Implications and future research
weight loss
We have shown that a remotely delivered web and phone weight loss BC prevention programme can be successfully delivered within a UK healthcare setting from a central location to multiple distant centres to FHRPC attendees. The remote programmes were evaluated pre-pandemic and are likely to be more acceptable now. The pandemic has changed public and NHS perceptions for delivering remote programmes online and avoiding the need for hospital visits [An estimated 20% of women in the UK are at moderate or high BC risk [Further optimisation and decisions around implementation of the intervention will be undertaken based on the qualitative and quantitative process analysis of the present trial, suggesting four main elements that could strengthen an intervention that already shows promise. In particular, greater intensity of intervention during follow-up than the use of automated emails should help with maintenance of weight loss. The use of strategies to help women to better cope with emotional issues that impact on unhealthy eating would be useful. Facilitating peer support amongst participants and a greater focus on physical activity aswell as diet may be warranted. We will aim to strengthen the intervention in consultation with the target population and key stakeholders, i.e. clinicians in high risk clinics and commissioners of these services. This work will also include the development of training materials for dietitians who will be delivering the intervention.A future large scale RCT across multiple clinics will test whether the BCPP can be implemented across the network of FHRPCs. This trial could test the BCPP against a simpler control group provided with written information only, since the control group herein contained potentially effective elements of the interventions [