Abstract
BackgroundThe Get Healthy Information and Coaching Service® (GHS) is a population-wide telephone-based program aimed at assisting adults to implement lifestyle improvements. It is a relatively uncommon example of the translation of efficacious trials to up-scaled real-world application. GHS participants who completed the 6-month coaching program made significant initial improvements to their weight, waist circumference, Body Mass Index (BMI), physical activity and nutrition behaviours. This study examines the maintenance of anthropometric and behaviour change improvements 6-months after program completion.MethodsGHS coaching participants (n=1088) were recruited between February 2009 and June 2011. Participants were eligible if they completed the 6-month coaching program and had available data at 12-month follow-up (n=277). Weight, waist circumference, BMI, fruit and vegetable consumption and physical activity were collected at baseline and 6-months by GHS coaches and 12-months (6-months post program) by independent evaluators. Matched pair t-tests, mixed linear regression and logistic regression analyses were performed to assess maintenance of program effects.ResultsImprovements in weight (−2.9 kg, 95% CI: -3.6, -2.1), waist circumference (−5.4 cm, 95% CI: -6.7, -4.1), BMI (−1.1units, 95% CI: -1.5, -0.8), and fruit (+0.3 serves per day, 95% CI: 0.2, 0.3) and vegetable (+0.5 serves per day 95% CI: 0.3, 0.6) consumption were observed from baseline to 12-months. Apart from vegetable consumption, there were no significant differences between 6-month and 12-month changes from baseline, indicating these risk factor improvements were maintained from the end of the coaching program. There were also improvements in the proportion of participants undertaking recommended levels of physical activity from baseline to 12-months (increase of 5.2%), however the improvements made at end of the coaching program were not maintained at the 6-month follow up.ConclusionsThis study provides preliminary evidence that the GHS has potential to contribute to substantial improvements in the chronic disease risk factor profile of program completers and facilitates sustained maintenance six months after completing the coaching program.
Highlights
The Get Healthy Information and Coaching ServiceW (GHS) is a population-wide telephone-based program aimed at assisting adults to implement lifestyle improvements
Obesity contributes to a significant number of chronic diseases and conditions, and with obesity prevalence continuing to rise [1], the implementation of population wide initiatives that impact on overweight and obesity, and the chronic disease risk factor profile of the community is a priority
Previous research has demonstrated the effectiveness of the GHS coaching program on anthropometric and behavioural risk factor measures at program completion [4], confirming that results observed in the precursor trials [5,6,7,8,9,10,11,12] can be reproduced in populationbased, translational context [13]
Summary
The Get Healthy Information and Coaching ServiceW (GHS) is a population-wide telephone-based program aimed at assisting adults to implement lifestyle improvements It is a relatively uncommon example of the translation of efficacious trials to up-scaled real-world application. Aside from these, the studies that report on the long-term maintenance of behaviour change have been limited to telephone based within controlled settings and often with a population of adults with particular chronic diseases [16] or within workplaces [7] as opposed to the general population in a real-world setting This paucity of evidence is apparent within trials of telephone-based programs, and in physical activity and nutrition intervention trials more generally, where a recent systematic review found that only 35% of included studies reported on maintenance of outcomes following the end of program [17]. This is compounded by telephone counselling itself frequently being used as a strategy for maintaining behaviour change after a more intensive intervention [16,18,19]
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