A Multi-Method Needs Assessment for Developing a Weight Loss Programme for Couples Seeking Fertility Treatment (WELCOME)

Supervisory team: Dr Gertraud Stadler (health psychology and intervention expert), Professor Marjon van der Pol (expert in health economics, time and risk preferences, and discrete choice experiments), Professor Alison Avenell (expert for obesity and weight loss interventions, systematic reviews) Dr Abha Maheshwari (Director of Aberdeen Fertility Centre).

Weight loss is beneficial for fertility in overweight women. A recent systematic review showed that overweight women with fertility problems had higher pregnancy rates following weight loss interventions with reduced calorie diets and exercise (Best, Avenell & Bhattacharya, 2017). However, there is ample room for improving these interventions as the available studies showed moderate weight loss and participant retention (Mutsaerts, Kuchenbecker, Mol, Land & Hoek, 2013). A couple-based intervention approach may be more successful in achieving weight loss compared to interventions involving individuals only (Best, Avenell, Bhattacharya, & Stadler, 2017). Interventions drawing on the support of close others are more successful in achieving behaviour change and weight loss compared to interventions for individuals only (Arden‐Close & McGrath, 2017; McLean, Griffin, Toney & Hardeman, 2003). Weight loss interventions delivered to one person have ripple effects on untreated partners (Gorin, Lenz, Cornelius, Huedo‐Medina, Wojtanowski & Foster, 2018; Gorin et al., 2008). However, to date, there are no couple-based weight loss interventions available in the UK, within or outwith the fertility context (Arden‐Close & McGrath, 2017). Currently, it is not clear what preferences for intervention content and delivery overweight women and their partners in the UK have, and what the feasibility and acceptability of a couple-based weight loss intervention is for couples seeking fertility treatment in the UK. This project aims to conduct a needs assessment for developing a couple-based weight loss intervention for future testing in a multi-centre effectiveness trial.

Research questions:

Question 1 Evidence Synthesis Update: in overweight women, men and couples seeking fertility treatment, what weight loss and behaviour change interventions have been used since the last relevant reviews (Best et al., 2017; Arden‐Close & McGrath, 2017), and how effective are they for weight loss and improving fertility outcomes?

Question 2 Preferences: what preferences do overweight women and their partners seeking fertility treatment and stakeholders have regarding social support, intervention content and delivery to facilitate weight loss and improve fertility outcomes?

Question 3 Feasibility and acceptability: how feasible and acceptable is delivering a couple-based weight loss intervention for women and their partners?

Proposed research and techniques:

We will use mixed methods within an Intervention Mapping approach for this project (Eldredge, Markham, Ruiter, Kok & Parcel, 2016). In Study 1, the student will update two relevant systematic reviews (Best et al., 2017 on weight loss and fertility outcomes; Arden‐Close & McGrath, 2017 on health behaviour change interventions for couples) and identify content, delivery mode, and effectiveness of these interventions. Based on this evidence, we will adapt intervention modules for use in UK fertility clinics, building on prior couple-based interventions used by this research team:

(a) couple referral to a commercial weight loss programme (Gorin et al., 2018); and

(b) couple support via text messages (Berli, Stadler, Inauen & Scholz, 2016).

In Study 2a, the student will conduct in-depth phone interviews with women and their partners seeking fertility treatment, and focus groups with staff at the fertility clinic and other stakeholders (volunteers and staff at the charity Fertility Network UK), to elicit preferences and needs for the weight loss intervention. In Study 2b, a discrete choice experiment will be used to identify preferences and supportive behaviour change techniques in women and their partners seeking fertility treatment (Ryan et al., 2014; van der Pol & Cairns, 2001). In Study 2c, we will evaluate all study materials with couples seeking fertility treatment in a think-aloud protocol. We will revise study materials for content and language. In Study 3, we will deliver the intervention to ten couples seeking fertility treatment and evaluate feasibility and acceptability of the intervention.

Useful previous experience:

This project will suit a student with an interest in intervention development in health psychology, behavioural economics or other behavioural science disciplines. An understanding of behaviour change, living with health problems, statistics and data management and a willingness to learn and develop new expertise and skills is essential. Good scientific writing skills and practical experience of statistical analysis and literature review will also be essential. Experience with collecting empirical data, advanced statistical methods and database management is highly desirable, as is experience of conducting qualitative interviews and managing data electronically.