Schmittdiel Julie A, Adams Sara R, Goler Nancy, Sanna Rashel S, Boccio Mindy, Bellamy David J, Brown Susan D, Neugebauer Romain S, Ferrara Assiamira
Division of Research, Kaiser Permanente Northern California, Oakland, California, USA.
Wellness Coaching Center, The Permanente Medical Group, Vallejo, California, USA.
Obesity (Silver Spring). 2017 Feb;25(2):352-356. doi: 10.1002/oby.21723.
To evaluate the impact of a population-based telephonic wellness coaching program on weight loss.
Individual-level segmented regression analysis of interrupted time series data comparing the BMI trajectories in the 12 months before versus the 12 months after initiating coaching among a cohort of Kaiser Permanente Northern California members (n = 954) participating in The Permanente Medical Group Wellness Coaching program in 2011. The control group was a 20:1 propensity-score matched control group (n = 19,080) matched with coaching participants based on baseline demographic and clinical characteristics.
Wellness coaching participants had a significant upward trend in BMI in the 12 months before their first wellness coaching session and a significant downward trend in BMI in the 12 months after their first session equivalent to a clinically significant reduction of greater than one unit of baseline BMI (P < 0.01 for both). The control group did not have statistically significant decreases in BMI during the post-period.
Wellness coaching has a positive impact on BMI reduction that is both statistically and clinically significant. Future research and quality improvement efforts should focus on disseminating wellness coaching for weight loss in patients with diabetes and those at risk for developing the disease.
评估一项基于人群的电话健康指导计划对体重减轻的影响。
对中断时间序列数据进行个体水平的分段回归分析,比较2011年参加北加利福尼亚凯撒医疗集团健康指导计划的一组成员(n = 954)在开始指导前12个月与开始指导后12个月的体重指数(BMI)轨迹。对照组是一个倾向得分匹配的对照组(n = 19,080),根据基线人口统计学和临床特征与指导参与者进行匹配。
健康指导参与者在首次健康指导课程前12个月的BMI有显著上升趋势,在首次课程后12个月的BMI有显著下降趋势,相当于基线BMI临床上显著降低超过一个单位(两者P < 0.01)。对照组在后期BMI没有统计学上的显著下降。
健康指导对BMI降低有积极影响,在统计学和临床上均有显著意义。未来的研究和质量改进工作应侧重于在糖尿病患者和有患糖尿病风险的人群中推广用于减肥的健康指导。