{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T05:13:55Z","timestamp":1778303635691,"version":"3.51.4"},"reference-count":76,"publisher":"National Institute for Health and Care Research","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001921","name":"Public Health Research programme","doi-asserted-by":"publisher","award":["NIHR129703"],"award-info":[{"award-number":["NIHR129703"]}],"id":[{"id":"10.13039\/501100001921","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journalslibrary.nihr.ac.uk"],"crossmark-restriction":false},"short-container-title":[],"abstract":"\n Background<\/jats:title>\n Men with obesity infrequently engage with weight management services.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n To determine: (1) percentage weight loss at 12 and 24 months for text messages with or without financial incentives compared to control; (2) secondary outcomes; (3) cost-effectiveness; (4) moderators of effectiveness and (5) participant and stakeholder perspectives.<\/jats:p>\n <\/jats:sec>\n \n Design and methods<\/jats:title>\n Assessor-blinded randomised controlled trial. United Kingdom National Health Service perspective cost-effectiveness over 24 months and modelled lifetime horizon. Mixed-methods process evaluation.<\/jats:p>\n <\/jats:sec>\n \n Setting and participants<\/jats:title>\n \n Five hundred and eighty-five men with body mass index \u2265\u200530\u2005kg\/m\n 2<\/jats:sup>\n enrolled (July 2021\u2013May 2022) in Belfast, Bristol and Glasgow; final follow-up June 2024.\n <\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n \n Random allocation to 12 months of behavioural text messages plus financial incentives (\n N<\/jats:italic>\n \u2005=\u2005196), same texts alone (\n N<\/jats:italic>\n \u2005=\u2005194) or 12-month waiting list control group offered 3 months of texts between 12 and 15 months (\n N<\/jats:italic>\n \u2005=\u2005195). A \u00a3400 financial incentive was lost if weight loss targets were not met.\n <\/jats:p>\n <\/jats:sec>\n \n Main outcome measures<\/jats:title>\n Weight change as a percentage of baseline weight at 12 and 24 months comparing control with (1) texts with financial incentives and (2) texts alone.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of 585 men (mean age 51 years; mean weight: 119\u2005kg), 227 (39%) lived in lower socioeconomic areas, 146 (25%) reported a mental health condition and 253 (40%) had multiple long-term conditions. Follow-up was completed by 426 (73%) at 12 months and 377 (64%) at 24 months.<\/jats:p>\n \n At 12 months, mean percentage weight changes (standard deviation) were \u22124.8% (6.1) (\u22125.7\u2005kg), \u22122.7% (6.3) (\u22123.0\u2005kg), and\u2005\u2212\u20051.3% (5.5) (\u22121.5\u2005kg) for the incentives, text-only, and control groups, respectively. Compared to control, weight loss was significantly greater with incentives [\u22123.2% (97.5% confidence interval \u22124.6 to \u22121.9;\n p<\/jats:italic>\n \u2005<\u20050.001)] but not texts alone (\u22121.4%; confidence interval \u22122.9 to 0.0;\n p<\/jats:italic>\n \u2005=\u20050.053). At 24 months, changes were \u22123.9% (\u22124.6\u2005kg), \u22122.6% (\u22123.1\u2005kg), and \u22122.2% (\u22122.6\u2005kg), no significant between-group differences. Intervention costs were \u00a3243 for texts with incentives, \u00a3110 for texts alone. There were no significant differences between 24-month costs and quality-adjusted life-years. Long-term modelling found texts with incentives versus control were: quality-adjusted life-year difference (95% confidence interval): 0.02 (0.007 to 0.029); cost difference: \u00a3176 (\u00a343; \u00a3311); incremental cost-effectiveness ratio: \u00a39748 (\u00a37705 to \u00a311,791). For texts alone versus control: quality-adjusted life-year difference: 0.03 (0.015 to 0.037); cost difference: \u00a316.5 (\u2212\u00a3117; \u00a3152); incremental cost-effectiveness ratio: \u00a3628 (\u2212\u00a35914 to \u00a35384).\n <\/jats:p>\n There were no moderator effects for socioeconomic, health or well-being status for either comparison versus control. The texts with incentives group had a higher engagement in weight goal setting, food changes, self-weighing, confidence, satisfaction and quality of life compared to the control.