How NHS Choices Helps Users Lose Weight and Get Healthy

1
Customer Insight Public information
April 2013
Benefits of NHS Choices for site users who
want to lose weight or get fitter

2
Contents
• Introduction
• Sample and methodology
• Key takeaways
• Profile of users using NHS Choices for weight loss
• Does NHS Choices influence exercising and eating behavior?
• Use of online resources

3
Introduction.
• The extension of the Business Case for the continuance of the NHS Choices service
beyond November 2011 identified a series of benefits. This research was conducted to
measure the extent to which the following benefits have been realised:
• B19 decreasing the prevalence of obesity (B19) and
• B17 citizens living a healthier lifestyle
• NHS Choices provides key content areas aimed at tackling obesity and helping users
achieve weight loss via four key content areas: healthy eating, exercise/fitness, losing
weight and the Couch to 5k plan.
• Previous research has indicated users have used NHS Choices to adopt healthy
lifestyles and one in twelve (8%) users have reported the site has helped them lose
weight.
• Specific research objectives include:
• Determine the impact of the site on those who say they have used it to help
manage their weight, exercise or eat more healthily
• Determining what content has been used to lose weight
• Usefulness and effectiveness of weight loss information and tools
• Other sources of information/interventions followed both online and offline
• Self reported behaviour change as a result of using NHS Choices
• The findings of this research should be considered as preliminary findings to an
academic research study that is going to be conducted by the National Obesity
Observatory.

4
Sample and Methodology
Type of survey Online pop-up survey on selected pages of the NHSC website
Methodology Online survey
Fieldwork dates February to March 2013
Sample Total sample completes N=928
Sample distribution General public – self selecting sample of site visiting for themselves
Invitation pages http://www.nhs.uk/Pages/HomePage.aspx
/Tools/Pages/Healthyweightcalculator.aspx
/livewell/loseweight/Pages/Loseweighthome.aspx
/Livewell/healthy-living/Pages/height-weight-chart.aspx
/LiveWell/Goodfood/Pages/Goodfoodhome.aspx
/Livewell/Goodfood/Pages/eatwell-plate.aspx
/LiveWell/c25k/Pages/couch-to-5k.aspx
/Livewell/loseweight/Pages/BodyMassIndex.aspx
/Livewell/Goodfood/Pages/eight-tips-healthy-eating.aspx
/livewell/fitness/Pages/Fitnesshome.aspx
/Livewell/Healthyhearts/Pages/Cholesterol.aspx
/Livewell/fitness/Pages/physical-activity-guidelines-for-adults.aspx
Sample & Methodology

5
5
Conclusions
1. Approximately 60% of survey participants have used NHS
Choices for weight loss and taking more exercise. 50% have
used NHS Choices to eat more healthily.
2. Approx. 75% of users reported to be satisfied with NHS
Choices for helping achieve weight management/weight loss
goals.
5. Data suggests NHS Choices helps facilitate and maintain
behavioural change for a healthier lifestyle; losing weight,
exercising & eating healthier.
Key takeaways.
4. Data shows a significant increase in normal healthy BMI and
decrease in obesity after using NHS Choices.
3. 50% reported to have lost weight as a result of using NHS
Choices. On average users reported to lose 1.5 stones (9.5kg)
since using NHS Choices.

6
Of the 57% who have used NHSC, 20% use the site to eat more healthily and 8%
use the site to lose weight.
43%
57%
Yes
No
6%
2%
3%
20%
8%
2%
3%
5%
7%
7%
7%
7%
8%
Eat more healthily
Help you lose weight
Help during pregnancy
Sleep better
Start an exercise programme
Improve mental wellbeingbetter cope with stress
Researchinformation (on healthillnessessymptoms)
Stop smoking
Decide to get child vaccinated
Decide to go for a health screening
Started running
Reduce your alcohol intake
Something else
• 42% of personal site users have used the site to make a positive health behavioural change such as eating more healthily,
taking up exercise, losing weight, stopping smoking etc.
Q. In the last 12 months, have you ever used the
information from NHS Choices to make a health
related behavioural choice (from a specified list)?
Base all who have used the NHS Choices website for personal use n=233 un-weighted base, n=5727 weighted base
Omnibus survey

