The qualitative component of our study was conducted from March to August 2017 in military installations across Singapore. Our research team comprised one female Masters of Public Health (MPH) student and one male military physician pursuing a PhD. Both researchers had experience in qualitative methods, neither had a history of excess body weight. Analysis was guided and supported by two senior co-authors with expertise in qualitative methods and physical activity promotion.

To elicit the instructors’ perspectives we scheduled three separate focus groups involving a convenience sample of five to nine instructors each. Eligible discussants would have instructed in at least one full run of the residential programme. The focus groups were conducted onsite in a meeting room each lasting approximately on hour. We maintained the integrity of groups, meaning military leaders, fitness trainers and ancillary staff would not mix. The facilitator gave a short three-minute overview highlighting the problem of weight gain following the residential programme. Using a topic guide developed by our team (see Supplementary Table 1) the facilitator subsequently prompted participants to share their thoughts on what could be done differently to prevent relapse. A second member of the research team observed and took hand-written notes. The facilitator recorded key issues on a large sheet of poster paper for all participants to review. The session was concluded with a participatory learning and action exercise where participants were allowed to rank order and confirm key priorities in weight loss management using a ten-seed technique, which has been shown to stimulate participation and foster group consensus [39]. Audio-recordings were not made in order to promote more open sharing by participants who were all employees of the military.

To explore participant experiences further, we recruited a second convenience sample of 20 individuals who were randomly selected from the list of trainees who had completed the programme in December 2016. Our aim was to interview participants in-depth 6 months after completion of the programme within a 6-week period. Starting in May 2017 we wrote to each of their superior officers to schedule interviews that would be conducted behind closed doors near the place of work. Participation was voluntary and informed consent was required. No incentives were provided for participation in the interviews.

Key priorities identified by the focus groups informed the topic guide (see Supplementary Table 2) used in the in-depth interviews. The introduction to the study started with the process of obtaining informed consent. Subsequently the participant and the two researchers conducted a short ice-breaker comprising a brief self-introduction and an exercise of taking each other’s weight on a portable scale. Thereafter one researcher commenced the interview while the second team member observed and compiled field notes. All interviews were recorded on an audio device. The topic guide was structured to cover the interviewees’ lifestyles with an emphasis on physical activity and diet before, during, and after the residential programme. Participants were encouraged to reflect on their school, work and home environments. Before concluding the interview, participants were asked if they had any questions or concerns. After each interviewee was dismissed the researchers took time to reflect on the field notes and identify how the data added to the overall narrative. This process was refined over the first three interviews and ultimately helped determine when saturation had been reached.

Data from the focus groups and interviews were organised using the NVIVO 12 software package. The qualitative dataset was coded by one researcher using a thematic framework (see Table Table1)1) comprising the six constructs of exercise regulations proposed by Deci & Ryan and embedded in the BREQ-3 instrument [4042]. Interviewees were categorised, based on their weight trajectories as maintainers or relapsers, where a maintainer was defined as not having regained more than 50% of weight lost during the programme. The cross-tabulation function in the NVIVO 12 was used to compile relevant data for comparative analyses.

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