(P31-027-23) Self-Efficacy as a Predictor of Weight Loss in Patients With Obesity or Elevated BMI Using a Health Coaching Intervention for Weight Management in Primary Care: The GEM Study

Objectives: To quantify changes in self-efficacy to resist overeating in patients enrolled in the Goals for Eating and Moving (GEM) intervention compared to patients receiving Enhanced Usual Care (EUC).

To highlight the relationship between self-efficacy and weight reduction in the GEM arm compared to the EUC arm.

Methods: We randomized 19 patient-centered medical home teams from two New York City healthcare systems to either the GEM or EUC arm. Eligible participants were English or Spanish-speaking patients (ages 18-69 years) with obesity (BMI >30 kg/m²) or with BMI >25 kg/m² and a weight-related comorbidity (ex. Hypertension). The GEM arm included a tablet-delivered goal setting tool, < 12 health coaching calls, and provider counseling. Patients in the EUC arm received health education materials. In each arm, BMI was measured, and Weight Efficacy Lifestyle surveys were administered at baseline and 12 months. Surveys included 8 items to quantify self-efficacy on a 10-point scale (0 = not at all confident, 10 = completely confident) with higher sum scores associated with increased likelihood to resist overeating. A mixed ANOVA was used to compare mean self-efficacy at baseline to 12 months (within-subjects factor) and between the GEM and EUC arms (between-subject factor). We then assessed the correlation between changes in self-efficacy and changes in BMI.

Results: Participants who completed the 12-month follow-up included 125 GEM patients and 170 EUC patients. The mean score for self-efficacy to resist overeating at baseline was 55.4 (SD 17.2) and 57.9 (SD 17.7) in the GEM and EUC arms respectively. At 12-months, mean self-efficacy increased to 64.7 (SD 15.7) and 61.5 (SD 16.4) in the GEM and EUC arms respectively. The difference in the change in self-efficacy between the GEM and EUC arm was significant (p < 0.001) with the GEM arm experiencing a greater increase in self-efficacy to resist overeating by 12-months. The correlation between change in BMI and change in self-efficacy was negative for the GEM and EUC arms (-0.137 and -0.256 respectively).

Conclusions: The GEM intervention significantly increased self-efficacy to resist overeating, which directly correlated with BMI reduction. Technology assisted health coaching interventions may improve the management and health outcomes of patients with elevated BMI.

Funding Sources: NIDDK [1R01DK111928]