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. 2025 Nov 3;20(11):e0308770.
doi: 10.1371/journal.pone.0308770. eCollection 2025.

Co-development of an acceptance and commitment therapy-based intervention to increase intrinsic motivation of adolescents to change weight: The AIM2Change study

Jennifer S Cox  1 , Aidan J Searle  1 , Idoia Iturbe  2 , Gail A Thornton  3 , Ingram Wright  4 , Claire Semple  4 , Ken Clare  5 , Julian P Hamilton-Shield  1 , Elanor C Hinton  1
Affiliations

Co-development of an acceptance and commitment therapy-based intervention to increase intrinsic motivation of adolescents to change weight: The AIM2Change study

Jennifer S Cox et al. PLoS One. .

Abstract

Childhood obesity levels continue to rise, with significant impact on individuals and the NHS. The 'Complications of Excess Weight' (CEW) clinics provide support to young people with complications of their weight. Our objective was to co-develop, with young people, a new intervention; AIM2Change, to enable young people to develop their intrinsic motivation to manage weight, using Acceptance and Commitment Therapy (ACT), with a person-centred approach. Young people from the Care of Childhood Obesity (CoCO) clinic in Bristol, UK, were recruited to co-develop this intervention. The study was registered on ISRCTN (ISRCTN16607863). The seven-session, ACT-based intervention was delivered one-to-one, securely online. Qualitative interviews were conducted after each intervention session was delivered. Qualitative data were coded and reviewed regularly to make iterative changes to individual sessions and the overall programme. Fourteen co-developers were recruited, of whom nine completed the co-development process (female = 4; median age (IQR)=15(1.5); 4 with a parent; Indices of Multiple Deprivation (IMD) median = 3.5, range = 1-10). Iterative changes made during co-development included introducing an earlier focus on eating behaviour and body image, with more practical activities to increase engagement. Thematic analysis of co-developer feedback identified four themes: theoretical understanding; delivery and receipt of therapy; view of strategies and engagement; real world benefits of co-development process. Framework analysis was conducted to map data pertaining to these themes into matrices according to each participant and session. Insights from the co-development process have shaped AIM2Change to optimise the intervention's value, relevance and acceptability. Findings suggest that AIM2Change meets an unmet need in delivery of current childhood weight management services.

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Conflict of interest statement

I have read the journal’s policy and the authors of this manuscript have the following competing interests: Dr Hinton is employed by both the University of Bristol as a Senior Research Fellow (through which she completed this work) and also on a part-time basis with Oxford Medical Products as a Clinical Studies Manager. Please note the work reported in this paper was conducted fully independently from the industry role. All co-authors have no conflict of interest to declare.

Figures

Fig 1
Fig 1. Stages and theoretical framework of AIM2Change intervention development.
Fig 2
Fig 2. Screenshot of the CUBE.
Questions for each dimension appear on the left of the screen with the slider to move the data point in blue. The CUBE appears on the right, with each dimension on a different axis: Contribute on the x‐axis, Voice on the y‐axis, agenda on the z‐axis and change as colour of the data point (yellow is neutral; red is resists change, green is willing to change). The cube can be rotated using the mouse so that contributors can explore the data points in relation to the different dimensions [28,29].
Fig 3
Fig 3. Participant flow diagram.
This diagram is prepared in the style of a CONSORT flow diagram (https://www.consort-spirit.org/).
See this image and copyright information in PMC

References

    1. NCD-RisC NRFC. Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults. Lancet. 2017;390:2627–42. - PMC - PubMed
    1. World Health Organization. Obesity and overweight; 2024. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
    1. Di Cesare M, Sorić M, Bovet P, Miranda JJ, Bhutta Z, Stevens GA, et al. The epidemiological burden of obesity in childhood: a worldwide epidemic requiring urgent action. BMC Med. 2019;17(1):212. doi: 10.1186/s12916-019-1449-8 - DOI - PMC - PubMed
    1. Pulgarón ER. Childhood obesity: a review of increased risk for physical and psychological comorbidities. Clin Ther. 2013;35(1):A18-32. doi: 10.1016/j.clinthera.2012.12.014 - DOI - PMC - PubMed
    1. Hawton K, Apperley L, Parkinson J, Owens M, Semple C, Canvin L, et al. Complications of excess weight seen in two tier 3 paediatric weight management services: an observational study. Arch Dis Child. 2025;110(3):216–20. doi: 10.1136/archdischild-2024-327286 - DOI - PubMed

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