Enjoy Life LocallY (ELLY): feasibility study of a community co-designed incentive intervention to support healthy weight and wellbeing

Interventions to support health and wellbeing often attract advantaged, time-rich, organised people, potentially exacerbating health inequalities and failing to support those less advantaged. Our aim was to co-design and feasibility test a novel community-based incentive system to promote healthy weight and wellbeing in disadvantaged communities. Intervention co-designed with two disadvantaged communities in Scotland. Single-arm, 12-week feasibility study. Inclusion criteria: aged ≥18 years living within a 20 min walking distance from ELLY activities. Exclusion criteria: not resident during the intervention. Participants were recruited via pop-up cafés outside schools, shops, existing clubs and activities. ELLY intervention components: free soup twice weekly (café/delivery/pickup); loyalty card stamped for engagement in activities (to encourage preparatory behaviours towards healthy weight and wellbeing) exchanged for £25 shopping card for regular activity attendance over 12 weeks; goal-setting, information resources, self-monitoring of weight and wellbeing. Outcome measures: acceptability and feasibility of recruitment, retention, and intervention components assessed by self-report questionnaire (0, 3 months) and interviews (3 months). Further interviews post-intervention assessed behaviour change (6 months). Outcomes for a future trial prioritised by communities: healthy weight (BMI), mental wellbeing (WEMWBS), health-related quality-of-life (EQ-5D-5L) and connectedness (Social Connectedness Scale). Sample size: minimum 30 participants per community based on an estimated event rate of 5% for unforeseen problems. Written consent required. Study approved by GCU(HLS/NCH/22/036). Sample characteristics: n=75; 63/75 (84%) female, baseline BMI mean 31·9 (SD 7·3), 48/75 (64%) from disadvantaged areas (SIMD quintiles 1–2). Recruitment completed in 3 months; retention (65/75 [87%]) at 3 months; acceptability of intervention (soup 38/65 [59%], loyalty card and assets 51/65 [79%]); redeemable stamped loyalty cards (55/75 [73%]). Outcomes collected (65/75 [87%] completion rate) within-person change (mean [95% CI]): BMI –0·15 (0·31); EQ-5D-5L 0·02 (0·04); WEMWBS 0·8 (2·39); Social Connectedness Scale 0·8 (3·72). ELLY is acceptable, feasible and shows promise for improving healthy weight and wellbeing in disadvantaged communities. A full trial is warranted to determine effectiveness and cost-effectiveness, with consideration of scalability. Chief Scientist Office (HIP