<\/jats:p>\n <\/jats:sec>\n \n Limitations<\/jats:title>\n Generalisability to women, diverse ethnic groups and people with low literacy is uncertain. Not generalisable to people with no mobile phone access. Retention was lowest in the text messages alone group.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Texts with financial incentives have a modest but important effect to 12 months with clinically relevant weight loss maintenance to 24 months, are cost-effective and equally effective regardless of socioeconomic or health characteristics.<\/jats:p>\n <\/jats:sec>\n \n Future work<\/jats:title>\n Implementation, adapt for women, other cultures and longer-term follow-up.<\/jats:p>\n <\/jats:sec>\n \n Funding<\/jats:title>\n This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number NIHR129703.<\/jats:p>\n <\/jats:sec>","DOI":"10.3310\/gjph0909","type":"journal-article","created":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T07:40:01Z","timestamp":1757403601000},"page":"1-46","update-policy":"https:\/\/doi.org\/10.3310\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness and cost-effectiveness of text message and financial incentives for weight management in men with obesity: The Game of Stones RCT"],"prefix":"10.3310","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2906-8757","authenticated-orcid":true,"given":"Lisa","family":"Macaulay","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9765-2464","authenticated-orcid":true,"given":"Catriona","family":"O\u2019Dolan","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9832-2777","authenticated-orcid":true,"given":"Stephan","family":"Dombrowski","sequence":"additional","affiliation":[{"name":"Faculty of Kinesiology, University of New Brunswick, New Brunswick, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2352-4324","authenticated-orcid":true,"given":"James","family":"Swingler","sequence":"additional","affiliation":[{"name":"Aberdeen Centre for Evaluation, University of Aberdeen, Aberdeen, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7883-0608","authenticated-orcid":true,"given":"Seonaidh","family":"Cotton","sequence":"additional","affiliation":[{"name":"Centre for Healthcare Randomised Trials, University of Aberdeen, Aberdeen, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4813-5628","authenticated-orcid":true,"given":"Alison","family":"Avenell","sequence":"additional","affiliation":[{"name":"Aberdeen Centre for Evaluation, University of Aberdeen, Aberdeen, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9786-8118","authenticated-orcid":true,"given":"Dwayne","family":"Boyers","sequence":"additional","affiliation":[{"name":"Health Economics Research Unit, University of Aberdeen, Aberdeen, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6749-5763","authenticated-orcid":true,"given":"Abraham M","family":"Getaneh","sequence":"additional","affiliation":[{"name":"Health Economics Research Unit, University of Aberdeen, Aberdeen, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4295-6110","authenticated-orcid":true,"given":"Cindy","family":"Gray","sequence":"additional","affiliation":[{"name":"School of Social and Political Sciences, University of Glasgow, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5873-3632","authenticated-orcid":true,"given":"Kate","family":"Hunt","sequence":"additional","affiliation":[{"name":"Institute for Social Marketing and Health, University of Stirling, Stirling, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0606-8167","authenticated-orcid":true,"given":"Frank","family":"Kee","sequence":"additional","affiliation":[{"name":"Centre for Public Health, Queen\u2019s University Belfast, Belfast, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9650-2376","authenticated-orcid":true,"given":"Alice","family":"MacLean","sequence":"additional","affiliation":[{"name":"Institute for Social Marketing and Health, University of Stirling, Stirling, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3386-1504","authenticated-orcid":true,"given":"Michelle","family":"McKinley","sequence":"additional","affiliation":[{"name":"Centre for Public Health, Queen\u2019s University