The Coaching on Lifestyle (CooL) Intervention for Overweight and Obesity: A Longitudinal Study into Participants’ Lifestyle Changes

Abstract

Combined lifestyle interventions (CLIs) can be effective in reducing weight and improving lifestyle-related behaviours but it is unclear how CLIs can best be implemented in practice in order to achieve sustained lifestyle changes. The Coaching on Lifestyle programme (CooL) is a CLI in the Netherlands, in which professional lifestyle coaches counsel adults and children (and/or their parents) who are obese or at high risk of obesity to achieve a sustained healthier lifestyle. The CooL intervention consists of group and individual sessions addressing the topics of physical activity, dietary behaviours, sleep and stress. Our longitudinal one-group pre-post study aimed to identify lifestyle changes among participants (adults, children and their parents) at 8 and 18 months after initiation. We assessed constructs ranging from motivation and behaviour-specific cognitions to behaviours and health outcomes. Positive and sustained changes among adults were found regarding perceived autonomy, motivation, perceived barriers, lifestyle behaviours, quality of life and weight. Among children and their parents, few improvements were found regarding behaviours and quality of life. CooL has been successful in coaching adult participants towards sustained behavioural change during the intervention period. Mixed results and smaller effect sizes were found for children and their parents.

The added value of frequent physical activity group sessions in a combined lifestyle intervention: A cluster randomised trial in primary care

“…The lack of a control group receiving no intervention does not allow causal conclusions about the effectiveness of CLI and CLI+, but results are in line with observational studies regarding effects on lifestyle and motivation of this specific CLI in primary care ( Rutten et al, 2014 , Helmink et al, 2011 ). Comparable lifestyle interventions have also shown positive results with regard to body composition, although the magnitude of changes differs between studies ( Knowler et al, 2002 , Look Ahead Research Group, 2010 , Tuomilehto et al, 2001 , Goodpaster et al, 2010 , Hardcastle et al, 2008 , Vermunt et al, 2012 , Driehuis et al, 2012 , van Rinsum et al, 2018 ). The decreases in BMI and waist circumference in the current study were markedly larger than found in three earlier studies ( Hardcastle et al, 2008 , Vermunt et al, 2012 , Driehuis et al, 2012 ).…”

“…Interventions of shorter duration and/or less guidance than e.g. the Look AHEAD trial yielded relevant effects on lifestyle and weight after six to twelve months of guidance ( Goodpaster et al, 2010 , Hardcastle et al, 2008 , van Rinsum et al, 2018 ), while others showed small or even no effects after 2.5 to three years of guidance ( Vermunt et al, 2012 , Driehuis et al, 2012 ).…”

“…In primary care settings, practice nurses have been suggested to function as a lifestyle coach (LSC) due to their expertise, contact with general practitioner (GP) and potential reach ( Goodpaster et al, 2010 , Hardcastle et al, 2008 , Vermunt et al, 2012 , Driehuis et al, 2012 ). Recently, in the Netherlands a programme delivered by LSCs showed favourable changes in psychosocial determinants, behaviour and weight ( van Rinsum et al, 2018 ). Yet, because many intervention trials were performed in researcher controlled settings and so few intervention trials have been executed in primary care settings ( Knowler et al, 2002 ), the question remains how much guidance is required and feasible in daily practice.…”

Prevention and treatment of obesity

“…A total of 13 lifestyle coaches, who had completed a post-graduate training course at the Dutch Academy for Lifestyle and Health (AV-LEG), were involved in the pilot programme. More information about the content of the programme can be found elsewhere, as well as the methods, techniques and working approaches used in the intervention [123,162].…”

“…The study protocol of the CooL study has been published and presents a detailed description of the study and the methods [123]. The lifestyle changes achieved among CooL participants have been reported in an earlier publication [162]. Briefly, the results showed positive and sustained changes among adults regarding motivation, behaviour-specific cognitions, lifestyle behaviours, quality of life and weight.…”