BackgroundThe prevalence of obesity and associated metabolic conditions continue to be challenging and costly to address for health care systems; 71% of American adults were overweight, with 35% of men and 40% of women diagnosed with obesity in 2014. Digital health coaching is an innovative approach to decreasing the barriers of cost and accessibility of receiving health coaching for the prevention and management of chronic disease in overweight or obese individuals.ObjectiveTo evaluate the early impact of a mobile phone-based health coaching service on weight loss and blood pressure management in a commercially insured population.MethodsThis was a retrospective study using existing registry data from a pilot commercial collaboration between Vida Health and a large national insurance provider, which enrolled adult members who were overweight (body mass index >25 kg/m2) and able to engage in a mobile phone-based coaching intervention. Participants received 4 months of intensive health coaching via live video, phone, and text message through the Vida Health app. Participants were also provided with a wireless scale, pedometer, and blood pressure cuff. Of the 1012 enrolled, 763 (75.40%) participants had an initial weight upon enrollment and final weight between 3 and 5 months from enrollment; they served as our intervention group. There were 73 participants out of the 1012 (7.21%) who had weight data 4 months prior to and after Vida coaching, who served as the matched-pair control group.ResultsParticipants in the intervention group lost an average of 3.23% total body weight (TBW) at 4 months of coaching and 28.6% (218/763) intervention participants achieved a clinically significant weight loss of 5% or more of TBW, with an average of 9.46% weight loss in this cohort. In the matched-pair control group, participants gained on average 1.81% TBW in 4 months without Vida coaching and lost, on average, 2.47% TBW after 4 months of Vida coaching, demonstrating a statistically significant difference of 4.28% in mean percentage weight change (P<.001). Among 151 intervention participants with blood pressure data, 112 (74.2%) had a baseline blood pressure that was above the goal (systolic blood pressure >120 mmHg); 55 out of 112 (49.1%) participants improved their blood pressure at 4 months by an entire hypertensive stage—as defined by the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.ConclusionsMobile phone app-based health coaching interventions can be an acceptable and effective means to promote weight loss and improve blood pressure management in overweight or obese individuals. Given the ubiquity of mobile phones, digital health coaching may be an innovative solution to decreasing barriers of access to much-needed weight management interventions for obesity.

Complex care management improved health-related motivation and provided a renewed sense of control for study participants, who were experiencing the loss of physical function and social well-being due to their chronic diseases. These findings support the importance of relationship-centered care models in programs for low-income, chronically ill patients. Future research should focus on identifying and spreading best practices that effectively empower patients to feel more in control of their health. (PsycINFO Database Record

Introduction. While quality of life (QoL) has become an increasingly important outcome measure following hematopoietic stem cell transplant (HSCT), ongoing support services available to patients post-HSCT patients are limited due to high cost and limited reimbursement. Smartphone devices offer a novel means by which to offer low cost, longitudinal support through the use of virtual health coaches. However there is little existing research on the acceptability and effectiveness of using smartphones to deliver health coaching for patients with malignant diseases after HSCT. Methods. Patients were recruited in the outpatient setting in the stem cell transplant clinic at MD Anderson Cancer Center to enroll in digital health coaching. Upon enrollment, patients were asked to download a smartphone application (Vida Health), which allowed participants to communicate in real time with a health coach through live video, phone, or text messages. Coaches provided health education, offered ongoing encouragement, and helped patients set small weekly goals to enhance nutrition, physical activity, stress management, and medication adherence. Patients completed the Functional Assessment of Cancer Therapy - Bone Marrow Transplant (FACT-BMT) survey at baseline and 3-month follow up. Results. A total of 62 patients completed at least 3 months of Vida health coaching. The median age was 56 years (45-72 years) and 41% were women. Time elapsed since HSCT ranged from 3 months to 9 months with primary diagnoses being: Myeloma 50%, Lymphoma 20%, Other Hematologic Malignancy 30%. Primary goals as stated by patients were: 72% optimizing nutrition, 60% stress management and emotional support, 60% remembering to take medications, 45% improving sleep, 20% staying physically active. 68% of patients sent at least one message to coach with an average 29 messages sent from patient to coach during the 3 month coaching period. FACT-BMT scores improved significantly after coaching with a 27% improvement in physical wellbeing (pre-coaching mean 6.1, post-coaching 4.7) and a 53% improvement in functional wellbeing (pre-coaching mean 13.8, post-coaching 21.1). Emotional wellbeing also increased 40% (from mean of 10.3 to 6.2). Conclusion. These preliminary findings suggest digital health coaching may help post-HSCT patients improve QoL, particularly among physical, functional, and emotional domains. We believe that utilizing novel tools such as smartphone-enabled health coaching may offer an important means by which to continue to support patients' wellbeing outside of the clinic. Disclosures Chen: Vida Health: Employment, Equity Ownership. Mao:Vida Health: Employment.