Tuesday 27 January
A new Lifestyle Energy Activity and Nutrition (LEAN) programme is in development to help adults with a learning disability manage their weight using modern arts-based theatre.
New research into the LEAN programme aims to develop a health, wellbeing and weight management solution for adults with a learning disability, that will help reduce their likelihood of developing a range of health and social problems.
Targeted at people who have or are at risk of obesity and other comorbidities such as type 2 diabetes, the programme aims to use arts-based theatre and digital approaches.
These modern approaches are designed to make the programme more enjoyable for people, addressing feedback from the previous LEAN programme that first piloted in the NHS from 2010 to 2013.
Clinicians and researchers from our trust, Teesside University, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust (CNTW), NHS England, University of Cambridge, Northumbria University, Camphill Village Trust and Teesside Mind are carrying out the research. It has received £96,000 in funding from the National Institute for Health and Care Research’s (NIHR) Team Science Award for the initial development and set-up.
The project is being co-created with people with lived experience through a collaboration with two North East theatre groups – The Twisting Ducks Theatre Company and The Lawnmowers Independent Theatre Company.
Jo Smith, a consultant dietician in our trust and senior clinical academic at Teesside University, said: “It is recognised that people with a learning disability are more likely to have an increased risk of being overweight or having obesity.
The former LEAN programme had positive results, with 63% of participants losing or maintaining their weight. However, it needed improving to reflect the changing evidence on weight management in people with a learning disability.
“Future development of the programme is expected to explore ways of making weight management more engaging, potentially bringing together physical activity, mental wellbeing and the existing nutritional elements in a theatre‑based setting. However, further development and funding would be needed before a revised programme is created.”
Through workshops and with help from lived experience experts, the research team has co-developed a plan as to what the programme’s content and delivery could look like.
Simon, a lived experience expert, said: “I thoroughly enjoyed it. I like that it is going to help others. [It’s] nice to give back to the community and help people in the long run.
“Some things were hard and complicated to understand, but the team have helped me in understanding what things meant.
“I liked the workshops with everyone. I enjoyed building the leaflets, sorting out the colour coordination, making it look smart and easily readable by creating easy read materials.”
Simon’s support worker Alex said that he has seen an increase in Simon’s confidence, and he has grasped information quickly and been able to engage with complicated activities.
“Out of parents, support workers, healthcare workers, or you, who is the expert on you? Well, we are. We are the experts about us,” Simon added.
Research assistant Alex Carne-Watson added: “Involving people with lived experience isn’t a nice-to-have – it’s essential. Their insight grounds our work in real world priorities, challenges our assumptions and helps us design solutions that are practical, respectful and more likely to make a meaningful difference.
“Our next steps in the project include applying for funding to refine the intervention based on co-design feedback and begin our feasibility testing with partner sites. We plan to evaluate acceptability, usability and early signals of impact, and use those findings to prepare for a larger-scale trial.”
Jo added: “We hope that through evidence from this research study we can reinstate the LEAN programme as a fully commissioned service across TEWV.”
“This will provide a generic mainstream weight management programme for adults with a learning disability.
“It will also help reduce social care costs and NHS treatment costs associated with caring for adults with learning disabilities, obesity and/or Multiple Long-Term Conditions and Multimorbidity such as physical noncommunicable diseases and mental health conditions.”
