Abstract P242: The Effects of Wellness Coaching on Lowering Stroke Risk Factors in a Wisconsin Native American Population

Abstract

Objective: Native Americans are disproportionally affected by obesity, diabetes and stroke. This study tests the hypothesis that weight loss and change in BMI are related to coaching participation in the first 52 weeks of a two-year study. Methods: Participants of the “Stroke Prevention in the Wisconsin Native American Population” study age ≥55 years with three or more stroke risk factors were assigned to a High Risk-Intensive Coaching arm (n=49); informed consent was obtained for all participants. These participants engaged in routine wellness coaching visits centered around lifestyle modification in an effort to reduce risk factors for stroke. Data analysis was performed with SPSS (SPSS, IBM Corporation, Armonk, NY, US) and R (RStudio, PBC, Boston, MA, US). Continuous variables are reported with median and interquartile range (IQR). A participation score (total coaching sessions attended ÷ 52 weeks) was calculated for each participant and total weight loss for the first 52 weeks was also calculated (baseline weight in pounds - the weight in pounds at the last coaching session closest to week 52), (n=49). The Wilcoxon Signed Rank test was used to test the hypothesis that weight loss or change in BMI was significantly different than baseline. A smoothing spline was used to assess a potential dose-response relationship between participation score and weight loss and change in BMI. Results: Of the 49 participants examined, 36 were female and 13 were male, with a median age of 66 (IQR =10.0) years. Risk factors observed at baseline included smoking (n=11, 22.4%), median BMI of 31.6 lb/in 2 (IQR=7.7), and median physical activity of 90 minutes per week (IQR=210.0). Biometric measures were also recorded at baseline, with a median systolic blood pressure of 149 mmHg (IQR=26.0) and median diastolic of 80 mmHg (IQR=14.0), median total cholesterol of 156 mg/dL (IQR=57.0), median LDL of 87 mg/dL (IQR=57.0), median HDL of 46 mg/dL (IQR=16.0), median non-HDL of 110 mg/dL (IQR=61.0), and median hemoglobin A1C of 6.5 mg/dL (IQR=1.2). Participation score median of 0.33 (IQR=0.375) range 0.06-0.87. Weight loss median 3.6 (IQR=9.45) range -41 to 35 pounds. A spline analysis found a significant dose-response relationship between participation score in the first 52 weeks of the study and weight loss (r 2 =0.199 deviance 23%, p=0.006) and BMI (r 2 =0.145, deviance 16.7%, p=0.010). Conclusion: Preliminary results suggest that participation in a wellness coaching program may be associated with weight loss and change in BMI in this study population. Future work will continue to examine how coaching is related to weight loss and change in BMI in a larger cohort and with a wider age range.