Empowering Pacific Patients on the Weight Loss Surgery Pathway: A Co-designed Evaluation Study

Obes Surg. 2024 Mar;34(3):959-966. doi: 10.1007/s11695-024-07084-w. Epub 2024 Feb 12.

Abstract

Purpose: Despite having the highest medical needs by population for weight loss treatment, Pacific patients in Aotearoa New Zealand face substantial levels of attrition in publicly funded weight loss surgery programs. In collaboration with the Auckland City Hospital bariatric surgery team, a Pacific-led preoperative weight loss surgery program was co-designed, delivered, and evaluated between 2020 and 2023.

Materials and methods: This was a single-arm, prospective co-designed evaluation study that took place at Auckland City Hospital in Aotearoa New Zealand. Participants were Pacific patients (n = 14) referred to the weight loss surgery program. Survey and video diaries were analyzed to determine if the program had the potential to increase Pacific patient retention through the preoperative stage of weight loss surgery, increase surgery completion rates, and improve the quality of treatment experiences.

Results: Nine out of 14 participants attended all preoperative sessions. Six participants subsequently underwent weight loss surgery. Program components that had positive impacts on patient success and satisfaction were accessibility, information quality, having Pacific role models, cultural safety, and the group support system. The patients found the program to be culturally anchored and there was support for the implementation of the program going forward.

Conclusion: This study demonstrated how a culturally anchored intervention can increase patient retention for those patients who may not respond to mainstream treatment. Adjusting existing preoperative weight loss surgery programs to integrate Pacific-led models of healthcare has the potential to increase Pacific patient resiliency to follow through with surgery.

Keywords: Bariatric surgery; Co-design; Culturally competent; Metabolic surgery; Pacific cultural competency; Pacific-led; Preoperative surgery work-up; Weight loss surgery.

MeSH terms

  • Bariatric Surgery*
  • Delivery of Health Care
  • Humans
  • Obesity, Morbid* / surgery
  • Power, Psychological
  • Prospective Studies