Benefits of NHS Choices for those wanting to lose weight or get fitter

1 Customer Insight Public information

April 2013

Benefits of NHS Choices for site users who

want to lose weight or get fitter


Contents

• Introduction

• Sample and methodology

• Key takeaways

• Profile of users using NHS Choices for weight loss

• Does NHS Choices influence exercising and eating behavior?

• Use of online resources


Introduction.

• The extension of the Business Case for the continuance of the NHS Choices service beyond November 2011 identified a series of benefits. This research was conducted to measure the extent to which the following benefits have been realised:

• B19 decreasing the prevalence of obesity (B19) and

• B17 citizens living a healthier lifestyle

• NHS Choices provides key content areas aimed at tackling obesity and helping users achieve weight loss via four key content areas: healthy eating, exercise/fitness, losing weight and the Couch to 5k plan.

• Previous research has indicated users have used NHS Choices to adopt healthy lifestyles and one in twelve (8%) users have reported the site has helped them lose weight.

• Specific research objectives include:

• Determine the impact of the site on those who say they have used it to help manage their weight, exercise or eat more healthily

• Determining what content has been used to lose weight

• Usefulness and effectiveness of weight loss information and tools

• Other sources of information/interventions followed both online and offline

• Self reported behaviour change as a result of using NHS Choices

• The findings of this research should be considered as preliminary findings to an academic research study that is going to be conducted by the National Obesity Observatory.


Sample and Methodology

Type of survey Online pop-up survey on selected pages of the NHSC website

Methodology Online survey

Fieldwork dates February to March 2013

Sample Total sample completes N=928

Sample distribution General public – self selecting sample of site visiting for themselves

Invitation pages http://www.nhs.uk/Pages/HomePage.aspx

/Tools/Pages/Healthyweightcalculator.aspx

/livewell/loseweight/Pages/Loseweighthome.aspx

/Livewell/healthy-living/Pages/height-weight-chart.aspx

/LiveWell/Goodfood/Pages/Goodfoodhome.aspx

/Livewell/Goodfood/Pages/eatwell-plate.aspx

/LiveWell/c25k/Pages/couch-to-5k.aspx

/Livewell/loseweight/Pages/BodyMassIndex.aspx

/Livewell/Goodfood/Pages/eight-tips-healthy-eating.aspx

/livewell/fitness/Pages/Fitnesshome.aspx

/Livewell/Healthyhearts/Pages/Cholesterol.aspx

/Livewell/fitness/Pages/physical-activity-guidelines-for-adults.aspx

Sample & Methodology

http://www.nhs.uk/Pages/HomePage.aspx

http://www.nhs.uk/Livewell/Goodfood/Pages/eatwell-plate.aspx




http://www.nhs.uk/Livewell/fitness/Pages/physical-activity-guidelines-for-adults.aspx










5

Conclusions

1. Approximately 60% of survey participants have used NHS

Choices for weight loss and taking more exercise. 50% have

used NHS Choices to eat more healthily.

2. Approx. 75% of users reported to be satisfied with NHS

Choices for helping achieve weight management/weight loss

goals.

5. Data suggests NHS Choices helps facilitate and maintain

behavioural change for a healthier lifestyle; losing weight,

exercising & eating healthier.

Key takeaways.

4. Data shows a significant increase in normal healthy BMI and

decrease in obesity after using NHS Choices.

3. 50% reported to have lost weight as a result of using NHS

Choices. On average users reported to lose 1.5 stones (9.5kg)

since using NHS Choices.


Of the 57% who have used NHSC, 20% use the site to eat more healthily and 8%

use the site to lose weight.

43%

57%

Yes

No

6%

2%

3%

20%

8%

2%

3%

5%

7%

7%

7%

7%

8%

Eat more healthily

Help you lose weight

Help during pregnancy

Sleep better

Start an exercise programme

Improve mental wellbeing\better cope with stress

Research\information (on health\illnesses\symptoms)

Stop smoking

Decide to get child vaccinated

Decide to go for a health screening

Started running

Reduce your alcohol intake

Something else

• 42% of personal site users have used the site to make a positive health behavioural change such as eating more healthily,

taking up exercise, losing weight, stopping smoking etc.

