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/m2), 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.

KEYWORDS

Behavior change, BMI, interactive health coaching, readiness to change, self-efficacy, weight.

Employee weight management through health coaching

OBJECTIVE

This study will evaluate the effectiveness of an interactive health coaching intervention at lowering weight.

METHODS

The study involved 5405 overweight or obese employees aged 18-85, who entered the program sometime during 2001-2008.

RESULTS

Average body mass index (BMI) significantly decreased from 32.1 at baseline to 31.4 at 3 months, 31.0 at 6 months, and 30.6 at 12 months. Decreasing BMI was more pronounced in older age groups and among women, those using weight loss medication, those with higher BMI, and those with higher motivation and confidence to make behavior changes. When the effects of these variables on the decreasing trend in BMI were simultaneously estimated, only baseline classifications of BMI, health status, and confidence remained significant. Change in BMI through 12 months was -0.7% for those with normal weight, -2.0% for overweight, -3.6% for obese, and -7.1% for morbidly obese individuals at baseline. Among morbidly obese individuals, decrease in BMI through 12 months was -7.6% for those with "high" confidence to lose weight at baseline vs -4.4% for those with low confidence. Better health status at baseline was also related to more pronounced weight loss.

CONCLUSION

Interactive health coaching significantly lowered BMI among participants through 3, 6, and 12 months of follow-up.

The consultant orthodontic service--1996 survey

OBJECTIVE

To evaluate the working patterns and facilities of the consultant orthodontist service.

DESIGN

A cross-sectional survey.

SETTING

Consultant orthodontist departments in the UK.

SUBJECTS AND METHODS

All consultant orthodontists in the UK were sent a questionnaire that gathered information on the individual consultant, the facilities available, the new patients referred and patients under current treatment.

RESULTS

The consultant orthodontist service provided treatment to a high number of patients who were in definite need of orthodontic treatment. A marked reduction in the use of removable appliances suggests improving standards of care and provision of more complex treatment. The caseload was high and a fair proportion of patients were returned to their referring dentists with treatment plans. The consultant service has not completely evolved into a service that provides treatment at a super-specialist level alone.

CONCLUSIONS

There has been little change in the consultant orthodontist service over the past ten years. Arguably, this is because of the wishes of the purchasers and the shortage of trained orthodontic manpower as a direct result of poor manpower planning and lack of funds for post-graduate training.

Missing anterior teeth: treatment options and their orthodontic implications

Recent advances in restorative and surgical materials and techniques have increased the treatment options available for patients who are missing an anterior tooth. The factors influencing the management of such patients and the orthodontic implications of these treatment options are discussed in this paper.

The orthodontic/restorative interface. Restorative procedures to aid orthodontic treatment

Restorative procedures which complement orthodontic treatment and which may be carried out by the orthodontist are summarized. The importance of planning, with the restorative requirements in mind and the maintenance of prepared space (individual tooth or abutment positions) in all three planes of space during the period of retention, is described. The importance of liaison regarding the timing of the placement of the definitive restoration, if it is to be carried out by another dental surgeon, is stressed.

Autotransplantation of premolar teeth to replace missing maxillary central incisors

Orthodontic treatment decisions when maxillary central incisors are absent or are of poor prognosis, are discussed. Autotransplantation of mandibular first premolars to the incisor region is suggested as an approach in selected cases. The literature is reviewed, surgical technique described and case selection summarized. Cases are reported where autotransplantation of premolars to the maxillary incisor region has produced good functional and aesthetic results.

The diagnostic value of panoramic radiographs in children aged nine to ten years

The increased awareness of the possible harmful effects of ionizing radiation has resulted in concern at the number of panoramic radiographs taken in General Dental Practice. A study has been carried out to examine the diagnostic value obtained from panoramic radiographs taken at 9-10 years of age. Nine-hundred-and-eighty-two radiographs were examined and 261 (26.5 per cent) showed findings which would be of significance in orthodontic diagnosis and treatment planning.

Theoretical considerations of headgear therapy: a literature review. 2. Clinical response and usage

In Part 1 the literature on the direction and moment force systems of headgear therapy was discussed. The magnitude and duration of forces were briefly dealt with. In Part 2 the clinical response to the main directions of headgear force as reported in the literature will be described. Recommendations on the most appropriate direction and moment force systems for particular clinical situations will be made.

Theoretical considerations of headgear therapy: a literature review. 1. Mechanical principles

The literature of headgear therapy is reviewed and used to explain some of the theoretical mechanical principles of tooth movement and anchorage control achieved by this method. Part 1, Mechanical Principles, is a review of force directions, centres of rotation, force magnitude and duration. In Part 2, Clinical Response and Usage, the clinical uses of different directions of force are examined. Some of the clinical research into the changes produced by different headgears is described. An attempt is made to draw conclusions from the theoretical concepts discussed which may be of aid to the clinician.

Bilateral congenital fistulae of the lower lip

A case of bilateral congenital fistulae of the lower lip is reported and the condition briefly reviewed.

Inter- and intraexaminer variability in assessment of orthodontic treatment need

Two examiners assessed subjectively the orthodontic treatment need of a group of 183 10-year-old children. The examiners did not standardize the criteria establishing treatment need. Intraexaminer agreement was reached in 79.8% of the cases. Intraexaminer agreement was 91.7% for Examiner A and 93.4% of Examiner B. The paper highlights the subjective element in deciding orthodontic treatment need.