Building an Intersectoral Learning Community for, with and by People Living with Obesity in Rural Québec: A Participatory Study

Abstract

Background: Obesity is a complex societal health issue affecting nearly 30% of Canadians. Beyond its clinical definition, people living with obesity (PLWO) experience persistent social and structural barriers that influence their wellbeing. As nearly half of the determinants of health for PLWO are socio-economic, effective responses require collaboration beyond healthcare systems. In this context, a participatory research initiative, led by a citizen and a researcher, was launched to co-create the first intersectoral learning community for, with, and by PLWO in a rural region of Québec.   Approach: Using a participatory qualitative design, this study applied a participant-observation approach to analyse interactions and collaboration dynamics among actors engaged in three co-design workshops (March–June 2025). The analytical framework drew on Bilodeau, Parent, and Potvin’s model of effective intersectoral collaboration, identifying six key conditions for successful intersectoral collaboration. Twenty-two participants from health, community, municipality, and patient-partner sectors took part. Methods included structured observation grids, field notes, and audio recordings, thematically coded with NVivo using a deductive approach and triangulated analysis.   Results: The workshops fostered active engagement across diverse stakeholders and revealed the evolution of collaborative dynamics. Patient partners initiated most discussions and played a central leadership role. Exchanges evolved from broad ideas in the first workshop to context-adapted solutions in the second. The online session showed reduced engagement, highlighting the importance of in-person interaction. The persona method proved to be a key facilitator for grounding discussions in lived experience and stimulating creative solution-oriented dialogue, leading to concrete cross-sector partnerships particularly between health and community actors. Missing representation from the education sector was identified as a gap for future iterations. Across sessions, participants identified and expanded a repertoire of relevant local initiatives and initiated collaborations beyond the workshops, illustrating both the potential and fragility of sustained cross-sector engagement in rural settings.     Implications: This study highlights how a structured, participatory learning community can strengthen integrated, person-centred care for people living with obesity (PLWO), particularly in rural settings. The workshops led to the first cross-sector collaborations beyond the learning community, demonstrating how such approaches can enhance local capacity, empower people with lived experience, and promote integrated, equity-oriented care. The findings suggest that intersectoral collaboration, trust-building, and adaptive facilitation methods are essential for sustainable community partnerships. The model provides transferable lessons for integrated care initiatives that aim to embed co-design with people with lived experience and address other complex health issues requiring cross-sector collaboration.