Campbell, TavisRouleau, CodieWilliamson, Tamara Marie2024-09-192024-09-192024-09-17Williamson, T. M. (2024). Design and feasibility of a behavioural weight loss treatment for patients with atrial fibrillation and obesity referred to cardiac rehabilitation (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.https://hdl.handle.net/1880/119776Background: Moderate weight loss (i.e., ≥10%) reduces symptom burden and disease progression among patients with atrial fibrillation (AF) and co-morbid obesity (BMI ≥ 30 kg/m2). Cardiac rehabilitation (CR) improves AF risk factors (e.g., hypertension, cardiorespiratory fitness, lipids) and thus represents an ideal multidisciplinary setting for AF management. Yet, few CR programs include targeted behavioural weight loss treatment (BWLT) for patients with cooccurring obesity. Evidence-based approaches to integrating BWLT into CR are needed to encourage sustainable weight loss in this patient group. Purpose: The purpose of this dissertation was to adapt and establish the acceptability of a Small Change BWLT that could be integrated into an existing CR program for patients with AF and obesity prior to efficacy testing in a randomized clinical trial (RCT). Methods: Chapter 2 was a qualitative descriptive exploration of patients’ preferences, barriers, and enablers to participating in a Small Change BWLT in CR. Chapter 3 was a pre-post feasibility study to adapt the BWLT to patients with AF and obesity, and establish the acceptability of the modified program. Chapter 4 was a protocol for an RCT comparing the efficacy of the BWLT + CR in terms of 12-month weight loss relative to the traditional CR program. Results: Barriers and enablers identified in Chapter 2 were used to adapt the BWLT program and included changes to patient education materials and discussion of AF risk factors. In Chapter 3, patients reported strong liking of the adapted program, however weight loss at 6 months was not clinically or statistically significant. The BWLT was further refined using the findings from Chapter 3 to inform the protocol in Chapter 4, which is currently recruiting patients (NCT05230823). Conclusion: While the benefits of a Small Changes BWLT + CR for weight loss among patients with AF and obesity relative to CR-only remain to be seen, the results of this dissertation provide important acceptability and feasibility evidence suggesting that program uptake, adherence, and completion may be favourable in the RCT. Future directions including the potential addition of adjunct pharmacotherapy to BWLT and additional therapeutic BWLT components (e.g., values-based behaviour change, self-compassion) are discussed.enUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.obesityweight lossatrial fibrillationcardiac rehabilitationbehavioural weight loss treatmentHealth SciencesPsychologydoctoral thesis