solely defined by weight to recognising it as a disease defined by health impairment, shifting management goals towards patient-centred health outcomes, aligning with existing evidence-based principles of chronic disease management. However, producing high-quality CPGs is no guarantee that recommendations will be implemented in healthcare practice. Recent data shows less than one third of HCPs in Ireland are using the CPGs for obesity management in their day-to-day practice. Hence, there is an obvious need for an active implementation strategy to encourage uptake of these obesity guidelines into clinical practice.
Having a deep understanding of local context-and guideline-specific determinants and using this understanding to design tailored implementation strategies (known as an ‘implementation intervention’) can help promote professional engagement/uptake of clinical practices and is recommended to support regional/national scale-up. This study will use implementation science to deliver a targeted, theory and evidence-informed intervention aimed at optimising uptake of the national CPGs for the management of obesity in adults in Ireland. This implementation intervention will be a first, and although designed for the Irish context, it will be modifiable and adaptable so that it can guide implementation of CPGs for the management of obesity internationally.
Underpinned by the Theoretical Domains Framework, the research is mapped across three studies.
Study 1 will employ a ‘best fit’ framework approach to synthesise qualitative, quantitative, and mixed methods evidence on factors that affect HCPs uptake of obesity CPGs/recommendations. Study 2 will identify current practice and quantify gaps in CPGs uptake nationally (cross-sectional survey) and will interview HCPs to further explore barriers/enablers that need addressing to facilitate better CPGs. Finally, using co-design, study 3 will develop an implementation intervention ensuring its feasibility, acceptability and local relevance.
Skills Required
(If applying for this project you will be asked to outline how you meet the skills required below)
The scholar will be from a social or health sciences background with experience conducting research or working in the health service. It is desirable that they would have some knowledge around obesity and the complexity relating to its management. The PhD training and project will ensure that the scholar develops strong research skills and expertise in implementation science and its related competencies, including evidence synthesis, application of theoretical frameworks, participatory research methods, and developing and evaluating complex interventions including the selection of appropriate measures and outcomes. The scholar will possess a commitment to stakeholder engagement and meaningful collaboration with the public and health professionals at various points in the research process. They will have an opportunity to do research in an applied context, work closely with health service management and healthcare providers in carrying out research, and participate in the dissemination and translation of results into health service planning and delivery.
Supervisory team:
Dr Grainne O’Donoghue, PI/Primary Supervisor
Associate Dean for Physiotherapy and Subject Head of Physiotherapy, and an Associate Professor in the UCD School of Public Health, Physiotherapy and Sports Science, UCD
Dr James Matthews
Associate Professor, School of Public Health, Physiotherapy and Sports Science, UCD
Additional support (Doctoral Studies Panel members) will be provided to the scholar:
Key Policy Stakeholder Partner: Dr Cathy Breen (ASOI Chair and National Clinical Programme for Obesity)
Key Practice Stakeholder Partner: Dr Mick Crotty (GP and lead author on ‘Primary Care Clinical Practice Guideline for Obesity Management in Adults in Ireland’).
Public Patient Involvement: Ms Susie Birney (Coalition for People Living with Obesity (ICPO)
Implementation Science: Dr Fiona Curran (School of Public Health, Physiotherapy and Sports Science, UCD)
The project will be based in UCD