Belfast, Belfast, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3883-2502","authenticated-orcid":true,"given":"Claire","family":"Torrens","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6375-2918","authenticated-orcid":true,"given":"Katrina","family":"Turner","sequence":"additional","affiliation":[{"name":"Centre for Academic Primary Care, University of Bristol, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0636-1184","authenticated-orcid":true,"given":"Marjon","family":"van der Pol","sequence":"additional","affiliation":[{"name":"Health Economics Research Unit, University of Aberdeen, Aberdeen, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1039-5646","authenticated-orcid":true,"given":"Graeme","family":"MacLennan","sequence":"additional","affiliation":[{"name":"Centre for Healthcare Randomised Trials, University of Aberdeen, Aberdeen, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4372-9681","authenticated-orcid":true,"given":"Pat","family":"Hoddinott","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"6221","published-online":{"date-parts":[[2026,5]]},"reference":[{"key":"key2026050910340000_ref1-bib1","volume-title":"WHO Acceleration Plan to Stop Obesity","author":"World Health Organization","year":"2024"},{"key":"key2026050910340000_ref2-bib2","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1056\/NEJMoa1614362","article-title":"Health effects of overweight and obesity in 195 countries over 25 years","volume":"377","author":"Afshin","year":"2017","journal-title":"N Engl J Med"},{"key":"key2026050910340000_ref3-bib3","volume-title":"Obesity Profile: Short Statistical Commentary","author":"Office for Health Improvement & Disparities","year":"2024"},{"key":"key2026050910340000_ref4-bib4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/hta18350","article-title":"Systematic reviews of and integrated report on the quantitative, qualitative and economic evidence base for the management of obesity in men","volume":"18","author":"Robertson","year":"2014","journal-title":"Health Technol Assess"},{"key":"key2026050910340000_ref5-bib5","doi-asserted-by":"crossref","first-page":"106402","DOI":"10.1016\/j.ypmed.2020.106402","article-title":"eHealth interventions for reducing cardiovascular disease risk in men: a systematic review and meta-analysis","volume":"145","author":"McMahon","year":"2021","journal-title":"Prev Med"},{"key":"key2026050910340000_ref6-bib6","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1016\/j.amepre.2022.04.002","article-title":"Use and impact of type 2 diabetes prevention interventions","volume":"63","author":"Campione","year":"2022","journal-title":"Am J Prev Med"},{"key":"key2026050910340000_ref7-bib7","doi-asserted-by":"crossref","first-page":"e13436","DOI":"10.1111\/obr.13436","article-title":"A systematic review examining socioeconomic factors in trials of interventions for men that report weight as an outcome","volume":"23","author":"McDonald","year":"2022","journal-title":"Obes Rev"},{"key":"key2026050910340000_ref8-bib8","doi-asserted-by":"crossref","first-page":"e12999","DOI":"10.1111\/obr.12999","article-title":"A systematic review with meta-analyses of text message-delivered behaviour change interventions for weight loss and weight loss maintenance","volume":"21","author":"Skinner","year":"2020","journal-title":"Obes Rev"},{"key":"key2026050910340000_ref9-bib9","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1111\/obr.12657","article-title":"Paying people to lose weight: the effectiveness of financial incentives provided by health insurers for the prevention and management of overweight and obesity \u2013 a systematic review","volume":"19","author":"Ananthapavan","year":"2018","journal-title":"Obes Rev"},{"key":"key2026050910340000_ref10-bib10","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1080\/17437199.2015.1030685","article-title":"The utility of monetary contingency contracts for weight loss: a systematic review and meta-analysis","volume":"9","author":"Sykes-Muskett","year":"2015","journal-title":"Health Psychol Rev"},{"key":"key2026050910340000_ref11-bib11","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1093\/abm\/kaac066","article-title":"Evaluation of the effectiveness of behavioral economic incentive programs for goal achievement on healthy diet, weight control and physical activity: a systematic review and network meta-analysis","volume":"57","author":"Boonmanunt","year":"2023","journal-title":"Ann