Background and Goal: Obesity is a significant health issue, particularly among veterans and racial/ethnic minority groups. Primary care is a key setting for addressing obesity. However, many barriers, including time constraints and limited patient engagement, make effective treatment challenging. This study evaluated whether a technology-assisted health coaching intervention called Goals for Eating and Moving (GEM) could help high-risk patients lose weight more effectively than enhanced usual care (EUC).
Study Approach: Researchers conducted a two-arm, cluster-randomized controlled trial involving 19 primary care teams across two health care systems. Patients with obesity or overweight conditions and related comorbidities were randomized to receive either the GEM intervention or EUC. The GEM intervention included one in-person and up to 12 telephone-delivered coaching sessions. Coaches supported goal setting and weight management program engagement, facilitated by a software tool and motivational interviewing. Patients randomized to EUC received educational handouts. The study measured weight changes and other health outcomes over 12 months.
Main Results:
- There was no significant difference in weight loss between patients in the GEM intervention and those in EUC at 12 months.
- Participants in the GEM group reported a significant increase in weekly physical activity compared to those in the EUC group.
- Attendance at weight management programs like MOVE! or DPP did not significantly differ between the GEM and EUC groups.
- While more frequent health coaching calls were associated with greater weight loss, overall patient engagement with coaching was low.
Why It Matters: The findings of this study highlight the complexities of managing obesity in high-risk populations and the limitations of relying solely on technology-assisted health coaching in primary care settings.
A Cluster-Randomized Study of Health Coaching for Weight Management in Primary Care
Melanie R. Jay, MD, MS, et al
Department of Medicine, New York University Grossman School of Medicine, New York, New York
Department of Population Health, New York University Grossman School of Medicine, New York, New York
New York Harbor Veterans Health Affairs, New York, New York
PRE-EMBARGO LINK (Link expires at 5 p.m. September 23rd, 2024)
