Telephone based coaching for adults at risk of diabetes: impact of Australia's Get Healthy Service.

Abstract

The Get Healthy Information and Coaching Service (GHS), an effective 6-month telephone-based healthy lifestyle coaching service, includes a population-targeted diabetes prevention module (DPM) tailored for adults at risk for type 2 diabetes. This study determined DPM's reach and impact on anthropometric and lifestyle risk factors. Pre-post evaluation design examined self-reported anthropometric (body weight, waist circumference) and lifestyle risk factors (physical activity and dietary behaviors) of DPM participants. Descriptive and chi-square analyses were performed on sociodemographic variables. Behavioral changes were assessed using matched pairs analysis, independent samples analysis, and multivariate analysis. There were 4,222 DPM participants (76.0% female; 75.9% aged ≥ 50; 95.4% spoke English at home). The DPM included higher proportions of older adults (≥50) (75.9% vs. 46.5%; p < .001), retirees (28.7% vs. 18.5%; p < .0001), less educated (33.3% vs. 24.9%; p < .0001), more disadvantaged (41.7% vs. 34.8%; p < .001) and living in regional or rural areas (43.2% vs. 39.8%; p < .001) than the GHS program. DPM participants reported significant improvements at six months for all anthropometric (-3.3 kg weight; -1.2 BMI units; -4.3 cm waist circumference) and behavioral risk factors (+0.2 fruit serves/day; +0.7 vegetables serves/day; -0.2 sweetened drinks/day; -0.2 takeaway meals/week; +1.1 30-min walking sessions/week; +0.7 30-min moderate activity sessions/week; +0.2 20-min vigorous activity sessions/week). Nearly one-third (31.1%) of participants lost ≥5% body weight. The DPM reached priority population groups, those typically underrepresented in diabetes prevention programs and resulted in clinically relevant improvements in anthropometric and lifestyle risk factors in adults at increased risk for type 2 diabetes.