Factors Associated with Attrition and Success in a Worksite Wellness Telephonic Health Coaching Program

Objectives: This study identifies factors associated with attrition and improvements in body mass index (BMI) in a telephonic health coaching program. Methods: A cohort study design was used with 6,129 employees aged 21-88 years, enrolled in telephonic health coaching sometime during 2002 through 2008. Results: Attrition through 3, 6 and 12 months of follow-up was 13%, 17% and 36%, respectively. Those currently making changes in physical activity or nutrition had the highest BMI (kg/m(2)), lowest levels of exercise and the poorest overall health at baseline. They were also most likely to continue with health coaching through 12 months. Those not ready to make changes at this time or having maintained an appropriate level of physical activity or nutrition for more than six months were least likely to continue with health coaching through 12 months. They also had the lowest BMI, highest levels of exercise and the best overall health. Among those continuing with health coaching through 12 months, the percent decrease in BMI between baseline and 12 months was: 1.5% for normal weight, 2.7% for overweight, 4.1% for class I & II obesity and 7.2% for class III obesity; 4.3% for high confidence to lose weight, 3.5% for medium confidence to lose weight and 3.1% for low confidence to lose weight; and 3.8% for very good or good general health, 4.5% for average general health and 6.8% for poor/very poor general health. Conclusions: Attrition in the telephonic health coaching program is greatest among those least in need of behavior change. Of those who continued in the program, the greatest decrease in BMI occurred in those in greatest need for behavior change.