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      Health professionals’ perceptions of weight loss programmes and recommendations for future implementation: a qualitative study

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          Abstract

          Objective

          Obesity is an increasing public health challenge and most weight loss programmes are still inadequate to support sustainable weight loss. One reason for the continued lack of success might be the dominant biomedical, individualised approach to weight loss. Holistic approaches that focus on overall health and well-being in addition to weight loss are increasingly recommended. In Denmark, health professionals in the municipalities are responsible for developing and conducting weight loss programmes. The objective of this study was to explore what health professional’s perceived as an ideal, holistic weight loss programme that could be feasibly implemented in the municipalities.

          Design

          A phenomenological-hermeneutical qualitative study was performed using semistructured interviews.

          Setting

          Thirty-two Danish municipalities were weight loss programmes are developed and conducted.

          Participants

          Thirty-five health professionals with experience conducting weight loss programmes.

          Results

          Three themes emerged from the analysis: Support from the social network are important both during and after a weight loss, Changing the self-belief by positive discussions and doing activities, Maintaining changes through daily life.

          Conclusion

          Future municipal weight loss programmes should emphasise overall health and well-being instead of weight loss and adopt a holistic approach including a focus on social relationships, meaningful activities and successes as part of a balanced daily life.

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          Most cited references29

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          Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness.

          Qualitative content analysis as described in published literature shows conflicting opinions and unsolved issues regarding meaning and use of concepts, procedures and interpretation. This paper provides an overview of important concepts (manifest and latent content, unit of analysis, meaning unit, condensation, abstraction, content area, code, category and theme) related to qualitative content analysis; illustrates the use of concepts related to the research procedure; and proposes measures to achieve trustworthiness (credibility, dependability and transferability) throughout the steps of the research procedure. Interpretation in qualitative content analysis is discussed in light of Watzlawick et al.'s [Pragmatics of Human Communication. A Study of Interactional Patterns, Pathologies and Paradoxes. W.W. Norton & Company, New York, London] theory of communication.
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            Is Open Access

            Saturation in qualitative research: exploring its conceptualization and operationalization

            Saturation has attained widespread acceptance as a methodological principle in qualitative research. It is commonly taken to indicate that, on the basis of the data that have been collected or analysed hitherto, further data collection and/or analysis are unnecessary. However, there appears to be uncertainty as to how saturation should be conceptualized, and inconsistencies in its use. In this paper, we look to clarify the nature, purposes and uses of saturation, and in doing so add to theoretical debate on the role of saturation across different methodologies. We identify four distinct approaches to saturation, which differ in terms of the extent to which an inductive or a deductive logic is adopted, and the relative emphasis on data collection, data analysis, and theorizing. We explore the purposes saturation might serve in relation to these different approaches, and the implications for how and when saturation will be sought. In examining these issues, we highlight the uncertain logic underlying saturation—as essentially a predictive statement about the unobserved based on the observed, a judgement that, we argue, results in equivocation, and may in part explain the confusion surrounding its use. We conclude that saturation should be operationalized in a way that is consistent with the research question(s), and the theoretical position and analytic framework adopted, but also that there should be some limit to its scope, so as not to risk saturation losing its coherence and potency if its conceptualization and uses are stretched too widely.
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              Methodological challenges in qualitative content analysis: A discussion paper.

              This discussion paper is aimed to map content analysis in the qualitative paradigm and explore common methodological challenges. We discuss phenomenological descriptions of manifest content and hermeneutical interpretations of latent content. We demonstrate inductive, deductive, and abductive approaches to qualitative content analysis, and elaborate on the level of abstraction and degree of interpretation used in constructing categories, descriptive themes, and themes of meaning. With increased abstraction and interpretation comes an increased challenge to demonstrate the credibility and authenticity of the analysis. A key issue is to show the logic in how categories and themes are abstracted, interpreted, and connected to the aim and to each other. Qualitative content analysis is an autonomous method and can be used at varying levels of abstraction and interpretation.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2020
                18 November 2020
                : 10
                : 11
                : e039667
                Affiliations
                [1 ]departmentDepartment of Public Health , University of Southern Denmark Faculty of Health Sciences , Odense, Denmark
                [2 ]departmentDepartment of Health , University College Copenhagen , Kobenhavn, Denmark
                [3 ]departmentDepartment of occupational therapy , Wayne State University , Detroit, Michigan, USA
                Author notes
                [Correspondence to ] Christina Jessen-Winge; cwinge@ 123456health.sdu.dk
                Author information
                http://orcid.org/0000-0001-8323-8863
                Article
                bmjopen-2020-039667
                10.1136/bmjopen-2020-039667
                7677371
                33208329
                d15fe3e6-ad0a-457a-a6d9-72e36519e5ef
                © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 22 April 2020
                : 12 October 2020
                : 20 October 2020
                Categories
                Health Services Research
                1506
                1704
                Original research
                Custom metadata
                unlocked

                Medicine
                qualitative research,public health,primary care
                Medicine
                qualitative research, public health, primary care

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