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Lookup NU author(s): Jade Thorne, Professor Nicola HeslehurstORCiD
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).
© 2026 The Author(s). Published by S. Karger AG, BaselIntroduction: Experiencing weight stigma negatively impacts health yet remains present in healthcare environments. Hospital environments must be inclusive for people living with obesity (PLwO). The aim of this study was to develop and refine a checklist to increase obesity inclusivity in UK National Health Service (UK NHS) hospital environments, with input from healthcare professionals (HCPs), researchers, PLwO, and their carers and family members (C/FM). Methods: This study used a sequential mixed-methods approach. Phase 1 used a converging coding matrix to integrate existing checklists and reviewed language for inclusivity. In phase 2, HCPs, researchers, PLwO, and C/FM were recruited from professional and patient networks to provide feedback on the integrated checklist using a mixed-methods survey (February-March 2025) and qualitative semi-structured interviews (May-July 2025). Descriptive statistics and deductive and inductive framework analyses were used to identify patterns in the data to inform refinement of the checklist and implementation recommendations (Phase 3). Results: Searches identified five checklists, which were integrated, resulting in categories for reading materials, furniture, equipment, and access and infrastructure. Sixty-nine participants completed the survey, and eighteen were interviewed. Overall, participants considered the checklist comprehensive. Integration of the qualitative survey and interview data resulted in four themes: (1) recommendations and thoughts about checklist components; (2) wording, language, images, and structure; (3) patient impact and care experiences; (4) implementation barriers and support. Primary implementation barriers related to funding, space, outdated infrastructure, and deep-rooted weight bias. Management buy-in, training, education, endorsement, and accreditation schemes were considered facilitators. Twenty recommendations were developed to support hospitals with implementation. Conclusion: Findings indicate that a clear, practical, and inclusive checklist could support hospitals in reducing weight stigma and improving care experiences for PLwO. The collaboratively developed and refined checklist offers a practical tool for hospitals to use. However, support will be required for effective and complete implementation.
Author(s): Nguyen GT, Thorne JH, Goodlet S, Davies L, Combet Aspray E, Papamargaritis D, Miras AD, Le Brocq S, Cooke S, Harland J, Heslehurst N
Publication type: Article
Publication status: Published
Journal: Acta Cytologica
Year: 2026
Pages: Epub ahead of print
Online publication date: 17/06/2026
Acceptance date: 01/06/2026
Date deposited: 24/08/2026
ISSN (print): 0001-5547
ISSN (electronic): 1938-2650
Publisher: S. Karger AG
URL: https://doi.org/10.1159/000552921
DOI: 10.1159/000552921
Data Access Statement: The data that support the findings of this study are not publicly available due to privacy and confidentiality restrictions. Ano nymised data may be made available from the corresponding author upon reasonable request, subject to appropriate ethical and data protection considerations
PubMed id: 42308134
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