The contribution of lifestyle coaching of overweight patients in primary care to more autonomous motivation for physical activity and healthy dietary behaviour: results of a longitudinal study (original) (raw)
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International journal of environmental research and public health, 2018
Combined lifestyle interventions (CLIs) can be effective in reducing weight and improving lifestyle-related behaviours but it is unclear how CLIs can best be implemented in practice in order to achieve sustained lifestyle changes. The Coaching on Lifestyle programme (CooL) is a CLI in the Netherlands, in which professional lifestyle coaches counsel adults and children (and/or their parents) who are obese or at high risk of obesity to achieve a sustained healthier lifestyle. The CooL intervention consists of group and individual sessions addressing the topics of physical activity, dietary behaviours, sleep and stress. Our longitudinal one-group pre-post study aimed to identify lifestyle changes among participants (adults, children and their parents) at 8 and 18 months after initiation. We assessed constructs ranging from motivation and behaviour-specific cognitions to behaviours and health outcomes. Positive and sustained changes among adults were found regarding perceived autonomy, ...
Motivational Intervention of Obesity in Primary Care Through Physical Activity Program
Telehealth and Medicine Today, 2019
Obesity and overweight are significant public health problems, worldwide. Hence, there is the importance of developing and applying strategies that reduce weight in this population. We set out to evaluate the effectiveness of obesity intervention with three different approaches-one of them with a platform that promotes physical activity. Methods: Randomized, controlled, parallel clinical trial that compared three arms, multicenter study in overweight or obese patients, with a 12-month follow-up. The patients were randomized into three groups: Intervention in the primary care center with intervention G1: Control group, which received the usual recommendations of losing weight following the SEEDO 2000 (Sociedad Española para el Estudio de la Obesidad) Consensus, G2: Motivational intervention of obesity (IMOAP) with a trained nurse and small periodic work groups, and G3: IMOAP adding the use of a digital platform to record physical activity, monitors it, and, in turn, favors the practice of this (aka iwopi: the concept that physical activity has a positive impact beyond the activity). Variables collected included: weight, height, body mass index (BMI), waist circumference, lipid parameters, blood pressure, and glycosylated hemoglobin. After the interventions, clinical relevance indicators were studied. Relative risk (RR), absolute risk reduction (ARR), relative risk reduction (RRR), and number needed to treat (NNT), both for intention to treat and for biological efficacy. Results: Cholesterol levels in three groups were reduced. The BMI showed a general
American Journal of Lifestyle Medicine, 2017
Aim. To explore (1) general practitioners' (GPs') motivations to refer to lifestyle interventions and to investigate the association between GPs' own lifestyle behaviors and their referral behavior and (2) patient indicators in the decisionmaking process of the GPs' referral to lifestyle interventions. Method. A cross-sectional study was conducted among 99 Dutch primary care GPs. Their motivation to refer was assessed by beliefs regarding lifestyle interventions. GPs' referral behaviors were assessed-considering referral and self-reported actual referral-as well as their own lifestyle behaviors (physical activity, dieting, being overweight). Decision making regarding referring patients to lifestyle interventions was assessed by imposed patient indicators, spontaneously suggested decisive patient indicators, and case-based referring (vignettes). Results. A substantial group of GPs was not motivated for referral to lifestyle interventions. GPs' referral behavior was significantly associated with their perceived subjective norm, behavioral control, and their own physical activity and diet. Most important, patient indicators in referral to lifestyle interventions were somatic indicators and patients' motivation for lifestyle interventions. Conclusions. GPs' motivation and referral behavior might be improved by providing them with tailored resources about evidencebased lifestyle interventions, with support from allied health professionals and with official guidelines for a more objective and systematic screening of patients.
Psychology of Sport and Exercise, 2011
Objectives: While obesity is on the increase, interventions that seek to change physical activity or dietary behaviour tend to have limited success in the long-term. Consistently effective approaches for facilitating lifestyle change within primary health care settings are yet to be determined. Despite an increase in counselling interventions, little is known about how such interventions are received. The purpose of this study was to explore the experiences of obese patients, following participation in a counselling intervention, in order to identify the influences on behaviour change in relation to physical activity and diet. Design: A qualitative semi-structured interview study using inductive thematic content analysis. Methods: Fourteen overweight or obese patients participated in semi-structured interviews that focused on experiences of consultations; current physical activity and eating behaviour; facilitators and barriers to change. Results: Analysis of the interview transcripts revealed four themes that appeared to account for current lifestyle behaviour: (1) Monitoring and support; (2) Listening support; (3) Motivation and self-regulation; and (4) Barriers.