Q. In the last 12 months, have you ever used the

information from NHS Choices to make a health related behavioural choice (from a specified list)?

Base all who have used the NHS Choices website for personal use n=233 un-weighted base, n=5727 weighted base

Omnibus survey


Who is using the site for

weight loss?


Profile: Predominantly females, aged between 25-54 and working.

Female

80%

Male

20%

3%

14%

15%

25%

16%

17%

8%

2%

1%

Under 16

16-19

20-24

25-34

35-44

45-54

55-64

65-74

75+

.

35%

15%

9%8%

2%

23%

4%

Wor

king

full tim

e

Wor

king

par

t tim

e

Une

mploy

ed

Not

wor

king

Disab

led

A stu

dent

Oth

er

Base: = 928

Gender Age

Working Status

Q. Profile of respondents who use NHS Choices to manage mental health wellbeing/condition


20%

20%

7%

6%

3%

4%

4%

36%

Just started

1-2 months

3-4 months

5-6 months

7-8 months

9-10 months

11-12 months

More than one year

10

Approximately four fifths of respondents have been trying to lose

weight over one year and three quarters were either overweight or

obese when they started to use NHS Choices.

Base: Respondents with a weight loss goal = 535

16%

42%

32%

8%

1%Underweight

(BMI 15-18.5)

Normal/healthy

BMI (BMI 18.5-

25)

Overweight

(25-30)

Obese (30-39)

Morbidly

obese (>40)

Q. How would you describe your body weight

when you started using NHS Choices to

achieve your health goals? Q. How long have you been trying to lose weight?


8%

15%

23%

13%

20%

20%

All or most days

Every two or three days

About once a week

About once a fortnight

About once a month

Less often than once a

month

11

Almost half of the users visit NHS Choices at least once a week to

achieve weight loss, take more exercise and eat more healthily.

Base: All respondent = 928

46%

Q. How often have you used NHS Choices website in the last 12 months to help achieve your health goals?


Does NHS Choices

influence exercise and

eating behaviour?


Adaptation of DiClemente model of behaviour change.

Information/knowledge Individual is aware of the

problem and benefits

for change

Contemplation Individual thinks about

change and benefits

Ready to change Individual gets into the action

stage e.g. downloads the

couch to 5k running podcasts Make a change Integrating healthy

behaviour in the general

lifestyle

Maintaining a change Maintaining the

healthier lifestyle

Relapse Unhealthy behaviour

Is resumed

Results support change Direct experience

of benefits

A battery of statements were constructed to determine whether NHS Choices is effective at facilitating

behavioural change.


68%

66%

61%

67%

67%

59%

I feel more informed about the benefits

of exercising regularly

I feel more informed about how my

weight affects my health

I feel more informed about the benefits

of eating heathily

I feel more motivated to start an

exercise programme

I feel more motivated to start eating

healthier

I feel more motivated to lose weight

14 Base: All respondents = 928

Data suggests NHS Choices content helps facilitate behavioural change

by providing information and facilitating contemplation.

Information/

Knowledge

Contempla

tion

for change

Q. Below is a grid containing statements of possible outcomes you may have had as a result of using the NHS

Choices site. On a scale of 1 to 5 to what extent do you agree or disagree with the following statements?

% of respondents who agree with the statements (Top 2 box)

According to DiClemente

model information/knowledge

and contemplation are

important prerequisites for

behavioural change.


66%

60%

60%

58%

58%

55%

I tend to eat more fruit and vegetables

I try to eat less fat and sugar

I tend to make healthier food choices

I tend to exercise more

I tend to be more conscious about my

daily calorie intake

I tend to exercise regularly


Data suggests NHS Choices helps facilitate behavioural change for

losing weight, exercising and eating healthier.

Making a

change





55%

54%

47%

44%

39%

71%

69%

I tend to exercise regularly

I am fitter and healthier than before

I lost some weight

I feel more positive about the way I look

I have noticed an improvement in my

mental well being/coping with stress

I feel I will continue to eat a healthy diet

I feel I will continue to do a healthy

amount of physical activity


Data suggests NHS Choices helps achieve results and maintain

behavioural change for losing weight, exercising and eating healthier.

