A randomised controlled trial to investigate the feasibility and acceptability of a small change approach to prevent weight gain

Graham, Henrietta, Madigan, Claire and Daley, Amanda J. 2024. A randomised controlled trial to investigate the feasibility and acceptability of a small change approach to prevent weight gain. Journal of Behavioral Medicine 47 (2) , pp. 232-243. 10.1007/s10865-023-00455-1

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Abstract

A weight gain prevention strategy showing merit is a small change approach (increase energy expenditure and/or decrease energy intake by 100–200 kcal/day). Studies have tested a small change approach in intensive interventions involving multiple contacts, unsuitable for delivery at scale. The aim here was to assess the feasibility and acceptability of a remote small change weight gain prevention intervention. A randomised controlled trial of 122 participants was conducted. The intervention was a remote 12-week small change weight gain prevention programme (targeting dietary and/or physical activity behaviours). The comparator group received a healthy lifestyle leaflet. Data were collected at baseline and 12-weeks. The primary outcome was the feasibility and acceptability, assessed against three stop–go traffic light criteria: retention, number of participants randomised per month and adherence to a small change approach. Participants’ opinions of a small change approach and weight change were also measured. The traffic light stop–go criteria results were green for recruitment (122 participants recruited in three months) and retention (91%) and red for intervention adherence. Most participants (62%) found a small change approach helpful for weight management and the mean difference in weight was − 1.1 kg (95% CI − 1.7, − 0.4), favouring the intervention group. Excluding intervention adherence, the trial was feasible and acceptable to participants. Despite adherence being lower than expected, participants found a small change approach useful for weight management and gained less weight than comparators. With refinement to increase intervention adherence, progress to an effectiveness trial is warranted.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Professional Services > Academic & Student Support Service
Publisher:	Springer
ISSN:	0160-7715
Date of First Compliant Deposit:	3 December 2025
Date of Acceptance:	13 October 2023
Last Modified:	03 Dec 2025 11:00
URI:	https://orca.cardiff.ac.uk/id/eprint/182837

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