Lyndsey Thorne

Introduction/Problem

Over 70% of Americans are overweight or obese, increasing their risk for heart disease, stroke, cancer, and premature death. To improve likelihood of success, medical weight loss programs need to ensure patients’ have access to all resources, including a prepared support system. Good social support is linked to improved body mass and health habits. One wellness clinic in the Midwest had an evidence-based, group-style weight loss program that did not include patients’ social support. The purpose of this quality improvement initiative was to examine changes in patients’ body mass, health habits, and sense of support during formal program incorporation of the patients’ support system.

Methods

Adults in the program were asked to invite a support person to four sessions over two months. At each session, leaders discussed lifestyle changes and methods for support person encouragement and involvement. Data were collected five times, initially and two weeks after each session. Outcomes included body mass index, weekly minutes of physical activity and days of food journaling, and sense of support for healthy eating and physical activity from family and friends. Prior to analysis, data were separated into groups according to the number of sessions attended by a support person. Data were then examined using a repeated measures mixed ANOVA and the Friedman test, with post hoc testing as needed.

Findings

All groups had a statistically significant improvement in food journaling. Participants with no support person attendance had no other significant changes and clinically noted downward trends in sense of support from family for healthy eating and physical activity. Participants with a support person at 1-2 sessions had significant increases in sense of support from family for healthy eating and physical activity and improving trends in body mass index and physical activity. Participants with the most support, attendance at 3-4 sessions, had: 1) a significant decrease in body mass index, 2) significant increases in physical activity and sense of support from family for healthy eating and physical activity, and 3) upward trends in sense of support from friends for healthy eating and physical activity.

Practice Implications

Social support incorporation within the clinic’s group-style weight loss program is critical for patient success. The frequency of support person attendance is positively correlated with improvements in outcomes, including body mass, health habits, and sense of support. Further examination into types of support people, different group formats, and reasons for diffusely low support scores is needed. There are multiple opportunities for future quality improvement projects, such as incorporating social support in other, similar organizational programs, or using data collected for early intervention with collaborative partners, such as physical therapists and dieticians. Future research and projects would be best led by nurses, as they have extensive training in transformational leadership and multidisciplinary teamwork.