Coconstruction of Adjunct Behavioral Interventions to Bariatric Surgery: The INTER-Change Program

Objective: The INTER-Change program aims to use systematic frameworks to develop adjunct behavioral interventions to enhance long-term behavior change and improve outcomes in patients undergoing bariatric surgery (BS). This paper details the program strategies and how engagement of interested parties is shaping the research. Method: The core elements of this work include: (a) A living systematic review of behavioral weight management (BWM) interventions adjunct to BS; (b) Focus groups of interested parties, including patients, healthcare professionals, and administrators, on different aspects of designing and implementing adjunct behavioral interventions; (c) A patient-generated survey to assess needs for behavioral interventions to support BWM; (d) An international eDelphi study involving interested parties to prioritize intervention components and delivery structures; and (e) An international consensus meeting to construct testing intervention protocol(s). Results: The systematic review revealed that delivering BWM interventions during the postoperative period resulted in better weight maintenance; however, most interventions reviewed were poorly developed, and none included interested parties. Initial themes from ongoing focus groups highlighted nonweight-related outcomes as being key goals of adjunct behavior change interventions, with a strong emphasis on psychological well-being and health-related behaviors. The patient survey will add patients’ feedback on current interventions and expectations. Finally, the eDelphi process and international consensus meeting will integrate all the findings to develop more efficient behavioral interventions and appropriate testing protocol(s). Conclusions: This integrated knowledge translation approach will help ensure that the behavioral adjunct interventions are relevant to interested parties’ needs, well-designed, effective, and more likely to be implemented successfully.