Reduzir Iniquidades no Acesso e Gestão da Obesidade nos Cuidados de Saúde Primários em Portugal

The ultimate goal of the BRIDGE project is to gather evidence and implement interventions aligned with the Health Service Delivery Framework and Integrated Care Model for Obesity Prevention and Treatment. These efforts seek to contribute to universally accessible and sustainable obesity prevention and management services in primary healthcare (PHC) in Portugal. While some PHC units have initiated actions for delivering personalised care to individuals with obesity, they are not being implemented in a standardised manner. Therefore, the optimal implementation methods and the interventions' effectiveness remain unclear. Hence, this project seeks to generate up-to-date evidence on obesity management practices in PHC settings. It also aims to implement co-designed interventions targeting people living with obesity, healthcare professionals, and the general population, to enhance access to a more effective and equitable obesity care model. The specific objectives are divided in four work packages (WP), as follows: WP 1) Economics of Obesity in PHC: costs and effectiveness analyses 1.1. To estimate the direct and indirect economic costs of obesity in PHC settings using real-world data from SClínico®; 1.2. To estimate the cost-effectiveness of different obesity care models within PHC settings, by comparing health units that have implemented interventions based on the Integrated Care Model for Obesity Prevention and Treatment with those that have not; WP 2) Mixed-method approach: exploring access and delivery of obesity care in PHC 2.1. To explore the experiences, knowledge, attitudes, and practices of health professionals about obesity care in PHC, and their perspectives towards people with obesity, and potential stigmatising approaches; 2.2. To investigate the experiences, barriers, and facilitators of people living with obesity in accessing obesity-related care in PHC; WP 3) Obesity framing: societal narratives around people living with obesity 3.1. To analyse societal narratives around obesity, by conducting a mixed-method analysis of mainstream newspaper coverage of obesity in Portugal, evaluating frames of obesity in the Portuguese press and exploring obesity-related content; WP 4) From evidence to action: multi-level interventions and dissemination 4.1. To co-design with health professionals and people living with obesity, implement and evaluate a pilot intervention for effective obesity management in a family health unit, according to the Integrated Care Model for Obesity Prevention and Treatment recommendations; 4.2. To propose a matrix of performance indicators for monitoring purposes of effective obesity management in PHC; 4.3. To develop training intensive courses for capacitating healthcare professionals about how to diagnose and approach people with overweight and obesity in PHC; 4.4. To co-create with people living with obesity a national public health campaign on the root causes and prevention strategies of obesity, targeted at the Portuguese population. This multilevel approach on determinants of obesity management, such as the individual level (people with obesity), interpersonal (healthcare professionals), organisational (PHC settings), and societal (media and societal engagement), as well as the comparison of PHC units with different obesity care models will contribute to the identification of cost-effective practices, guiding interventions to enhance equitable access to obesity management in PHC settings.