Results

Maintaining

change





17

73%

75%

84%

Weight management (Lose,

maintain or gain weight)

Eat more healthily

Take more exercise

Base: All respondents = 928

More than four fifths stated they successfully achieved taking more exercise.

Three quarters of users reported to have successfully achieved their weight

loss goal and eating healthy goal.

Q. Overall, on scale of 1-5, how successful have you been in achieving your health goals?

Lost weight (n=535)

% successful in losing weight 73%

% of respondents who feel

they have successfully lost

weight (top 2 box).

% of respondents who feel they have been successful (Top 2 box)


Half of all respondents surveyed reported to have lost weight as a result

of using NHS Choices; there was a significant increase in normal healthy BMI and decrease

in obesity after using NHS Choices.

All surveyed 100%

(N=928)

Those who have lost weight using NHSC

16%

42%

32%

8%

2%

34%

42%

18%

4%

1%Underweight

(BMI 15-18.5)

Normal/healthy

BMI (BMI 18.5-

25)

Overweight

(25-30)

Obese (30-39)

Morbidly

obese (>40)

Before After

14%

18%

4%

Significant change

51% lost weight*

N=467

On average users

reported to lose

1.5 stones (9.5kg)

*Regardless of health goal

Q. Have you lost weight as a result of using NHS Choices?

Q. How would you describe your body weight when you started using NHS Choices to achieve your health goals?

Q. How would you describe your current body weight?


37%

19%

9%

4%

3%

3%

5%

20%

26%

24%

10%

6%

4%

3%

6%

21%

47%

15%

8%

3%

2%

3%

4%

19%

Just started

1-2 months

3-4 months

5-6 months

7-8 months

9-10 months

11-12 months

More than one year

Overall

Users who lost weight

Users who did not lose

weight

19

Almost half of users who did not lose weight had just started using NHSC.

Base: All respondent = 928

Q. How long have you been using NHS Choices to help you achieve your health goals?


Use of online resources.


71%

33%

28%

27%

17%

15%

12%

5%

Online information resources/website

Family and friends

Going to the gym

Online blogs and forums

Healthcare professionals e.g GP and

nurses

Self help books

Going to slimming clubs/support groups

Personal trainer

21

Almost three quarters use online information/resources for achieving

health goals.


Q. What has been useful to you when trying to achieve your health goals?


32%

26%

21%

14%

10%

10%

7%

5%

5%

4%

4%

16%

Only used NHS Choices

BBC Health

Myfitnesspal.com

Weightwatchers.co.uk

Mapmyrun.com

Livestrong.com

Weightlossresources.co.uk

Runkeeper.com

Tescodiets.com

Nikeplus.com

Bupa.co.uk

Other (Please specify)

22

What other websites in addition to NHS Choices have you used to help you achieve your health goal?


3%

3%

3%

2%

2%

2%

2%

2%

1%

Myspecialk.co.uk

Sainsburysdiets.co.uk

Rosemaryconley.com

Dietchef.co.uk

Cambridgeweightplan.com

Dukandiet.com

Slimmingsolutions.co.uk

Nutritionprogram.co.uk

Nutracheck.co.uk

BBC Health and My Fitness Pal are the most common online sites used in

conjunction with NHS Choices to achieve health goals.

Q. What other websites in addition to NHS Choices have you used to help you achieve your health goal?


63%

43%

37%

36%

34%

27%

26%

16%

13%

9%

7%

7%

3%

BMI healthy weight calculator

Written advice on healthy eating

Couch to 5K running podcasts

Written advice on physical activity

Written advice on losing weight

Healthy eating self assessment

'Losing weight - getting started' weight loss plan

Fitness self assessment

Home exercise guides

Strength and flex podcasts

Videos

'What's your sport' interactive tools

Online clinic on weight loss - expert advice

23


4.2

3.9

4.7

3.9

3.9

3.8

4.0

3.8

3.9

4.0

3.9

3.9

3.9

Approximately three fifths of users have used the NHS Choices

BMI calculator. Couch to 5K running podcasts & the BMI calculator are

perceived the most useful in helping achieving health goals. Q. What have you used on NHS Choices to help you achieve your health goals?

