{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T14:50:14Z","timestamp":1782399014401,"version":"3.54.5"},"reference-count":52,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000289","name":"Cancer Research UK","doi-asserted-by":"publisher","award":["RCCCEA\u2010Nov23\/100002"],"award-info":[{"award-number":["RCCCEA\u2010Nov23\/100002"]}],"id":[{"id":"10.13039\/501100000289","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Obesity Science &amp; Practice"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Obesity is a leading cause of ill health in England and places a substantial burden on health systems and the economy. Behavioral weight management services (WMS) are central to reducing obesity\u2010related risk, but their reach remains limited. Electronic signposting (eSignposting), which uses electronic health records and digital communication to connect patients with appropriate services, may improve access to behavioral WMS. Effective and equitable implementation of eSignposting requires a comprehensive understanding of the behavioral WMS ecosystem, including its key components and interdependencies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to characterize the behavioral WMS ecosystem in the East of England (Norfolk, Suffolk, and North\u2010East Essex) to identify opportunities and considerations for implementing eSignposting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A qualitative study was conducted using semi\u2010structured interviews with professional stakeholders (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a011) involved in the commissioning, referral, and delivery of behavioral WMS. Directed content analysis was used to develop ecosystem maps and a comprehensive inventory of services across the region.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The findings revealed a complex behavioral WMS landscape spanning the local authority, national, commercial, and voluntary sectors. Self\u2010referral and primary care referral emerged as the predominant routes to accessing behavioral WMS. Ecosystem maps identified key entry points where eSignposting could maximize reach and impact. Analysis of inter\u2010stakeholder relationships also highlighted potential unintended consequences of eSignposting, including increased pressure on local services, preferential uptake of digitally accessible commercial programmes, and the risk of digital exclusion among underserved populations, enabling these issues to be proactively addressed in the future design and implementation of eSignposting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The behavioral WMS ecosystem in East England is multifaceted and interconnected. Ecosystem mapping provides valuable insight into referral pathways and stakeholder relationships, supporting the development of effective and equitable eSignposting strategies to improve access to behavioral WMS while minimizing risks to service equity and sustainability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/osp4.70155","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T07:47:21Z","timestamp":1780645641000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mapping the Behavioral Weight Management Ecosystem in the East of England to Inform the Implementation of Electronic Signposting"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0164-2534","authenticated-orcid":false,"given":"Natalie An Qi","family":"Tham","sequence":"first","affiliation":[{"name":"School of Health Sciences University of East Anglia  Norwich UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2943-7167","authenticated-orcid":false,"given":"Fredrik Kjell","family":"Bodell","sequence":"additional","affiliation":[{"name":"Faculty of Industrial Design Engineering Delft University of Technology  Delft the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7184-269X","authenticated-orcid":false,"given":"Helen M.","family":"Parretti","sequence":"additional","affiliation":[{"name":"Norwich Medical School University of East Anglia  Norwich UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6339-2599","authenticated-orcid":false,"given":"Helena","family":"Jopling","sequence":"additional","affiliation":[{"name":"Department of Public Health West Suffolk NHS Foundation Trust  Bury St Edmunds 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