Enjoy Life LocallY (ELLY): A qualitative study of a co-designed healthy weight and wellbeing intervention in two disadvantaged Scottish communities

Abstract

People who are unable to achieve a healthy lifestyle are at greater risk of type II diabetes, some cancers, heart disease, stroke, mobility problems and poor outcomes from disease. For individuals living in disadvantaged areas, life circumstances such as low income, unemployment, working anti-social hours and limited local services present barriers to the challenge of living healthy lives. Working with two disadvantaged communities in Forth Valley, Scotland, we co-designed and implemented an evidence-informed, incentive-based intervention, Enjoy Life LocallY (ELLY), to support citizens with healthy weight and wellbeing. The intervention comprised free soup twice weekly (café/delivery/pickup); a loyalty card (stamped upon engagement in community assets such as local activities, groups and clubs) exchanged for a £25 shopping card when a minimum of 9 assets over 12 weeks were attended; goal setting; information resources; and self-monitoring of weight and wellbeing. ELLY was delivered by volunteers over a 12-week period, from September 2023 to November 2023, to 75 residents. Qualitative interviews were conducted at 12-weeks with 10 participants per community, to assess study feasibility and conceptualise pathways to how ELLY led to healthy weight and wellbeing outcomes. Data were analysed using framework analysis. The ELLY intervention demonstrated strong acceptability and feasibility and was positively received by participants. In-depth interview data informed the construction of a conceptual framework identifying pathways through which the intervention supports healthy weight and wellbeing, including positive changes in behaviour, strengthened social connectedness, improved dietary habits, measurable participant-reported health improvements and the acquisition of new skills and knowledge. Collectively, findings support the hypothesis that engagement in the ELLY intervention was associated with a range of important health outcomes for participants, making a valuable contribution to the evidence base on community-based interventions and highlighting the important role of co-designed community interventions in supporting underserved, disadvantaged communities in health improvement.