7
Who is using the site for
weight loss?

8
Profile: Predominantly females, aged between 25-54 and working.
Female
80%
Male
20%
3%
14%
15%
25%
16%
17%
8%
2%
1%
Under 16
16-19
20-24
25-34
35-44
45-54
55-64
65-74
75+
.
35%
15%
9%8%
2%
23%
4%
W
orking
fulltim
e
W
orking
parttim
e
Unem
ployed
Notworking
Disabled
A
student
O
ther
Base: = 928
Gender Age
Working Status
Q. Profile of respondents who use NHS Choices to manage mental health wellbeing/condition

10
20%
20%
7%
6%
3%
4%
4%
36%
Just started
1-2 months
3-4 months
5-6 months
7-8 months
9-10 months
11-12 months
More than one year
10
Approximately four fifths of respondents have been trying to lose
weight over one year and three quarters were either overweight or
obese when they started to use NHS Choices.
Base: Respondents with a weight loss goal = 535
16%
42%
32%
8%
1%
Underweight
(BMI 15-18.5)
Normal/healthy
BMI (BMI 18.5-
25)
Overweight
(25-30)
Obese (30-39)
Morbidly
obese (>40)
Q. How would you describe your body weight
when you started using NHS Choices to
achieve your health goals?Q. How long have you been trying to lose weight?

11
8%
15%
23%
13%
20%
20%
All or most days
Every two or three days
About once a week
About once a fortnight
About once a month
Less often than once a
month
11
Almost half of the users visit NHS Choices at least once a week to
achieve weight loss, take more exercise and eat more healthily.
Base: All respondent = 928
46%
Q. How often have you used NHS Choices website in the last 12 months to help achieve your health goals?

12
Does NHS Choices
influence exercise and
eating behaviour?

13
Adaptation of DiClemente model of behaviour change.
Information/knowledge
Individual is aware of the
problem and benefits
for change
Contemplation
Individual thinks about
change and benefits
Ready to change
Individual gets into the action
stage e.g. downloads the
couch to 5k running podcasts
Make a change
Integrating healthy
behaviour in the general
lifestyle
Maintaining a change
Maintaining the
healthier lifestyle
Relapse
Unhealthy behaviour
Is resumed
Results support change
Direct experience
of benefits
A battery of statements were constructed to determine whether NHS Choices is effective at facilitating
behavioural change.

14
68%
66%
61%
67%
67%
59%
I feel more informed about the benefits
of exercising regularly
I feel more informed about how my
weight affects my health
I feel more informed about the benefits
of eating heathily
I feel more motivated to start an
exercise programme
I feel more motivated to start eating
healthier
I feel more motivated to lose weight
14
Base: All respondents = 928
Data suggests NHS Choices content helps facilitate behavioural change
by providing information and facilitating contemplation.
Information/
Knowledge
Contempla
tion
for change
Q. Below is a grid containing statements of possible outcomes you may have had as a result of using the NHS
Choices site. On a scale of 1 to 5 to what extent do you agree or disagree with the following statements?
% of respondents who agree with the statements (Top 2 box)
According to DiClemente
model information/knowledge
and contemplation are
important prerequisites for
behavioural change.

15
66%
60%
60%
58%
58%
55%
I tend to eat more fruit and vegetables
I try to eat less fat and sugar
I tend to make healthier food choices
I tend to exercise more
I tend to be more conscious about my
daily calorie intake
I tend to exercise regularly
15
Data suggests NHS Choices helps facilitate behavioural change for
losing weight, exercising and eating healthier.
Making a
change

16
55%
54%
47%
44%
39%
71%
69%
I tend to exercise regularly
I am fitter and healthier than before
I lost some weight
I feel more positive about the way I look
I have noticed an improvement in my
mental well being/coping with stress
I feel I will continue to eat a healthy diet
I feel I will continue to do a healthy
amount of physical activity
16
Data suggests NHS Choices helps achieve results and maintain
behavioural change for losing weight, exercising and eating healthier.
Results
Maintaining
change

