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ODILE

 Overweight and Depression: Implementation of Lifestyle Intervention Group
Overweight and Depression: Implementation of Lifestyle Intervention
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Depression combined with overweight and/or increased abdominal circumference (hereafter referred to as “overweight”) is common (up to 40% of all cases of depression worldwide) and negatively affects health, quality of life and daily functioning. An unhealthy lifestyle plays an important role in this relation. For people with depression, changes in lifestyle require extra guidance and support.

The GLI-LEEF intervention has been specifically developed for patients with depression and overweight. This 18-week program—based on the certified Coaching on Lifestyle (CooL) intervention—addresses nutrition, physical activity, sleep, relationships, substance use, and psychological aspects unique to this vulnerable population.

Pilot studies show that implementing GLI-LEEF improves both psychological and physical health, with significant enhancements in quality of life and reductions in depressive symptoms.

However, implementing GLI-LEEF as part of standard care poses considerable challenges. Previous research has shown that only a small portion of the intended target group was approached for this intervention—and of those, only a limited number actually started the program.
These findings highlight a larger issue: despite the proven effectiveness of the intervention, there is still insufficient knowledge about how to sustainably implement it within standard primary and secondary care for patients with both depression and overweight.

To address this, this ZonMw-funded research focuses on identifying key determinants of implementation, aligning them with tailored implementation strategies, and jointly testing those strategies with general practitioners and mental health professionals in the Drenthe region.

Research Question

How can this specifically developed lifestyle intervention reach more people in the target group and become part of standard primary and secondary healthcare?   

Goals

This project has four main objectives:

  1. To gain insight into barriers and facilitators for implementing a combined lifestyle intervention designed for patients with depression in standard care;
  2. To compile an overview of implementation strategies tailored to the identified factors;
  3. To achieve successful implementation of GLI-LEEF by:
    - inviting more participants for the intervention,
    - increasing the number of patients who start GLI-LEEF,
    - increasing the number of patients who complete the intervention,
    - and encouraging more healthcare professionals to embed GLI-LEEF in their standard care;
  4. To deliver a decision support tool to help choose appropriate implementation strategies.

Tijdlijn

Lees meer over de fasen die zijn en worden uitgevoerd binnen ODILE door middel van de tijdlijn.

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Relevance

Social Relevance

This project addresses the urgent need to integrate evidence-based lifestyle interventions into standard care for patients with depression and overweight—a combination that affects hundreds of thousands of people in the Netherlands.  

The aim is to establish GLI-LEEF as a routine care option in general practice and mental health care so that patients with depression and overweight have access to evidence-based lifestyle care that addresses both their mental and physical health needs.  

Achievements so far

The project has:  

  • Developed the GLI-LEEF intervention and successfully conducted pilot studies in both general practice and mental health settings;  
  • Demonstrated improved functional and personal recovery as well as symptom reduction;  
  • Established partnerships across the care network in Drenthe;  
  • Integratively aligned with regional health policy (IZA-regional plan Drenthe).  
     

  • Through participatory implementation research, the project collaborates from the outset with patients, healthcare professionals, and policymakers. The project structure includes representation based on the “7Ps Framework” (Patients and the public, Providers, Purchasers, Payers, Policy makers, Product makers, Principal investigators), ensuring that all voices are heard throughout the implementation process.  

  • The intervention is implemented directly in 10 general practices and 3 mental health (GGZ) locations, creating change while generating knowledge. A systematic approach using the CFIR (Consolidated Framework for Implementation Research) ensures that successful strategies can be replicated in other contexts.  

  • The intended impact is to make lifestyle interventions more accessible to patients with depression combined with overweight. By removing barriers to referral and participation in GLI-LEEF, more patients with mental health issues will gain access to effective lifestyle healthcare.  

    In addition, the project provides valuable knowledge about implementing lifestyle interventions in primary and secondary care. This knowledge can be applied to other healthcare interventions as well. The decision support tool developed will enable other regions and care organizations to successfully implement similar interventions, extending the impact beyond Drenthe. On the long term, this may contribute to national guideline changes where lifestyle interventions become a routine part of depression care.  

  • The project is funded by ZonMw under the funding round “Lifestyle in Healthcare: Implementation & Impact” and is part of the broader FOUR-C (Cure and Care in the Community Context) research program at UMCG. Collaboration partners include Hanze University of Applied Sciences (Centre of Expertise Healthy Ageing), GGZ Drenthe, Dokter Drenthe, and the Cooperative Paramedical Care Group Gezond in Drenthe. This collaboration brings together expertise in implementation science, general practice, psychiatry, and lifestyle medicine.

Contact

Universitair Medisch Centrum Groningen (UMCG)
Eerstelijnsgeneeskunde en Langdurige Zorg
Huispost FA21
Postbus 196
9700 AD Groningen