Total Lifestyle Coaching: A Pilot Study Evaluating the Effectiveness of a Mind–Body and Nutrition Telephone Coaching Program for Obese Adults at a Community Health Center

Abstract

BackgroundStress and obesity are interrelated and common among low-income adults. Mind–body interventions have been shown to reduce psychological distress and have been incorporated into many weight loss interventions. However, few of these programs have incorporated a telephone coaching component.ObjectiveWe designed and piloted a novel weight loss telephone coaching intervention for this population and examined its effectiveness on weight loss and improvements in health behaviors in obese community health center patients.MethodsThis was a 6-month, single-arm, prospective, pre–post pilot study. The study took place at a community health center near Boston, Massachusetts. Participants were 27 overweight and obese community health center patients. The intervention consisted of one in-person intake with the registered dietitian, trained in mind–body approaches, and approximately 1 phone coaching session every 2 weeks for 6 consecutive months. Anthropometric data consisted of weight, body mass index (BMI), and blood pressure. Questionnaires consisted of the Perceived Stress Scale-10 item, the CIGNA Healthy Eating Survey, Section H: Behavioral Eating, a physical activity questionnaire, and a nutritional habits questionnaire. We used paired samples t tests to assess pre–post changes in weight, BMI, blood pressure, perceived stress, behavioral eating, and physical activity. We also conducted semistructured exit interviews to learn about participants’ experiences in this program.ResultsThere was a trend toward weight reduction (P < .1, Cohen’s d = 0.33) and significant improvements in systolic blood pressure (P = .001, Cohen’s d = 0.72), perceived stress (P = .001, Cohen’s d = 0.75), and behavioral eating (P = .009, Cohen’s d = 0.54). Improvements in weight were sustained 6 months after completion of the intervention.ConclusionResults suggest that a telephone nutrition health coaching intervention is feasible and may facilitate weight loss in obese community health center patients. Future randomized-controlled studies are warranted to better understand these improvements.Clinicaltrials.gov registrationNCT03025217

Preference for Telehealth Sustained Over Three Months at an Outpatient Center for Integrative Medicine

“…Historically, integrative medicine services have been delivered in-person with telehealth-delivery playing only a small role, typically limited to intervention trials. 1 – 4 Barriers to telehealth-delivery of services exist across patient and provider levels, including lack of payment models, delivery platforms, health and technological literacy, and provider buy-in. 5 , 6 Integrative medicine prioritizes an authentic, healing relationship between patient and provider, one barrier frequently cited is the concern that virtual modalities may harm rapport.…”

Nutritional intervention strategies for the management of overweight and obesity in primary health care: A systematic review with meta‐analysis

“…Our search strategy identified 16,701 potentially relevant articles, of which 70 (45 RCTs 24–68 and 25 UBAs 69–93 ) met the inclusion criteria for this SLR with MA (Figure S1). Seventy‐six percent of the studies were published in the last 10 years, and most of them were conducted in Europe ( n = 26) and North America ( n = 24) compared to Oceania, Asia and South America.…”

“…In the current analyses, prescriptive dietary approaches were more effective than behavioural approaches in decreasing anthropometric measures among subjects with overweight and obesity when UBAs were considered. Prescriptive dietary interventions of the studies were based on individualized dietary plans mostly delivered by dietitians, nutritionists and/or experienced nurses 69,70,77,80,81,86,90 ; whereas in several studies based on behavioural approach, an individualized dietary plan was not delivered 71,72,76,78,79,82,83,85,88,89,93 . In this sense, a systematic review by Wadden et al 16 demonstrated that behavioural counselling is efficient for patients with overweight/obesity recruited from PHC.…”

Meeting the Challenge of Providing Nutrition Services During the COVID-19 Pandemic

“…As early as 2008, Eakin and coworkers (15) published one of many studies that demonstrate adults patients, even from disadvantaged communities, can achieve modest improvements in diet and physical activity though a telephone delivered intervention-as good and sometimes even better than face-toface counseling (16)(17)(18)(19)(20)(21)(22)(23). Nutrition care delivered via telephone for other conditions, too, have been found to be effective (24)(25).…”