Modelling of intersectoral resources for people living with obesity: pilot study of an environmental analysis

Context: Living with obesity is a complex, multifactorial health issue, and the healthcare system contributes only 20% of the factors affecting the health of a person living with obesity (PLO). Interventions dedicated to PLO need to be rethought according to an integrated, person-centred, and intersectoral approach to consider the complexity of living with obesity.

Objective: To model the involvement of the different sectors and services mobilized in the follow-up of PLO in a region of Quebec.

Study design: Qualitative study. An environmental scan was conducted between September 2023 and January 2024 using a literature review and semi-structured interviews.

Setting: Regional County Municipality of Montmagny, semi-rural region (Chaudière-Appalaches), in Quebec, Canada.

Study population: PLO, healthcare professionals and community workers.

Intervention: A literature review was conducted to identify current and potential intersectoral interventions dedicated to PLO in Canada. This was followed by semi-structured interviews with a citizen partner, a health system manager, and a community worker to document their perspectives and implications and contextualize findings to the study region.

Outcome measures: Qualitative data analysis was conducted deductively using the Health system Pineault framework and Network actor theory. Health resources modelling was carried out according to systems modelling principles.

Results: Health professionals and community workers did not know, use, or coordinate all sectors of the community that may be involved in PLOs' health. For social and organizational reasons, PLOs did not use many public health system resources, and private community resources were not coordinated with the public system.

Conclusions: This pilot study shows that care and services dedicated to PLO are currently centred on the healthcare system. The resources available in the community are still little known to PLOs and healthcare professionals and are essentially served by the private system.