TY - JOUR
T1 - Evaluating an insurer-based health coaching program
T2 - Impact of program engagement on healthcare utilization and weight loss
AU - Reid, Natalie
AU - Bennett, Wendy
AU - Coughlin, Janelle
AU - Thrift, Jennifer
AU - Kachur, Sarah
AU - Gudzune, Kimberly A.
N1 - Funding Information:
This project was conducted as part of the Johns Hopkins HealthCare (JHHC) Population Health – Welch Center for Prevention, Epidemiology, and Clinical Research (Welch Center) Collaboration, funded by Johns Hopkins HealthCare LLC. KAG was supported by a career development award from the National Heart, Lung, and Blood Institute ( K23HL116601 ).
Publisher Copyright:
© 2018 The Authors
PY - 2018/12
Y1 - 2018/12
N2 - Insurers and employers are increasingly offering lifestyle and weight-loss coaching programs; however, few evaluations have examined their effectiveness. Our objectives were to determine whether level of program engagement was associated with differences in healthcare utilization and weight pre/post coaching. We conducted a retrospective evaluation of enrollees in an insurer-based telephonic health coaching program in Maryland (2013–2014). Our independent variables were program engagement benchmarks (≥3 and ≥6 sessions). Our dependent variables included change in outpatient and emergency department (ED) visits (more visits post program, fewer visits post, or no change pre-post) and associated costs (difference pre-post) using claims data. We calculated mean percent weight change from baseline. We used multivariate-adjusted linear and multinomial logistic regression, as appropriate, to examine the association between outcomes and engagement benchmarks. We included 225 enrollees with mean age 50.7 years, 81.3% women, and mean body mass index of 35.0 kg/m2. Most participants focused on weight management (75.6%) and improving general health (57.8%). Few individuals had outpatient or ED visits, and no significant changes in healthcare utilization were associated with program engagement. Among the weight management subgroup (n = 170), mean weight change was −2.1% (SD 5.1). Participants achieved significantly greater weight loss if they met the 6-session engagement benchmark (β −3.5%, p < 0.01). Weight management is a popular focus for health coaching participants, and these programs can achieve modest weight loss. Programs should consider designing and testing strategies that promote engagement, given that weight-loss success was improved if participants completed at least 6 coaching sessions.
AB - Insurers and employers are increasingly offering lifestyle and weight-loss coaching programs; however, few evaluations have examined their effectiveness. Our objectives were to determine whether level of program engagement was associated with differences in healthcare utilization and weight pre/post coaching. We conducted a retrospective evaluation of enrollees in an insurer-based telephonic health coaching program in Maryland (2013–2014). Our independent variables were program engagement benchmarks (≥3 and ≥6 sessions). Our dependent variables included change in outpatient and emergency department (ED) visits (more visits post program, fewer visits post, or no change pre-post) and associated costs (difference pre-post) using claims data. We calculated mean percent weight change from baseline. We used multivariate-adjusted linear and multinomial logistic regression, as appropriate, to examine the association between outcomes and engagement benchmarks. We included 225 enrollees with mean age 50.7 years, 81.3% women, and mean body mass index of 35.0 kg/m2. Most participants focused on weight management (75.6%) and improving general health (57.8%). Few individuals had outpatient or ED visits, and no significant changes in healthcare utilization were associated with program engagement. Among the weight management subgroup (n = 170), mean weight change was −2.1% (SD 5.1). Participants achieved significantly greater weight loss if they met the 6-session engagement benchmark (β −3.5%, p < 0.01). Weight management is a popular focus for health coaching participants, and these programs can achieve modest weight loss. Programs should consider designing and testing strategies that promote engagement, given that weight-loss success was improved if participants completed at least 6 coaching sessions.
KW - Health insurance
KW - Health services research
KW - Risk reduction behavior
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U2 - 10.1016/j.pmedr.2018.10.024
DO - 10.1016/j.pmedr.2018.10.024
M3 - Article
C2 - 30425918
AN - SCOPUS:85056206810
SN - 2211-3355
VL - 12
SP - 343
EP - 348
JO - Preventive Medicine Reports
JF - Preventive Medicine Reports
ER -