Mapping components of behavioural weight management interventions using electronic survey and component selection by expert consensus: the BE:COME Study.

Face-to-face group-based programme delivery was the most common delivery mode, but was more prevalent in real-world services than in randomised controlled trials.

• Face-to-face group-based delivery was the most common answer for 28.6% of randomised controlled trials and 63.2% of real-world services.
• 19 real-world services and 6 randomised controlled trials were mapped using an intervention template.
• This represents a notable difference in how interventions are delivered between research and practice settings.

Community centres were the most common setting for real-world services but were not used in any of the randomised controlled trials.

• Community centre was the most common setting for 0% of randomised controlled trials and 69.2% of real-world services.
• This finding highlights a substantial difference in the physical setting between research trials and real-world commissioned services.
• Data were collected from 19 real-world services and 6 randomised controlled trials.

Programme duration of 12 weeks was far more common in real-world services than in randomised controlled trials.

• A total duration of 12 weeks was reported for 7.1% of randomised controlled trials and 57.9% of real-world services.
• This suggests that real-world services are more homogeneous in duration compared to randomised controlled trials.
• The mapping was performed using the standardised reporting of adult behavioural weight management interventions to aid evaluation (SRAW-AE) template.

The standardised reporting template used to map interventions was time-intensive and had practical limitations in its implementation.

• The template can take up to 1.5 hours to complete.
• The template for randomised controlled trials was not completed by the trials themselves, but by one BECOME researcher.
• Mapping for real-world services was performed by a local contact for each service.

An expert group by consensus identified components of behavioural weight management interventions considered important for attendance, completion, and weight loss for use in future component network meta-analysis.

• Component selection was derived from an online survey followed by group discussion to reach consensus.
• The expert group included lived experience members alongside research and clinical experts.
• Some components of interest to the expert group were not suitable for analysis or were not part of the SRAW-AE template.
• Population subgroups of interest could not be included in future research as this information was not collected in the data request.

Interventions varied in eligibility and exclusion criteria, delivery, duration, type of dietary and physical activity advice, and participant monitoring between real-world services and randomised controlled trials.

• Summary descriptions were provided for each programme displaying variability in eligibility and exclusion criteria.
• Differences were observed in eligibility, delivery, duration, type of advice, and participant monitoring.
• Real-world services showed less internal variation compared to randomised controlled trials.
• All included interventions were compliant with National Institute for Health and Care Excellence (NICE) guidance.

The lack of detailed intervention description in prior research has made behavioural weight management interventions difficult to compare for effectiveness.

• The authors state that interventions 'have been difficult to compare for effectiveness and value because they have not been described well enough.'
• National guidelines for commissioning are described as 'particularly broad' due to a lack of evidence.
• This lack of evidence 'will ultimately hamper the commissioning of such programmes.'
• This mapping work is described as preparatory work for the BECOME study, which will use component network meta-analysis to determine effective components.