Behav Med"},{"key":"key2026050910340000_ref12-bib12","doi-asserted-by":"crossref","first-page":"e2124132","DOI":"10.1001\/jamanetworkopen.2021.24132","article-title":"Effect of financial incentives and environmental strategies on weight loss in the healthy weigh study: a randomized clinical trial","volume":"4","author":"Glanz","year":"2021","journal-title":"JAMA Netw Open"},{"key":"key2026050910340000_ref13-bib13","doi-asserted-by":"crossref","first-page":"e032653","DOI":"10.3310\/phr08110","article-title":"Text messaging and financial incentives to encourage weight loss in men with obesity: the Game of Stones feasibility RCT","volume":"8","author":"Dombrowski","year":"2020","journal-title":"Public Health Res"},{"key":"key2026050910340000_ref14-bib14","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1007\/s10389-022-01785-1","article-title":"Designing financial incentives for health behaviour change: a mixed-methods case study of weight loss in men with obesity","volume":"32","author":"van der Pol","year":"2022","journal-title":"J Public Health"},{"key":"key2026050910340000_ref15-bib15","doi-asserted-by":"crossref","first-page":"e032653","DOI":"10.1136\/bmjopen-2019-032653","article-title":"Game of Stones: feasibility randomised controlled trial of how to engage men with obesity in text message and incentive interventions for weight loss","volume":"10","author":"Dombrowski","year":"2020","journal-title":"BMJ Open"},{"key":"key2026050910340000_ref16-bib16","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1186\/s13063-022-06504-5","article-title":"Effectiveness and cost-effectiveness of text messages with or without endowment incentives for weight management in men with obesity (Game of Stones): study protocol for a randomised controlled trial","volume":"23","author":"Macaulay","year":"2022","journal-title":"Trials"},{"key":"key2026050910340000_ref17-bib17","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1001\/jama.2024.7064","article-title":"Text messages with financial incentives for men with obesity: a randomized clinical trial","volume":"332","author":"Hoddinott","year":"2024","journal-title":"JAMA"},{"key":"key2026050910340000_ref18-bib18","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1007\/s11136-011-9903-x","article-title":"Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L)","volume":"20","author":"Herdman","year":"2011","journal-title":"Qual Life Res"},{"key":"key2026050910340000_ref19-bib19","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.jad.2009.06.019","article-title":"A 4-item measure of depression and anxiety: validation and standardization of the patient health questionnaire-4 (PHQ-4) in the general population","volume":"122","author":"L\u00f6we","year":"2010","journal-title":"J Affect Disord"},{"key":"key2026050910340000_ref20-bib20","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1186\/1477-7525-5-63","article-title":"The Warwick-Edinburgh mental well-being scale (WEMWBS): development and UK validation","volume":"5","author":"Tennant","year":"2007","journal-title":"Health Qual Life Outcomes"},{"key":"key2026050910340000_ref21-bib21","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1038\/oby.2009.353","article-title":"Measuring weight self-stigma: the weight self-stigma questionnaire","volume":"18","author":"Lillis","year":"2010","journal-title":"Obesity (Silver Spring)"},{"key":"key2026050910340000_ref22-bib22","doi-asserted-by":"crossref","first-page":"1432","DOI":"10.1002\/oby.24316","article-title":"Secondary analysis of the Game of Stones trial for men with obesity: examining moderator effects and exploratory outcomes","volume":"33","author":"Dombrowski","year":"2025","journal-title":"Obesity (Silver Spring)"},{"key":"key2026050910340000_ref23-bib23","doi-asserted-by":"crossref","first-page":"1610","DOI":"10.1001\/jama.2019.3087","article-title":"Reporting of Multi-Arm Parallel-Group Randomized Trials: Extension of the CONSORT 2010 Statement","volume":"321","author":"Juszczak","year":"2019","journal-title":"JAMA"},{"key":"key2026050910340000_ref24-bib24","article-title":"Long-term effects of text messages with financial incentives for men with obesity: 2-year follow-up of the Game of Stones