Primary care-based Lifestyle Course Effective at Improving Appalachian Health Behaviors

Abstract Background: Lifestyle interventions can be one of the most successful methods of preventing and treating chronic medical conditions to improve overall health. We assessed the effectiveness of a primary-care based free 8-week lifestyle course centered in Appalachia.

Abstract Methods: All participants who completed the Finding Wellness program from June 2017 to December 2020 were included. Participants completed a pre and post health habits survey. Height and weight were measured at the start and end of the 8-week session. Hemoglobin A1C was collected at the start and 3-month follow up. BMI and hemoglobin A1C were followed using health record data for 24 months post class. Health survey questions included topics on overall health, physical activity level, sleep, and eating patterns. Analysis comparing pre and post results was performed using SAS 9.4. Study approved by West Virginia University institutional review board.

Abstract Results: Three hundred and seventy-five individuals enrolled in the program during the study period. Most participants were white (96.2%) and female (60.8%). Average BMI reduced from 37.0 to 36.2, hemoglobin A1C in diabetics decreased 0.1 percentage points and BMI in diabetic patients decreased from 39.2 to 36.8 sustained over 24 months. Percentage reporting overall health status as good or very good increased from 61% to 74% (p < 0.01). Physical activity: Significant reduction in the number reporting they never participate in exercise 26.6% to 11.3% (p < 0.01) and never participate in stretching 61.5% to 32.4 % (p < 0.01). No changes seen in number participating in strength exercises. Eating patterns: Significant reduction in the number reporting never eating fruits 7.5% to 2.9% (p=0.04) and vegetables 8% to 2.9% (p=0.07). Significant reduction in those reporting they are not aware of the calorie content of foods they eat 27.4% to 7.5% (p < 0.01). No significant change in sleep habits.

Abstract Conclusion: Our findings from this project indicate effectiveness of a primary care-based lifestyle class in improving eating patterns, physical activity levels, weight, and hemoglobin A1c. Next steps are to collect data on more health behavior domains as well as over a longer period to determine sustainable change.

Funding: N/A

Conflict of Interest: The authors report no conflicts of interest related to this research.