A qualitative study of the experiences of participants in X-Fittt 2.0, a combined lifestyle intervention for citizens with a low socioeconomic status

Abstract

AbstractX‑Fittt 2.0 is a two-year combined lifestyle intervention (CLI) for people with a low socioeconomic status (SES), which starts with 12 weeks of intensive guidance, followed by a follow-up trajectory. In the first 12 weeks, participants receive three weekly sports sessions (two in a group with a sports coach, one individually), dietary advice and monitoring by a dietician, and four hours of coaching by a lifestyle coach to work on personal goals. The follow-up trajectory consists of a total of six hours of lifestyle coaching to encourage behavioural maintenance. The aim of this study was to gain insight into the experiences of participants with X‑Fittt 2.0. Therefore, 17 group discussions after 12 weeks (n = 71) and individual interviews after 1–2 years (n = 68) were held and thematically analysed. This resulted in five themes: ‘goals of the participant’, ‘programme content’, ‘accessibility of the programme’, ‘group dynamics’ and ‘guidance’. Most participants participated because of their health. They considered the programme accessible because the atmosphere in the sports centre was pleasant and X‑Fittt 2.0 was offered free of charge. The majority of participants liked the fact that the programme was offered in a group ‘with people like them’, referring to people who are overweight, because they did not have to be ashamed of themselves, which motivated them. The participants were especially satisfied with the guidance from the lifestyle coach and sports coach. However, they would have expected more guidance from the dietician. Overall, most participants were satisfied with the programme, but many also indicated that the first 12 weeks were too short to achieve sustainable behavioural change. Furthermore, quite a few participants indicated to have stopped sports after the first 12 weeks, because they could not afford to continue. The insights obtained can be used to better adapt (existing) CLIs to people with low SES.