Co-designing an intersectoral learning community to address the needs of people living with obesity: a participatory mixed-methods study in a semi- rural region of Quebec, Canada
This participatory mixed-methods study in semi-rural Quebec demonstrates that while co-designing an intersectoral learning community successfully strengthened relational and cognitive foundations for collaboration among diverse stakeholders to address obesity, the initiative has not yet achieved fully integrated collective action due to challenges in strategic representation, governance, and resource allocation.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
Obesity is often misunderstood as a simple matter of personal choice, a calculation of calories eaten versus calories burned. However, modern science recognizes it as a complex, chronic condition shaped by a web of factors: biology, genetics, the environment, and the culture we live in. Because the causes are so widespread, the solutions cannot come from doctors alone. The healthcare system, which focuses on treating illness, addresses only a small fraction of the forces that determine health. To truly help people living with obesity, communities must bring together people from many different walks of life—doctors, city planners, teachers, community leaders, and the people who live with the condition every day. This approach, known as intersectoral collaboration, relies on the idea that when diverse groups work together, they can see the problem more clearly and build better solutions than any single group could manage on its own.
In a semi-rural region of Quebec, Canada, a team of researchers set out to test whether this kind of collaboration could be built from the ground up. They gathered a group of twenty-five people from civil society, healthcare, community organizations, and local government to co-design a "learning community." This was not a traditional meeting where experts lecture an audience; it was a participatory process where everyone, including people living with obesity, worked together to define the problems and imagine solutions. The researchers wanted to see if bringing these different voices together could create a shared understanding and a plan for action. Over the course of four workshops held between March and November 2025, the group used creative methods to break down barriers between their different worlds. They discussed weight stigma, access to resources, and mental health, eventually moving toward a shared vision for the future.
The process began with a focus on creating a safe and respectful environment. Before the first meeting, the team established a set of shared rules, or a charter, to ensure that everyone felt heard and that language used would not shame or stigmatize anyone. In the first workshop, the group used a method called a "World Café," where participants rotated through small tables to discuss key issues. This initial session revealed that while everyone agreed on the importance of the topic, the conversation was dominated by a few voices, particularly those from the healthcare sector and people with lived experience of obesity. Some community members and municipal representatives were quieter, listening more than speaking.
To bridge this gap, the second workshop introduced a powerful tool: personas. These were detailed, fictional stories about real-life people living with obesity, created using input from the participants and medical experts. Instead of talking about abstract statistics, the group discussed the specific daily struggles of these characters. This shift changed the dynamic of the room. By focusing on the needs of a specific person rather than a general category, the participants began to see how their different roles could fit together. A doctor could see how a community program might help, and a city planner could understand how local resources were missing. The personas acted as a common ground, allowing the group to move from parallel conversations to a collective effort to solve problems.
As the workshops progressed, the group's understanding of obesity deepened. They moved away from viewing it solely as a medical issue to be fixed by a doctor and began to see it as a societal challenge involving schools, housing, and community culture. Participants reported feeling more informed about the resources available in their region and more aware of the roles played by people in other sectors. One healthcare worker noted that the discussions had already changed how they approached patients in their clinic, making them more mindful of how they measured and discussed weight. The group successfully built a strong foundation of trust and shared knowledge, with ninety-five percent of respondents saying they felt able to express their views and that they were heard.
However, the study also revealed significant hurdles in turning this dialogue into lasting action. While the group felt good about their discussions, they were less certain about what would happen next. When asked later if the group had developed integrated solutions that went beyond simple coordination, fifty-two percent of respondents said they did not know. Similarly, seventy-six percent did not know if the partners had changed their roles to make these new solutions work. The group had identified that some crucial sectors, such as education and local elected officials, were missing from the table. Without these key players, it was difficult to imagine how the ideas generated could be funded or implemented.
The researchers found that the group had successfully built the relationships and the shared vision necessary to start working together, but they had not yet established the machinery to keep it going. There was no clear plan for who would make decisions, who would pay for the projects, or how the group would hold itself accountable. One participant worried that without a dedicated budget and a formal structure, the project would simply fade away, leaving the community with good ideas but no way to act on them. The study concluded that while the co-design process was a success in bringing people together and changing perspectives, it was not enough on its own to create a sustainable system of care.
The path forward requires more than just good intentions and a supportive climate. To move from talking to doing, the group needs explicit governance, dedicated resources, and the active involvement of decision-makers who can authorize change. The study suggests that building a learning community is a vital first step, but it must be followed by concrete steps to ensure that the collective capacity built during those workshops translates into real-world improvements for people living with obesity. The work in Quebec shows that when diverse groups sit down together, they can see the problem in a new light, but turning that new light into a lasting solution requires a structure that can hold the weight of the future.
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