trial","author":"Dombrowski","year":"2024","journal-title":"medRxiv"},{"key":"key2026050910340000_ref25-bib25","volume-title":"Guide to the Methods of Technology Appraisal","author":"National Institute for Health and Care Excellence","year":"2013"},{"key":"key2026050910340000_ref26-bib26","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1002\/oby.22407","article-title":"Is doctor referral to a low-energy total diet replacement program cost-effective for the routine treatment of obesity?","volume":"27","author":"Kent","year":"2019","journal-title":"Obesity (Silver Spring)"},{"key":"key2026050910340000_ref27-bib27","volume-title":"Classifications and Harmonisation","author":"Office for National Statistics (ONS)","year":"2024"},{"key":"key2026050910340000_ref28-bib28","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1186\/1471-2288-13-117","article-title":"Using the framework method for the analysis of qualitative data in multi-disciplinary health research","volume":"13","author":"Gale","year":"2013","journal-title":"BMC Med Res Methodol"},{"key":"key2026050910340000_ref29-bib29","doi-asserted-by":"crossref","first-page":"n2061","DOI":"10.1136\/bmj.n2061","article-title":"A new framework for developing and evaluating complex interventions: update of Medical Research Council guidance","volume":"374","author":"Skivington","year":"2021","journal-title":"BMJ"},{"key":"key2026050910340000_ref30-bib30","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1111\/j.1365-2929.2006.02467.x","article-title":"Making sense of qualitative data analysis: an introduction with illustrations from DIPEx (personal experiences of health and illness)","volume":"40","author":"Ziebland","year":"2006","journal-title":"Med Educ"},{"key":"key2026050910340000_ref31-bib31","article-title":"Mental health and weight loss in men: an exploratory mixed methods study of the Game of Stones trial","author":"Torrens","year":"2024","journal-title":"medRxiv"},{"key":"key2026050910340000_ref32-bib32","article-title":"Men with long-term conditions in the Game of Stones text messaging and financial incentives trial: an exploratory mixed methods study","author":"Macaulay","year":"2024","journal-title":"medRxiv"},{"key":"key2026050910340000_ref33-bib33","doi-asserted-by":"crossref","first-page":"101328","DOI":"10.1016\/j.lanepe.2025.101328","article-title":"Text messaging with or without financial incentives versus a waitlist control for weight loss in men: cost-effectiveness analysis of the Game of Stones randomised controlled trial","volume":"54","author":"Getaneh","year":"2025","journal-title":"Lancet Reg Health Eur"},{"key":"key2026050910340000_ref34-bib34","doi-asserted-by":"crossref","first-page":"e009348","DOI":"10.1161\/CIRCOUTCOMES.122.009348","article-title":"Long-term effect of weight regain following behavioral weight management programs on cardiometabolic disease incidence and risk: systematic review and meta-analysis","volume":"16","author":"Hartmann-Boyce","year":"2023","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"key2026050910340000_ref35-bib35","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.1001\/jama.2018.7777","article-title":"Behavioral and pharmacotherapy weight loss interventions to prevent obesity-related morbidity and mortality in adults: updated evidence report and systematic review for the us preventive services task force","volume":"320","author":"LeBlanc","year":"2018","journal-title":"JAMA"},{"key":"key2026050910340000_ref36-bib36","doi-asserted-by":"crossref","first-page":"e069719","DOI":"10.1136\/bmj-2021-069719","article-title":"Effectiveness of weight management interventions for adults delivered in primary care: systematic review and meta-analysis of randomised controlled trials","volume":"377","author":"Madigan","year":"2022","journal-title":"BMJ"},{"key":"key2026050910340000_ref37-bib37","doi-asserted-by":"crossref","first-page":"n1840","DOI":"10.1136\/bmj.n1840","article-title":"Association between characteristics of behavioural weight loss programmes and weight change after programme end: systematic review and meta-analysis","volume":"374","author":"Hartmann-Boyce","year":"2021","journal-title":"BMJ"},{"key":"key2026050910340000_ref38-bib38","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1002\/oby.21255","article-title":"Weight change among people