The Impact of Education Level on Weight Loss in a Primary Care-Anchored eHealth Lifestyle Coaching Program in Denmark: A Randomized Controlled Trial

Author:

Shahin Luma12,Olesen Thomas Bastholm3ORCID,Olsen Michael Hecht24,Laursen Ditte Hjorth5ORCID,Christensen Jeanette Reffstrup167ORCID,Brandt Carl J.13ORCID

Affiliation:

1. Research Unit for General Practice, Department of Public Health, University of Southern Denmark, 5230 Odense, Denmark

2. Department of Internal Medicine, Holbaek Hospital and Steno Diabetes Center Zealand, 2730 Herlev, Denmark

3. Steno Diabetes Center Odense, Odense University Hospital, 5000 Odense, Denmark

4. Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark

5. Liva Healthcare, Research and Innovation, 1434 Copenhagen, Denmark

6. DRIVEN, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230 Odense, Denmark

7. Research Unit of General Practice, 8000 Aarhus, Denmark

Abstract

In a randomized controlled trial including 340 people living with obesity, with and without type 2 diabetes, digital coaching has induced significant long-term weight loss compared to the usual methods of care. We investigated whether education level influenced this weight loss and which lifestyle changes supported the digital lifestyle coaching program. The intervention consisted of a 1 h face-to-face motivational interview followed by digital coaching using behavioral change techniques. At 6 months, the weight loss in the intervention group was significantly larger in participants with short education (6.0 vs. 2.2 kg, p < 0.01) (p = 0.006). Participants with long education experienced initially a modest weight loss, but the effect was maintained, leading to the largest weight loss at 24 months (5.06 [−11.98–1.86] kg), even though there were fewer coaching sessions in the maintenance period. In multiple regression analyses, the greater weight loss in the intervention group was associated with short education (β = 1.81, p = 0.02), improvements in everyday physical activity (β = 2.60, p = 0.014) and improvements in dietary habits (β = 3.84, p = 0.013). In conclusion, at 6 months, the effect of the intervention was more pronounced in people with short education through improvements in everyday physical activity and dietary habits. However, participants with long education sustained their weight loss at 24 months.

Publisher

MDPI AG

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