17
17
73%
75%
84%
Weight management (Lose,
maintain or gain weight)
Eat more healthily
Take more exercise
More than four fifths stated they successfully achieved taking more exercise.
Three quarters of users reported to have successfully achieved their weight
loss goal and eating healthy goal.
Q. Overall, on scale of 1-5, how successful have you been in achieving your health goals?
Lost weight (n=535)
% successful in losing weight 73%
% of respondents who feel
they have successfully lost
weight (top 2 box).
% of respondents who feel they have been successful (Top 2 box)

18
Half of all respondents surveyed reported to have lost weight as a result
of using NHS Choices; there was a significant increase in normal healthy BMI and decrease
in obesity after using NHS Choices.
All surveyed 100%
(N=928)
Those who have lost weight using NHSC
16%
42%
32%
8%
2%
34%
42%
18%
4%
1%
Underweight
(BMI 15-18.5)
Normal/healthy
BMI (BMI 18.5-
25)
Overweight
(25-30)
Obese (30-39)
Morbidly
obese (>40)
Before After
 14%
 18%
 4%
Significant change  
51% lost weight*
N=467
On average users
reported to lose
1.5 stones (9.5kg)
*Regardless of health goal
Q. Have you lost weight as a result of using NHS Choices?
Q. How would you describe your body weight when you started using NHS Choices to achieve your health goals?
Q. How would you describe your current body weight?

19
37%
19%
9%
4%
3%
3%
5%
20%
26%
24%
10%
6%
4%
3%
6%
21%
47%
15%
8%
3%
2%
3%
4%
19%
Just started
1-2 months
3-4 months
5-6 months
7-8 months
9-10 months
11-12 months
More than one year
Overall
Users who lost weight
Users who did not lose
weight
19
Almost half of users who did not lose weight had just started using NHSC.
Base: All respondent = 928
Q. How long have you been using NHS Choices to help you achieve your health goals?

20
Use of online resources.

21
71%
33%
28%
27%
17%
15%
12%
5%
Online information resources/website
Family and friends
Going to the gym
Online blogs and forums
Healthcare professionals e.g GP and
nurses
Self help books
Going to slimming clubs/support groups
Personal trainer
21
Almost three quarters use online information/resources for achieving
health goals.
Q. What has been useful to you when trying to achieve your health goals?

22
32%
26%
21%
14%
10%
10%
7%
5%
5%
4%
4%
16%
Only used NHS Choices
BBC Health
Myfitnesspal.com
Weightwatchers.co.uk
Mapmyrun.com
Livestrong.com
Weightlossresources.co.uk
Runkeeper.com
Tescodiets.com
Nikeplus.com
Bupa.co.uk
Other (Please specify)
22
What other websites in addition to NHS Choices have you used to help you achieve your health goal?
3%
3%
3%
2%
2%
2%
2%
2%
1%
Myspecialk.co.uk
Sainsburysdiets.co.uk
Rosemaryconley.com
Dietchef.co.uk
Cambridgeweightplan.com
Dukandiet.com
Slimmingsolutions.co.uk
Nutritionprogram.co.uk
Nutracheck.co.uk
BBC Health and My Fitness Pal are the most common online sites used in
conjunction with NHS Choices to achieve health goals.
Q. What other websites in addition to NHS Choices have you used to help you achieve your health goal?

23
63%
43%
37%
36%
34%
27%
26%
16%
13%
9%
7%
7%
3%
BMI healthy weight calculator
Written advice on healthy eating
Couch to 5K running podcasts
Written advice on physical activity
Written advice on losing weight
Healthy eating self assessment
'Losing weight - getting started' weight loss plan
Fitness self assessment
Home exercise guides
Strength and flex podcasts
Videos
'What's your sport' interactive tools
Online clinic on weight loss - expert advice
23
4.2
3.9
4.7
3.9
3.9
3.8
4.0
3.8
3.9
4.0
3.9
3.9
3.9
Approximately three fifths of users have used the NHS Choices
BMI calculator. Couch to 5K running podcasts & the BMI calculator are
perceived the most useful in helping achieving health goals.
Q. What have you used on NHS Choices to help you achieve your health goals?
Q. On a scale of 1 to 5, how useful have the following been in helping you achieve your health goals?
Usefulness
(Average on a 1-5 Scale)