randomized to minimal intervention control groups in weight loss trials","volume":"24","author":"Johns","year":"2016","journal-title":"Obesity (Silver Spring)"},{"key":"key2026050910340000_ref39-bib39","doi-asserted-by":"crossref","first-page":"12252","DOI":"10.1038\/s41598-022-15770-x","article-title":"A systematic review and meta-analysis of weight loss in control group participants of lifestyle randomized trials","volume":"12","author":"Bouzalmate Hajjaj","year":"2022","journal-title":"Sci Rep"},{"key":"key2026050910340000_ref40-bib40","volume-title":"Seven in 10 Adults Are Motivated to Get Healthier in 2021 due to COVID-19 [Press Release]","author":"Public Health England","year":"2021"},{"key":"key2026050910340000_ref41-bib41","volume-title":"Obesity and Mortality during the Coronavirus (COVID-19) Pandemic, England: 24 January 2020 to 30 August 2022 [Article]","author":"Office for National Statistics (ONS)","year":"2022"},{"key":"key2026050910340000_ref42-bib42","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1136\/jech-2012-201257","article-title":"What types of interventions generate inequalities? Evidence from systematic reviews","volume":"67","author":"Lorenc","year":"2013","journal-title":"J Epidemiol Community Health"},{"key":"key2026050910340000_ref43-bib43","doi-asserted-by":"crossref","first-page":"e019467","DOI":"10.1136\/bmjopen-2017-019467","article-title":"NHS Diabetes Prevention Programme in England: formative evaluation of the programme in early phase implementation","volume":"8","author":"Penn","year":"2018","journal-title":"BMJ Open"},{"key":"key2026050910340000_ref44-bib44","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1111\/dme.13562","article-title":"Progress of the Healthier You: NHS Diabetes Prevention Programme: referrals, uptake and participant characteristics","volume":"35","author":"Barron","year":"2018","journal-title":"Diabet Med"},{"key":"key2026050910340000_ref45-bib45","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1016\/S0140-6736(13)62420-4","article-title":"A gender-sensitised weight loss and healthy living programme for overweight and obese men delivered by Scottish Premier League football clubs (FFIT): a pragmatic randomised controlled trial","volume":"383","author":"Hunt","year":"2014","journal-title":"Lancet"},{"key":"key2026050910340000_ref46-bib46","doi-asserted-by":"crossref","first-page":"e13014","DOI":"10.1111\/obr.13014","article-title":"Impact of male-only lifestyle interventions on men\u2019s mental health: a systematic review and meta-analysis","volume":"21","author":"Drew","year":"2020","journal-title":"Obes Rev"},{"key":"key2026050910340000_ref47-bib47","volume-title":"Mind Your Language: How Men Talk about Mental Health London","author":"Men\u2019s Health Forum","year":"2018"},{"key":"key2026050910340000_ref48-bib48","doi-asserted-by":"crossref","first-page":"e036904","DOI":"10.1136\/bmjopen-2020-036904","article-title":"Digital telemedicine interventions for patients with multimorbidity: a systematic review and meta-analysis","volume":"10","author":"Kraef","year":"2020","journal-title":"BMJ Open"},{"key":"key2026050910340000_ref49-bib49","volume-title":"Obesity: Identification, Assessment and Management","author":"National Institute for Health and Care Excellence","year":"2023"},{"key":"key2026050910340000_ref50-bib50","doi-asserted-by":"crossref","first-page":"e615","DOI":"10.1016\/S2589-7500(22)00111-X","article-title":"Effectiveness of wearable activity trackers to increase physical activity and improve health: a systematic review of systematic reviews and meta-analyses","volume":"4","author":"Ferguson","year":"2022","journal-title":"Lancet Digit Health"},{"key":"key2026050910340000_ref51-bib51","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1016\/j.socscimed.2019.05.018","article-title":"Effectiveness and cost-effectiveness of incentives as a tool for prevention of non-communicable diseases: a systematic review","volume":"232","author":"Finkelstein","year":"2019","journal-title":"Soc Sci Med"},{"key":"key2026050910340000_ref52-bib52","doi-asserted-by":"crossref","first-page":"100585","DOI":"10.1016\/j.lanepe.2023.100585","article-title":"The public health implications of the cost-of-living crisis: outlining mechanisms and modelling