Q. On a scale of 1 to 5, how useful have the following been in helping you achieve your health goals?

Usefulness

(Average on a 1-5 Scale)


29

Improvements to the site (1)

Qualitative responses n=902

Food & diet

More recommended recipes

(Including vegetarian, low cost, gluten free, low fat options and meals suitable for diabetics)

3%

Introduce meal ideas/ plans

(including low cost meal plans)

3%

Online calorie counter and tracker 1%

Personalised advice (including dietician) 1%

Nutritional information/calories information/fat content for meals/recipes 1%

Information on vegetarian/vegan diets 1%

More information on eating disorders/psychology and overeating/stress eating 1%

Exercise

More exercise podcasts

(For different forms of exercise e.g. Pilates, yoga, circuit training, core strength)

4%

Develop Couch to 10K Podcast 2%

Number of calories burned doing different exercises 1%

Better music on Couch to 5K Podcast/ability to stream own music 1%

Make it easier to download Couch to 5K

(Ability to download on a wider range of Smart phones/omit the need for Flash)

1%


30

Improvements: quotes

Exercise

Pilates pod

cast would be

great.

Exercise

Podcasts or structured exercise

programs similar to couch25k for

other types of exercise would be

good, as not everyone will be suited

to running.

Food and diet

I used other sites in working

out how many calories I

burned doing certain

activities. maybe a little

more of this information

could be helpful.

.C25K

I would like the music used in the

podcasts to be available separately. .

C25K

I would really like to see a Bridge to

10k plan for Couch to 5k graduates.

Food and diet

the site has been pretty helpful although I

have used Google a lot to find out how

many calories there are in certain types of

foods and to try calculate my daily intake

minus exercise.

Food and diet

Healthy recipes, including reasons

why ingredients are useful, along with

nutritional info per recipe.


31

Improvements to the site (2)

Links

Provide links to local activity/sport organisations 3%

Ensure there are no broken links on the site 0.5%

Motivation

Information on keeping up motivation/overcoming psychological barriers 1%

Option for creating a personalised page

A personalised page for recording information i.e. weight/tailored advice 1%

Links

More links to healthy, easy to make

recipes.

Motivation

Having a podcast on motivation and

confidence and all that really

important psychological stuff

because that is where the issue is.


7%3%1%

30%

59%

10%

3%3%

34%

50%

Definitely

Probably

Not sure

Definitely not

Probably not

Take more exercise Eat more healthily Weight management

(lose, maintain or gain weight)

9%

2% 2%

36%%

51%

13%

3%4%

35%

45%

% of respondents

More than four fifths of users anticipate to continue using NHS Choices to help

achieve their current and future health goals and are likely to recommend NHS

Choices.

12%

2%

45%

38%

3%9%

2%1%

30%58%

Anticipated use of NHS Choices

Likelihood to recommend NHS Choices

Q. Do you anticipate continuing using NHS Choices to help you achieve your current and future health goals?


Conclusions

• Those invited to take part in the survey joined because they had used the site to

help them eat more healthily, lose weight or take more exercise - at least three

quarters of survey participants claimed to be successful in reaching their goals

• Overall half of them reported having lost weight as a result of using the site and

other resources. This was not just amongst those with the express goal of losing

weight, but also amongst those who stated they wanted to eat more healthily or

get fitter.

• Many of those who had not lost weight had recently started using the site, so they

may well be successful in reaching their goals in time, again demonstrating the

potential of the site

• It is clear from our web analytics reports that NHS Choices gets only a relatively

small share of the internet traffic. Promotion of the weight loss/healthy

eating/fitness content of the site would mean a greater number of the population

would have access to our valuable content

• Overall the elements of content used by survey participants users were given

good usefulness ratings with Couch to 5k receiving the highest rating by a big

margin


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Health & Medicine

Benefits of NHS Choices for those wanting to lose weight or get fitter