29
29
Improvements to the site (1)
Qualitative responses n=902
Food & diet
More recommended recipes
(Including vegetarian, low cost, gluten free, low fat options and meals suitable for diabetics)
3%
Introduce meal ideas/ plans
(including low cost meal plans)
3%
Online calorie counter and tracker 1%
Personalised advice (including dietician) 1%
Nutritional information/calories information/fat content for meals/recipes 1%
Information on vegetarian/vegan diets 1%
More information on eating disorders/psychology and overeating/stress eating 1%
Exercise
More exercise podcasts
(For different forms of exercise e.g. Pilates, yoga, circuit training, core strength)
4%
Develop Couch to 10K Podcast 2%
Number of calories burned doing different exercises 1%
Better music on Couch to 5K Podcast/ability to stream own music 1%
Make it easier to download Couch to 5K
(Ability to download on a wider range of Smart phones/omit the need for Flash)
1%

30
30
Improvements: quotes
Exercise
Pilates pod
cast would be
great.
Exercise
Podcasts or structured exercise
programs similar to couch25k for
other types of exercise would be
good, as not everyone will be suited
to running.
Food and diet
I used other sites in working
out how many calories I
burned doing certain
activities. maybe a little
more of this information
could be helpful.
.C25K
I would like the music used in the
podcasts to be available separately. .
C25K
I would really like to see a Bridge to
10k plan for Couch to 5k graduates.
Food and diet
the site has been pretty helpful although I
have used Google a lot to find out how
many calories there are in certain types of
foods and to try calculate my daily intake
minus exercise.
Food and diet
Healthy recipes, including reasons
why ingredients are useful, along with
nutritional info per recipe.

31
31
Improvements to the site (2)
Links
Provide links to local activity/sport organisations 3%
Ensure there are no broken links on the site 0.5%
Motivation
Information on keeping up motivation/overcoming psychological barriers 1%
Option for creating a personalised page
A personalised page for recording information i.e. weight/tailored advice 1%
Links
More links to healthy, easy to make
recipes.
Motivation
Having a podcast on motivation and
confidence and all that really
important psychological stuff
because that is where the issue is.

32
7%
3%1%
30%
59%
10%
3%3%
34%
50%
Definitely
Probably
Not sure
Definitely not
Probably not
Take more exercise Eat more healthilyWeight management
(lose, maintain or gain weight)
9%
2%2%
36%%
51%
13%
3%4%
35%
45%
% of respondents
More than four fifths of users anticipate to continue using NHS Choices to help
achieve their current and future health goals and are likely to recommend NHS
Choices.
12%
2%
45%
38%
3%
9%
2%1%
30%
58%
Anticipated use of NHS Choices
Likelihood to recommend NHS Choices
Q. Do you anticipate continuing using NHS Choices to help you achieve your current and future health goals?

33
Conclusions
• Those invited to take part in the survey joined because they had used the site to
help them eat more healthily, lose weight or take more exercise - at least three
quarters of survey participants claimed to be successful in reaching their goals
• Overall half of them reported having lost weight as a result of using the site and
other resources. This was not just amongst those with the express goal of losing
weight, but also amongst those who stated they wanted to eat more healthily or
get fitter.
• Many of those who had not lost weight had recently started using the site, so they
may well be successful in reaching their goals in time, again demonstrating the
potential of the site
• It is clear from our web analytics reports that NHS Choices gets only a relatively
small share of the internet traffic. Promotion of the weight loss/healthy
eating/fitness content of the site would mean a greater number of the population
would have access to our valuable content
• Overall the elements of content used by survey participants users were given
good usefulness ratings with Couch to 5k receiving the highest rating by a big
margin

34
Questions and comments to:
thechoicesteam@nhschoices.nhs.uk
please quote “Slideshare” in subject line

How NHS Choices Helps Users Lose Weight and Get Healthy

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