An Adaptation of Family-Based Behavioral Pediatric Obesity Treatment for a Primary Care Setting: Group Health Family Wellness Program Pilot

Efficacious Approach to Integrating Health and Wellness Coaching Into the Clinical Care for Weight Management: A Systematic Review and Proposal

“…Literature extensively shows health and wellness coaching is efficacious for weight management in a variety of primary care settings for obese and overweight patients ranging from children to adults (Table 1). Coaching has been successfully implemented in the care of children [44,45] , adolescents [46] , and adults [10,[47][48][49][50][51][52] . Coaching has also been incorporated into patient care with a variety of health professionals.…”

“…Coaching has also been incorporated into patient care with a variety of health professionals. This has been achieved with coaches plus PCP collaboration [8,10,4244,53] , with coaches alone [31,[44][45][46][47][48][49][50]52,53] , with physician coaches [34,46] , and with auxiliary health professional coaches such as Medical Assistants [38,47,54] , Nurse Practitioners [50] , and Registered Dietician Nutritionists [31] .…”

“…As to a method of implementing coaching in a clinical care process, this has been done for groups of patients [10] , parent-child groups [44,45] , via one-on-one sessions [10,31,34,38,[45][46][47][48][49][50]52] . Coaching was also integrated in-person [10,31,34,[46][47][48][49][50][51]54] and remotely via telephone [10,45,49,52] , a study-specific website [10] , email support [10,14] , as well as general mail, text message, and virtual video visit [45] .…”

“…The dosage of coaching interventions offered to patients varied as well including low-intensity or less than monthly coaching [31,4547,50] , moderate-intensity or at least monthly coaching [10,31,4951,54] , high-intensity or at least weekly [10,34,44,[46][47][48][49][50][51][52] , or with a combination of these throughout the intervention [10,31,47] . Length of intervention ranged from approximately four months [34,44,46] , six months [47,52,54] , approximately one year [45,[48][49][50] , and multiple years [10,31,51] .…”

“…Concerning health improvements, coaching has helped patients achieve clinically meaningful weight loss [10,31,[47][48][49][50][51]54] , maintain significant weight loss for two years [10,51] , decrease waist circumference [50] , decrease blood presure from hypertensive to normo tensive [49] , improve BMI from obese to normal [38,41,48] , normalize blood glucose levels [31,48] , and normalize cholesterol levels [31] . Other benefits of coaching included a general weight and fat loss [14,44,52,54] , lowered blood pressure [46] , lower triglyceride levels [46] , improved BMI [43][44][45] , lower HbA1c levels [43] , improved anthropomorphic body measurements [46] , 4 and behaviors conducive to weight loss [14,44,45,52] . Appel et al [10] RCT Clinically meaningful weight loss achieved and sustained in both intervention groups, with weight loss for both intervention groups being statistically significant compared to control (P < 0.001) with more individuals in the in-person HWC group achieving 5% or more weight loss (P = 0.73) compared to remote HWC Ball et al [46] RCT; Comparing HWC to single counseling session Compared to control, HWC groups had greater weight loss (P = 0.004 for HIP, P = 0.025 for YLP) and decreased BMI (P = 0.0002 for HIP, P = 0.03 for YLP).…”