The coaching on lifestyle (CooL) intervention for obesity, a study protocol for an action-oriented mixed-methods study

Abstract

BackgroundCombined lifestyle interventions (CLIs) have proved to be effective in changing and maintaining behavioural lifestyle changes and reducing overweight and obesity, in clinical and real-world settings. In this CLI, lifestyle coaches are expected to promote lifestyle changes of participants regarding physical activity and diet. In the Coaching on Lifestyle (CooL) intervention, which takes a period of 8 to 10 months, lifestyle coaches counsel adults and children aged 4 years and older (and their parents) who are obese or are overweight with an increased risk of developing cardiovascular diseases or type II diabetes. In group and individual sessions, themes such as physical activity, dietary behaviours, sleep and stress are addressed. The aim of the present study is to monitor the implementation process of the CooL intervention and to examine how the lifestyle coaches contribute to a healthier lifestyle of the participants.MethodsThis action-oriented study involves monitoring the implementation process of the CooL intervention and examining the lifestyle changes achieved by participants over time, in a one-group pre-post design using mixed methods. Methods include semi-structured interviews, observations, document analysis, biomedical parameters and questionnaires.DiscussionThe added value of the CooL study lies in its action-oriented approach and the use of mixed methods, including both qualitative and quantitative research methods. The long-term coaching used in the CooL intervention is expected to have beneficial effects on sustained lifestyle changes.Trial registrationNTR6208; date registered: 13–01-2017.

Prevention and treatment of obesity

“…The present paper reports on a research study we undertook to evaluate the process of implementing the CooL programme. More detailed information on the intervention and research components can be found in our research protocol, which has been published elsewhere [123]. A more detailed discussion of research findings has also been published in a research report (in Dutch) [78]*.…”

“…A detailed description of the study protocol can be found elsewhere [123]. Below, we providemore details about the CooL intervention, followed by the study design and methods.…”

“…Children younger than 10 years were considered too young to fill out a questionnaire. The constructs measured in the questionnaires were based on the theoretical framework of this study [123], which consists of psychological needs, parenting, motivation, behaviour-specific cognitions (e.g. barriers) and energy balance-related behaviours, which were assumed to produce the health outcomes (i.e.…”

“…However, the primary focus of this study was on the imple-mentation process (i.e. following the implementation and changes among participants) [123], which reduced the need for a usual care control group. Previous studies on CLIs that did include a control group have shown relative stable patterns of behaviour and weight within the control group [148,149].…”

“…Insights into implementation issues obtained from previous intervention studies on both adults and children in The Netherlands [35,38,54,86] have led to the design of the Coaching on Lifestyle (CooL) intervention for people who are overweight or obese [123]. The present paper discusses the results of the CooL intervention in a longitudinal one-group pre-post study using validated questionnaires and objective data.…”