Obesity, a complex chronic disease, is on the rise, leading to increased mortality, morbidity and societal challenges. This study explores intersectoral interventions focusing on the needs of people living with obesity (PLO).

An environmental scan of the published and unpublished literature will be conducted using Medline, Embase, Cumulated Index in Nursing and Allied Health Literature and specialised websites. To be included, citations must describe or evaluate an intersectoral intervention for PLO developed in primary care or community settings. Title and abstract, full-text screening and extraction will be completed by two independent reviewers. Discrepancies will be resolved through consensus. Data such as study and intervention characteristics will be extracted using a customised extraction template on Covidence and synthesised in a table. Findings from this study will guide intervention design and enhance intersectoral collaboration in primary care and community settings. A multidisciplinary group, including clinicians and two patient partners, will be consulted throughout the process. Despite the challenges of defining intersectoral collaboration and limited data on obesity as a chronic disease, this study is foundational for developing effective intersectoral interventions for PLO.

Ethics approval is not required. Findings will be disseminated through presentations at relevant conferences and other knowledge translation activities and will be published in a peer-reviewed journal.

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Obesity is a complex and multifactorial chronic disease with a gradually increasing prevalence.1–3 In Canada, the prevalence has tripled since 1985, affecting 26.8% of Canadian adults (7.3 million), surpassing diabetes (9.4%) and hypertension (22.6%).4–6 Obesity is defined as an excess and/or dysfunctional adiposity in the body.1 Body mass index7 and the Edmonton Obesity Staging System (staging tools)8 are the main parameters used to estimate the risks associated with obesity. However, these parameters are increasingly controversial in the literature, since they do not consider a person’s total or regional adiposity.9 10 Abdominal and visceral adiposity are terms introduced into the literature to assess the health risks of the distribution of adiposity in the body.1 11 People living with obesity (PLO) have increased mortality risk, higher morbidity, reduced life expectancy and diminished quality of life.12–15 For instance, obesity puts individuals at risk for conditions such as hypertension, coronary artery disease, obstructive sleep apnoea, type 2 diabetes, osteoarthritis and certain cancers among others.1 16 In addition to comorbidities, many PLO experience weight-related prejudices, stigmatisation and discrimination, impacting their health and leading them to avoid healthcare and receive inequitable treatment.17 18

Despite the recognition of obesity as a chronic disease, healthcare is still often medicocentric.17 Indeed, different factors, such as genetics, metabolism, behaviour, sociocultural influences, environment and ethnicity, can contribute to obesity.1 19 The healthcare system only contributes to 20% of a person’s health, and it alone is insufficient to support PLO.20 Considering different aetiological factors, an integrated and systemic versus a problem-focused approach is needed. This approach supports interventions across the care continuum that can range from lifestyle interventions (such as access to healthy food, green spaces and community networks) to bariatric surgery.21–23 Thus, intersectoral interventions accounting for all determinants of a person’s health (socioeconomic, genetic, environmental and biomedical) would reduce the health inequities experienced by PLO.24 25

The WHO introduced the concept of intersectoral action for health in 1997 as ‘a recognised relationship between one or more parts of the health sector and parts of another sector that has been formed to address an issue to achieve health outcomes (or intermediate health outcomes) more efficiently, effectively or sustainably than could be achieved by the health sector alone’.26 The literature emphasises the importance of developing intersectoral interventions for PLOs, but few health interventions encompass specific strategies to engage stakeholders such as clinicians, managers, policy makers, community members, and patients from different sectors actively.17

To effectively leverage available resources and expertise to improve health outcomes of PLO in Quebec, the OBESITY-INTER-COLLAB project was created. The OBESITY-INTER-COLLAB project is a participatory research project conducted in cogovernance with a citizen partner (LB) and a primary care researcher clinician (GL) to propose an innovative organisational approach to the healthcare and services currently offered to PLO in Quebec (Canada). The aim of this project is to coconstruct an intersectoral learning community dedicated to PLO, using a participatory research approach focused on their needs. The first step in achieving this goal is to conduct an environmental scan to model human and organisational resources for and with PLO. This will allow us to understand the models of intersectoral interventions that exist for and with PLOs in the literature, and how the resources and participants involved in these interventions are mobilised to create tangible effects on all the health determinants of PLOs. The results from the environmental scan will inform participants in the community of practice about interventions currently in place to support PLO and help them implement innovative interventions in their territories.

Environmental scans are a structured information-gathering methodology around a subject used in the healthcare sector to synthesise evidence for programme information, policy development and identifying service gaps.27 28 While environmental scans are increasingly recognised in research for investigating health issues, there is currently no universally accepted standard methodology for conducting this method.29 30 The methodological framework for environmental scans usually encompasses gathering information from multiple sources, which improves the validity of the conclusions by lowering biases. This environmental scan will use data collection by reviewing the published and grey literature regarding intersectoral health interventions targeting PLO. Thus, the scan will follow four steps based on Arksey and O’Malley’s methodological framework: (1) search strategies and data sources, (2) selection process, (3) data extraction and (4) data synthesis.

The environmental scan centres on the following question:

‘What intersectoral health interventions have been developed within the community and primary care settings for people living with obesity?’

Ethics approval is unnecessary for this review, as it involves reviewing and collecting data from published and/or publicly available sources. Dissemination of the results is planned through peer-reviewed publications and presentations to key stakeholders.

The environmental scan will identify potential intersectoral interventions for PLO. It aims to explore the characteristics of these types of interventions, including factors that contribute to their implementation and delivery, as well as knowledge gaps. The results of this scan may inform us on the actors needed to create an intersectoral collaboration and give information on their potential interaction, communes’ values and definitions. Therefore, it will help us design an intervention that responds to the needs of PLO. Environmental scan is a methodological approach from the business sectors to inform strategic decision-making, which has been widely adopted in the healthcare sector.39 However, it still lacks a consistent definition and a methodological guide to conduct this type of research in the literature.40 Thus, the environmental scan will include both the published and unpublished literature to ensure comprehensiveness but will be limited to publications in French and English. Challenges encountered with the grey literature, such as the difficulty accessing the information in a reproducible way, doing its inventory and evaluating the information, will be mitigated with double screening. However, the information collected in the grey literature search is complementary to that collected from traditional databases. Intersectorality is a relatively new approach that can be defined in various ways. Although there was a comprehensive search strategy, the various terms used to define intersectoral collaboration may limit the assessment of relevant citations. Additionally, obesity has only recently been acknowledged as a chronic disease, which may potentially limit the scope of available data.

Nevertheless, this study is the first step in establishing a practical base to help the project team develop an intervention for and with PLO that supports their overall health and well-being.

Our team includes two patient-partners, LB and MT, who will be involved throughout the review process and will be consulted from protocol development to dissemination. LB will also contribute as a reviewer.