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

Emma Chad-Friedman, Melanie Pearsall, Kathleen M Miller, Amy E Wheeler, John W Denninger, Darshan H Mehta, Michelle L Dossett, Emma Chad-Friedman, Melanie Pearsall, Kathleen M Miller, Amy E Wheeler, John W Denninger, Darshan H Mehta, Michelle L Dossett

Abstract

Background: Stress 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.

Objective: We 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.

Methods: This 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.

Results: There 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.

Conclusion: Results 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.

Clinicaltrialsgov registration: NCT03025217.

Keywords: behavior therapy; mind–body medicine; obesity; telemedicine; weight loss.

Figures

Figure 1.
Figure 1.
Participant Flow Diagram. N = number of participants, t = time point.
Figure 2.
Figure 2.
Participant Eating Habits at Baseline (Pre) and End Point (Post). The y-axis shows the number of times per day each type of food was consumed. Circle size is proportional to the number of respondents which is embedded in the middle of the circle.

References

    1. Centers for Disease Control and Prevention. Adult obesity facts. . Published 2016. Accessed December 30, 2016.
    1. Ogden CL, Carroll MD, Fryar CD, Flegal KM. Prevalence of Obesity Among Adults and Youth: United States, 2011–2014. Washington, DC: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2015. . Accessed December 29, 2016.
    1. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011–2012. JAMA. 2014; 311(8): 806–814.
    1. Finkelstein EA, Trogdon JG, Cohen JW, Dietz W. Annual medical spending attributable to obesity: payer-and service-specific estimates. Health Aff (Millwood). 2009; 28(5): w822–w831.
    1. Block JP, He Y, Zaslavsky AM, Ding L, Ayanian JZ. Psychosocial stress and change in weight among US adults. Am J Epidemiol. 2009; 170(2): 181–192.
    1. Torres SJ, Nowson CA. Relationship between stress, eating behavior, and obesity. Nutrition. 2007; 23(11–12): 887–894.
    1. Epel E, Lapidus R, McEwen B, Brownell K. Stress may add bite to appetite in women: a laboratory study of stress-induced cortisol and eating behavior. Psychoneuroendocrinology. 2001; 26(1): 37–49.
    1. Rutters F, Nieuwenhuizen AG, Lemmens SGT, Born JM, Westerterp-Plantenga MS. Acute stress-related changes in eating in the absence of hunger. Obesity (Silver Spring). 2009; 17(1): 72–77.
    1. Privitera GJ, King-Shepard QW, Cuifolo KN, Doraiswamy PM. Differential food intake and food choice by depression and body mass index levels following a mood manipulation in a buffet-style setting [published online ahead of print May 1, 2016]. J Health Psychol. doi:10.1177/1359105316650508.
    1. Chacko SA, Yeh GY, Davis RB, Wee CC. A mindfulness-based intervention to control weight after bariatric surgery: preliminary results from a randomized controlled pilot trial. Complement Ther Med. 2016; 28: 13–21.
    1. Katterman SN, Kleinman BM, Hood MM, Nackers LM, Corsica JA. Mindfulness meditation as an intervention for binge eating, emotional eating, and weight loss: a systematic review. Eat Behav. 2014; 15(2): 197–204.
    1. Levoy E, Lazaridou A, Brewer J, Fulwiler C. An exploratory study of Mindfulness Based Stress Reduction for emotional eating. Appetite. 2017; 109: 124–130.
    1. Olson KL, Emery CF. Mindfulness and weight loss: a systematic review. Psychosom Med. 2015; 77(1): 59–67.
    1. Rogers JM, Ferrari M, Mosely K, Lang CP, Brennan L. Mindfulness-based interventions for adults who are overweight or obese: a meta-analysis of physical and psychological health outcomes. Obes Rev Off J Int Assoc Study Obes. 2017; 18(1): 51–67.
    1. Ruffault A, Czernichow S, Hagger MS, et al. The effects of mindfulness training on weight-loss and health-related behaviours in adults with overweight and obesity: a systematic review and meta-analysis. Obes Res Clin Pract. 2017; 11(5S1): 90–111.
    1. Park ER, Traeger L, Vranceanu A-M, et al. The development of a patient-centered program based on the relaxation response: the Relaxation Response Resiliency Program (3RP). Psychosomatics. 2013; 54(2): 165–174.
