Role of general practice in the utilisation of the NSW Get Healthy Information and Coaching Service

Abstract

A lifestyle-modification telephone-based service is delivered in New South Wales (NSW; the Get Healthy Information and Coaching Service (GHS)) as an important obesity-prevention, population-wide program. The present study examined referrals from general practitioners (GP) versus self-referral to the GHS in terms of risk profile and effectiveness of outcomes. The study used a pre-post test design to assess changes in outcomes within the setting of a telephone-based lifestyle-support service available to NSW adults (18+ years) who self-referred or were referred by their health practitioner and/or GP, and registered for the GHS between February 2009 and August 2013 (n = 22 183). The GHS has two service components: (1) the provision of an information kit (one off contact) on healthy eating, being physically active and achieving and/or maintaining a healthy weight; and (2) a 6-month coaching program that includes 10 telephone calls aimed at achieving and maintaining lifestyle-related goals. Sociodemographic characteristics, referral source and self-reported anthropometric (height, waist and waist circumference (WC)) and behavioural risk factor (physical activity and nutrition-related behaviours) data were collected at baseline and at 6 months. Analysis revealed that GPs effectively recruited hard-to-reach subtargets, as well as adults who are obese and have an increased WC risk. Participants in the GHS coaching program, irrespective of GHS referral source, reported a mean weight loss of -3.8 kg, a decrease in WC of -5.0 cm and increases in both fruit and vegetable consumption and physical activity. In conclusion, GPs have an important role in GHS uptake (through proactive referral or as an adjunct to practice-based interventions) because they can recruit those most at need and facilitate improvements in their patients' risk factor profiles.

Identifying enablers and barriers to referral, uptake and completion of lifestyle modification programmes: a rapid literature review

“… 18 The empirical studies included in our review primarily described LMPs addressing cardiovascular diseases (7 of 11; 64%) 21 33 35 37–39 41 and diabetes (5 of 11; 45%). 35–38 41 These studies were conducted in Australia (6 of 11; 55%), 32–35 39 42 the UK (2 of 11; 18%), 36 37 the USA (1 of 11; 9%), 38 Canada (1 of 11; 9%) 43 and the Netherlands (1 of 11; 9%). 41 …”

Telephone‐delivered weight management services in the hospital outpatient setting: Decision‐makers’ perceptions of their use in routine practice

“…17 Participants referred by general practitioners compared with self-referral participants were more likely to request coaching compared with other referral sources that were more likely to request an information kit only. 17 This has also been demonstrated in smoking support services where improved reach 18,19 and representativeness 20 into smoking cessation support services was achieved when active referral processes were used compared with relying on self-referral alone. The Get Healthy Service facilitates a more integrated approach such as those seen in smoking cessation through Obesity management in the outpatient setting an established practitioner referral pathway where health professionals can directly refer patients into the service (via email or facsimile), with Get Healthy Service staff then contacting patients by telephone to invite them to participate in the service.…”

“…A pre–post observational study examined referral source of the Get Healthy Service . Participants referred by general practitioners compared with self‐referral participants were more likely to request coaching compared with other referral sources that were more likely to request an information kit only . This has also been demonstrated in smoking support services where improved reach and representativeness into smoking cessation support services was achieved when active referral processes were used compared with relying on self‐referral alone.…”

“…Integrating active referral protocols into the hospital setting may increase the number of patients engaging in such services. A pre–post observational study examined referral source of the Get Healthy Service . Participants referred by general practitioners compared with self‐referral participants were more likely to request coaching compared with other referral sources that were more likely to request an information kit only .…”

Healthy Lifestyle Program (HeLP) for low back pain: protocol for a randomised controlled trial

“…The GHS involves up to 10 individually tailored phone calls over a 6-month period, delivered by qualified and specially trained health professionals 51. Calls are usually made bimonthly for the first 3 months (n=6) to help facilitate behaviour change, with remaining calls tapering off for the following 3 months.…”