Lifestyle course produces 'significant and sustained results' in Appalachia
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Key takeaways:
- A course on lifestyle interventions improved weight, A1C, eating patterns, perceived health status and more.
- However, there were no significant changes in sleep habits and strength training participation.
DENVER — A primary care-based lifestyle course improved several health behaviors in Appalachia, according to the results of research presented at the American College of Lifestyle Medicine’s annual meeting.
Lifestyle-focused interventions have proven to be some of the most sustainable and successful methods of preventing and treating chronic medical conditions to improve one’s overall health, Joshua J. Moore, MD, a family medicine resident at West Virginia University (WVU), and colleagues reported.
Moore told Healio that they evaluated the effectiveness of WVU Medicine’s “Finding Wellness” program — a free, group-based lifestyle intervention course including weekly targeted lessons for 8 weeks — to see if the one-time course could “produce true and lasting change over time.”
“Our goal of the research is to discover what we could be doing better or what needs to change in the course to make it more effective,” Moore said.
The researchers included 375 participants whose A1C and BMI were measured before and after the program and who completed health habit surveys asking about eating patterns, exercise, sleep and overall health.
Moore and colleagues saw major improvements in several areas. Notably, there was an increase in overall perceived health status as “good” or “very good” from 61% to 74% by the course’s end. Also, the BMI of overall participants before and after participation dropped from 37.01 to 36.16 and the BMI of those with diabetes dropped from 39.16 to 36.83.
“We are based in the West Virginia Appalachia region, where our levels of obesity and chronic conditions are among the highest in the country, and yet we are able to see this population make a sustainable difference in their own health through lifestyle changes,” Moore said.
Additionally, the proportion of those who said they would never participate in stretching decreased from 61.5% to 32.4% and those who said they would never participate in exercise decreased from 26.6% to 11.3%.
Regarding nutrition, the researchers also observed decreases among those who said they never ate fruits and vegetables — from 8% to 3% — and those who said they were unaware of their food’s calorie content — from 27% to 7%.
“Just a free 8-week course can produce significant and sustained results over time,” Moore said. “This class has zero education on medications as it solely focuses on lifestyle changes, proving the importance and effectiveness of lifestyle interventions as the mainstay of treatment.”
Although their results indicate the lifestyle course is effective in improving weight, A1C, physical activity levels, eating patterns and perceived health status, the researchers wrote that there were no significant changes in sleep habits or number of those participating in strength training exercises. A course update may be warranted to improve these areas, they wrote.
“We now offer the course through Zoom, making it easier for people to attend throughout the state and region,” Moore said.
Perspective
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Anecdotally, I would expect these interventions to be successful on many metrics because those who complete the program likely were targeted for low health literacy and high need. Certainly, these are patients who can show great progress and are often the most personally rewarding to observe. Several downsides in the design include limited sample size, lack of a control group and self-reported behavior. Interestingly, the study showed some failures to improve aspects of health, specifically sleep modulation and strength training behaviors. It is with both the above positive and negative findings that this study could be used to design a more comprehensive program. In the future, you would need a more forward-looking study that draws a hypothesis before making conclusions, then providing a clearer roadmap for program improvement and future impact.
Perspective
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Moore JJ, et al. Primary care-based lifestyle course effective at improving Appalachian health behaviors. Presented at: Lifestyle Medicine Conference; Oct. 29-Nov. 1, 2023; Denver.
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