    1. Clarke T, Black L, Stussman B, Barnes P, Nahin R. Trends in the Use of Complementary Health Approaches among Adults: United States, 2002-2012. National Health Statistics Reports, Hyattsville, MD: National Center for Health Statistics, 2015.
    1. Murdock A, Rodgers C, Lindsay H, Tham TCK. Why do patients not keep their appointments? Prospective study in a gastroenterology outpatient clinic. J R Soc Med. 2002; 95(6): 284–286.
    1. Paterson BL, Charlton P, Richard S. Non-attendance in chronic disease clinics: a matter of non-compliance? J Nurs Healthc Chronic Illn. 2010; 2(1): 63–74.
    1. Wolever RQ, Eisenberg DM. What is health coaching anyway? Standards needed to enable rigorous research: comment on “Evaluation of a behavior support intervention for patients with poorly controlled diabetes.”. Arch Intern Med. 2011; 171(22): 2017–2018.
    1. Weinstock RS, Trief PM, Cibula D, Morin PC, Delahanty LM. Weight loss success in metabolic syndrome by telephone interventions: results from the SHINE study. J Gen Intern Med. 2013; 28(12): 1620–1628.
    1. Kelly JT, Reidlinger DP, Hoffmann TC, Campbell KL. Telehealth methods to deliver dietary interventions in adults with chronic disease: a systematic review and meta-analysis. Am J Clin Nutr. 2016; 104(6): 1693–1702.
    1. Ayisi Addo S, Steiner-Asiedu M. Telephone based weight loss intervention: relevance for developing countries. Crit Rev Food Sci Nutr. 2018, pp. 1–7. DOI: 10.1080/10408398.2018.1437536.
    1. CIGNA Healthy Eating Survey. . Accessed December 29, 2016.
    1. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983; 24(4): 385–396.
    1. Thorndike AN, Sonnenberg L, Healey E, Myint-UK, Kvedar JC, Regan S. Prevention of weight gain following a worksite nutrition and exercise program: a randomized controlled trial. Am J Prev Med. 2012; 43(1): 27–33.
    1. Wolf AM, Hunter DJ, Colditz GA, et al. Reproducibility and validity of a self-administered physical activity questionnaire. Int J Epidemiol. 1994; 23(5): 991–999.
    1. Borkan J. Immersion/crystallization. In: Crabtree B, Miller W. (eds). Doing Qualitative Research, 2nd ed Thousand Oaks, CA: SAGE, 1999.
    1. Barte JCM, ter Bogt NCW, Bogers RP, et al. Maintenance of weight loss after lifestyle interventions for overweight and obesity, a systematic review. Obes Rev Off J Int Assoc Study Obes. 2010; 11(12): 899–906.
    1. Turk MW, Yang K, Hravnak M, Sereika SM, Ewing LJ, Burke LE. Randomized clinical trials of weight loss maintenance: a review. J Cardiovasc Nurs. 2009; 24(1): 58–80.
    1. Wing RR, Tate DF, Gorin AA, Raynor HA, Fava JL. A self-regulation program for maintenance of weight loss. N Engl J Med. 2006; 355(15): 1563–1571.
    1. Brantley PJ, Stewart DW, Myers VH, et al. Psychosocial predictors of weight regain in the weight loss maintenance trial. J Behav Med. 2014; 37(6): 1155–1168.
    1. Spoor STP, Bekker MHJ, Van Strien T, van Heck GL. Relations between negative affect, coping, and emotional eating. Appetite. 2007; 48(3): 368–376.
    1. Dusek JA, Benson H. Mind-body medicine: a model of the comparative clinical impact of the acute stress and relaxation responses. Minn Med. 2009; 92(5): 47–50.
    1. Tang Y-Y, Hölzel BK, Posner MI. The neuroscience of mindfulness meditation. Nat Rev Neurosci. 2015; 16(4): 213–225.
    1. Puhl RM, Heuer CA. The stigma of obesity: a review and update. Obesity. 2009; 17(5): 941–964.
    1. Burke LE, Wang J, Sevick MA. Self-monitoring in weight loss: a systematic review of the literature. J Am Diet Assoc. 2011; 111(1): 92–102.
    1. Bennett WL, Wang N-Y, Gudzune KA, et al. Satisfaction with primary care provider involvement is associated with greater weight loss: results from the practice-based POWER trial. Patient Educ Couns. 2015; 98(9): 1099–1105.
    1. Beach MC, Roter D, Korthuis PT, et al. A multicenter study of physician mindfulness and health care quality. Ann Fam Med. 2013; 11(5): 421–428.
    1. Dobkin PL, Bernardi NF, Bagnis CI. Enhancing clinicians’ well-being and patient-centered care through mindfulness. J Contin Educ Health Prof. 2016; 36(1): 11–16.
    1. Wayne PM, Manor B, Novak V, et al. A systems biology approach to studying tai chi, physiological complexity and healthy aging: design and rationale of a pragmatic randomized controlled trial. Contemp Clin Trials. 2013; 34(1): 21–34.

Source: PubMed

Sponsorer og samarbeidspartnere

Medisinsk tilstand

Legemiddelintervensjoner

3
Abonnere