consequences","volume":"27","author":"Broadbent","year":"2023","journal-title":"Lancet Reg Health Eur"},{"key":"key2026050910340000_ref53-bib53","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.jclinepi.2021.03.002","article-title":"Adverse event recording failed to reflect potential harms: a review of trial protocols of behavioral, lifestyle and psychological therapy interventions","volume":"136","author":"Papaioannou","year":"2021","journal-title":"J Clin Epidemiol"},{"key":"key2026050910340000_ref54-bib54","doi-asserted-by":"crossref","first-page":"111275","DOI":"10.1016\/j.jclinepi.2024.111275","article-title":"Recording harms in randomized controlled trials of behavior change interventions: a scoping review and map of the evidence","volume":"169","author":"Papaioannou","year":"2024","journal-title":"J Clin Epidemiol"},{"key":"key2026050910340000_ref55-bib55","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1038\/s41366-023-01404-3","article-title":"Cost-effectiveness of goal-directed and outcome-based financial incentives for weight loss in low-income populations: the FIReWoRk randomized clinical trial","volume":"48","author":"Ladapo","year":"2024","journal-title":"Int J Obes (Lond)"},{"key":"key2026050910340000_ref56-bib56","doi-asserted-by":"crossref","first-page":"e396","DOI":"10.1016\/S2468-2667(17)30167-6","article-title":"Complex systems and individual-level approaches to population health: a false dichotomy?","volume":"2","author":"Sniehotta","year":"2017","journal-title":"Lancet Public Health"},{"key":"key2026050910340000_ref57-bib57","volume-title":"Turning the Tide: A 10-Year Healthy Weight Strategy [Report]","author":"Obesity Health Alliance","year":"2021"},{"key":"key2026050910340000_ref58-bib58","doi-asserted-by":"crossref","first-page":"e13438","DOI":"10.1111\/obr.13438","article-title":"A systematic review of inequalities in the uptake of, adherence to, and effectiveness of behavioral weight management interventions in adults","volume":"23","author":"Birch","year":"2022","journal-title":"Obes Rev"},{"key":"key2026050910340000_ref59-bib59","doi-asserted-by":"crossref","first-page":"e067607","DOI":"10.1136\/bmjopen-2022-067607","article-title":"Are there inequalities in the attendance and effectiveness of behavioural weight management interventions for adults in the UK? Protocol for an individual participant data (IPD) meta-analysis","volume":"13","author":"Birch","year":"2023","journal-title":"BMJ Open"},{"key":"key2026050910340000_ref60-bib60","doi-asserted-by":"crossref","first-page":"e258","DOI":"10.3399\/bjgp16X684337","article-title":"Inequalities in the uptake of weight management interventions in a pragmatic trial: an observational study in primary care","volume":"66","author":"Ahern","year":"2016","journal-title":"Br J Gen Pract"},{"key":"key2026050910340000_ref61-bib61","doi-asserted-by":"crossref","first-page":"d6500","DOI":"10.1136\/bmj.d6500","article-title":"Comparison of range of commercial or primary care led weight reduction programmes with minimal intervention control for weight loss in obesity: lighten up randomised controlled trial","volume":"343","author":"Jolly","year":"2011","journal-title":"BMJ"},{"key":"key2026050910340000_ref62-bib62","volume-title":"Now NHS Will Pay You \u00a3400 to Lose Weight","author":"Scottish Mail on Sunday","year":"2016"},{"key":"key2026050910340000_ref63-bib63","volume-title":"The Government\u2019s 10-year Plan for Health and Care.","author":"The King\u2019s Fund","year":"2024"},{"key":"key2026050910340000_ref64-bib64","doi-asserted-by":"crossref","first-page":"2509","DOI":"10.1016\/j.socscimed.2012.09.033","article-title":"\u2018Pay them if it works\u2019: discrete choice experiments on the acceptability of financial incentives to change health related behaviour","volume":"75","author":"Promberger","year":"2012","journal-title":"Soc Sci Med"},{"key":"key2026050910340000_ref65-bib65","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1186\/s12874-022-01570-4","article-title":"Ripple effects mapping: capturing the wider impacts of systems change efforts in public health","volume":"22","author":"Nobles","year":"2022","journal-title":"BMC Med Res Methodol"},{"key":"key2026050910340000_ref66-bib66","doi-asserted-by":"crossref","first-page":"e66","DOI":"10.1016\/S2542-5196(21)00005-X","article-title":"Planetary