The implementation of the coaching on lifestyle (CooL) intervention: lessons learnt
BMC Health Services Research
Background Combined lifestyle interventions (CLIs) are designed to help people who are overweight or obese maintain a healthy new lifestyle. The CooL intervention is a CLI in the Netherlands, in which lifestyle coaches counsel adults and children (and/or their parents) who are obese or at high risk of obesity to achieve a sustained healthier lifestyle. The intervention consists of coaching on lifestyle in group and individual sessions, addressing the topics of physical activity, dietary behaviours, sleep, stress management and behavioural change. The aim of this study was to evaluate the implementation process of the Coaching on Lifestyle (CooL) intervention and its facilitating and impeding factors. Methods Mixed methods were used in this action-oriented study. Both quantitative (number of referrals, attendance lists of participants and questionnaires) and qualitative (group and individual interviews, observations, minutes and open questions) data were collected among participants,...
European Journal of Internal Medicine, 2021
Background: People with obesity (PwO) often struggle to achieve and maintain weight loss. This can perpetuate and/or be influenced by feelings of low motivation. This analysis from ACTION-IO data identified factors associated with PwO motivation to lose weight. Methods: PwO completed an online survey in 11 countries. Exploratory multinomial logistic regression analyses identified independent variables associated with self-report of feeling motivated versus not motivated to lose weight. Results: Data from 10,854 PwO were included (5,369 motivated; 3,312 neutral; 2,173 not motivated). Variables associated with feeling motivated versus not motivated included (odds ratio [95% confidence interval]): acknowledgement of healthcare professional (HCP) responsibility to contribute to weight loss (2.32 [1.86-2.88]), comfort in talking to their HCP about weight (1.46 [1.24-1.72), agreement that it is easy to lose weight (1.73 [1.30-2.31]), and a goal of reducing risks from excess weight (1.45 [1.22-1.73]). Conversely, if PwO considered obesity less important than other diseases they were less likely to report feeling motivated (0.49
International Journal of Environmental Research and Public Health
Healthy Life Centers (HLCs) have been established throughout Norway to support lifestyle changes and promote physical and mental health. We conducted a 12-month observational study among participants in an HLC that aimed to improve physical activity (PA) and dietary behaviors, and this study examined predictors of completion, and changes in psychological variables, lifestyle behaviors, and physical health indicators. The participants (N = 120, 71% female, mean age = 44 years) reported symptoms of psychological distress (77%) and were obese (77%). No baseline characteristics were found to be consistent predictors of completion (42%). Completers had significant improvements in autonomous motivation for PA (d = 0.89), perceived competence for PA (d = 1.64) and diet (d = 0.66), psychological distress (d = 0.71), fruit intake (d = 0.64), vegetable intake (d = 0.38), BMI among all participants (d = 0.21) and obese participants (d = 0.34), body fat percentage among all participants (d = 0....
Sport Sciences for Health, 2004
Sedentary habits and obesity are important problems in public health. The main objective of this study has been to increase motivation level and physical activity practice in overweight and obese patients, through a counseling intervention made from primary care physicians (MMG). The counseling model has been taken from the program PACE (Patient-centered Assessment and Counseling for Exercise and Nutrition). In the period May-April 2002-2003, 145 patients, with a BMI≥27, underwent a physical activity counseling administered by 10 primary care physicians (MMG). The main measures of outcome were the change of physical activity level and the state of change score and their related improvements; secondary measures: BMI and abdominal circumference. The median follow-up was 7 months. 103 of 145 (71%) agreed to the project; afterwards their motivation level and physical activity increased. BMI and abdominal circumference were reduced. There were no differences between subjects about studied features (sex, age, instruction, work, health). The counseling, following PACE's model, positively influenced the increase of physical activity and motivational level correlated in the patients who participated in the study project. It is necessary to do further studies to evaluate the real efficacy and to understand how this problem influences public health.
Studies incorporating Motivational Interviewing via Co-Active life coaching (MI-via-CALC) have elicited positive results among obese adults; however there is a paucity of comprehensive MI-via-CALC-obesity research that includes sufficient statistical power and a validated comparison group. The purpose of this study was to compare two telephone-based interventions for obesity. University students were randomized to either a 12-week: (a) personalized MI-via-CALC program whereby a coach worked with participants to achieve goals; or (b) prescriptive education-based lifestyle treatment following the LEARN Program. This paper contains a detailed methodological account of the study with a view to informing the development of prospective coaching-based programs. Keywords: Behavioural Intervention; Obesity; Motivational Interviewing; Life Coaching; Students