The Impacts of a Primary Care-Based Dietitian Health Coaching Intervention on Patients' Health: An Observational Study

The objective of this study was to examine the cardiometabolic health of patients receiving a primary care-embedded dietitian administered health coaching intervention. We performed an observational analysis of clinical and questionnaire data from electronic health records (EHRs) among patients receiving the health coaching, including 3- and 6-month changes health and associations of patient characteristics and intervention exposure with outcomes. Questionnaires included health behaviors at baseline, 3, and 6 months. Biophysical data (weight [kg], BMI, HbA1c, blood pressure), number of coaching encounters, and demographics were also collected. Paired t tests and ANOVAs compared changes over time and subgroup differences. The analysis sample included 364 adults. Participants had significant weight reductions (mean decreases of -.96 and -1.07 kg after 3 and 6 months: ps < .0001) and BMI (6 months: -0.35 kg/m², P = .004). Among patients with diabetes or prediabetes, HbA1c values also significantly decreased (6 months: -0.55%; P = .018). Finally, the more coaching visits patients had, the greater their weight loss. Including dietitian-trained health coaches on primary care teams may improve clinical outcomes among patients at risk for or with chronic disease.