health care: a framework for sustainable health systems","volume":"5","author":"MacNeill","year":"2021","journal-title":"Lancet Planet Health"},{"key":"key2026050910340000_ref67-bib67","volume-title":"2024 UNDP Trends Report: The Landscape of Development","author":"United Nations Development Programme (UNDP)","year":"2024"},{"key":"key2026050910340000_ref68-bib68","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1002\/osp4.442","article-title":"Weight-related lifestyle behaviours and the COVID-19 crisis: an online survey study of UK adults during social lockdown","volume":"6","author":"Robinson","year":"2020","journal-title":"Obes Sci Pract"},{"key":"key2026050910340000_ref69-bib69","doi-asserted-by":"crossref","first-page":"2911","DOI":"10.3390\/nu13092911","article-title":"Impact of COVID-19 pandemic on weight and BMI among UK adults: a longitudinal analysis of data from the HEBECO study","volume":"13","author":"Dicken","year":"2021","journal-title":"Nutrients"},{"key":"key2026050910340000_ref70-bib70","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1186\/s12874-020-01136-2","article-title":"Recruiting men from across the socioeconomic spectrum via GP registers and community outreach to a weight management feasibility randomised controlled trial","volume":"20","author":"McDonald","year":"2020","journal-title":"BMC Med Res Methodol"},{"key":"key2026050910340000_ref71-bib71","doi-asserted-by":"crossref","first-page":"e073725","DOI":"10.1136\/bmj-2022-073725","article-title":"CONSORT Harms 2022 statement, explanation, and elaboration: updated guideline for the reporting of harms in randomised trials","volume":"381","author":"Junqueira","year":"2023","journal-title":"BMJ"},{"key":"key2026050910340000_ref72-bib72","volume-title":"Effects on Retention of Different Weight Assessment Approaches during Trials of Behavioural Weight Management Interventions (BWMI)","author":"MRC Hubs for Trials Methodology Research: The Northern Ireland Hub for Trails Methodology Research SWAT Store"},{"key":"key2026050910340000_ref73-bib73","volume-title":"NHS Long Term Plan","author":"National Health Service (NHS)","year":"2024"},{"key":"key2026050910340000_ref74-bib74","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12961-019-0494-2","article-title":"Intervention scalability assessment tool: a decision support tool for health policy makers and implementers","volume":"18","author":"Milat","year":"2020","journal-title":"Health Res Policy Syst"},{"key":"key2026050910340000_ref75-bib75","volume-title":"Digital Technologies for Delivering Multidisciplinary Weight-Management Services: Early Value Assessment","author":"National Institute for Health and Care Excellence","year":"2024"},{"key":"key2026050910340000_ref76-bib76","volume-title":"Obesity: Identification, Assessment and Management","author":"National Institute for Health and Care Excellence"}],"container-title":["Public Health Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/njl-admin.nihr.ac.uk\/document\/download\/2050985","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.journalslibrary.nihr.ac.uk\/sites\/journalslibrary\/files\/journal_data\/GJPH0909\/GJPH0909.xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/njl-admin.nihr.ac.uk\/document\/download\/2050985","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T05:07:44Z","timestamp":1778303264000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.journalslibrary.nihr.ac.uk\/phr\/GJPH0909"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":76,"alternative-id":["10.3310\/GJPH0909"],"URL":"https:\/\/doi.org\/10.3310\/gjph0909","relation":{},"ISSN":["2050-439X"],"issn-type":[{"value":"2050-439X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"This content has been made freely available to all.","name":"free","label":"Free to read"},{"value":"10-2020","name":"contractual_start_date","label":"contractual_start_date","group":{"name":"article_history","label":"Article History"}},{"value":"01-2025","name":"editorial_review_begun","label":"editorial review begun","group":{"name":"article_history","label":"Article History"}},{"value":"09-2025","name":"accepted_for_publication","label":"Accepted for publication","group":{"name":"article_history","label":"Article History"}}]}}