Background: People living with obesity in Queensland experience fragmented and inequitable access to publicly funded care, particularly in regional areas. To address these challenges, a person-centred, evidence-based obesity model of care was co-designed and implemented within a regional public health service.
Methods: A multi-phase project engaged consumers and health professionals to identify barriers and enablers to care and co-design solutions. Phase 1 involved consultations with 31 participants (12 consumers, 19 health professionals). Phase 2 included co-design workshops with consumers and clinicians (n=7) to develop recommendations. Phase 3 implemented the co-designed obesity model of care into a regional setting, using the Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework and a context-specific implementation plan. Evaluation was guided by the RE-AIM framework.
Results: Five interconnected themes were identified: obesity complexity, stigma, poor access to care, complex treatment decision-making, and inconsistent person-centred care. Participants reported limited service availability, fragmented referral pathways, inequitable regional access, and a reliance on short-term, generic care. Co-design generated six principles underpinning the model: standardised referral pathways, specialist multidisciplinary care, consumer partnership, governance and quality monitoring, workforce development including stigma training, and improved access and equity. Early implementation outcomes demonstrated improvements across RE-AIM domains. Multidisciplinary engagement was achieved, with 67% of clinicians completing training. Monitoring of recommended clinical quality indicators increased from 10% to 70%. Adoption occurred across participating services through establishment of assessment clinics and referral pathways providing access to all treatment modalities. Seventy-five percent of planned implementation strategies were delivered, supported by workforce development, strengthened governance, and enhanced local implementation capability.
Conclusions: Combining co-design and implementation science enabled development and successful regional implementation of a scalable obesity model of care. The project improved access, quality, and clinician engagement while establishing foundations for ongoing evaluation, sustainability, and broader implementation across public health services.