Abstract P119: Patient Evaluation of Technology and Coach Interaction in the Maintain Prime Weight Loss Maintenance Trial in Primary Care
Authors: Kayla Jordanova, Maribel Cedillo, Polina Kukhareva, Chaorong Wu, Jesell Zepeda, Elizabeth Rudd, Jorie M Butler, Bernadette Kiraly, Michael Flynn, Kensaku Kawamoto, Molly B Conroy
Journal: Circulation (2024)

Background: Participant experiences with lifestyle interventions can influence long-term engagement and outcomes. MAINTAIN PRIME is a pragmatic clinical trial adapted from an effective EHR-based weight maintenance program and designed for implementation by primary care staff. The trial assesses if health coaching with lifestyle tracking tools through the EHR patient portal (MyChart) helps patients better maintain weight loss compared to tracking tools alone. In this report we evaluated interim feedback on technology and coaching. Methods: Participants were adults with BMI ≥25 and intentional weight loss of ≥5% through healthy lifestyle changes. Participants were randomized to health coaching with tracking tools (coaching) or tracking tools alone (tracking) over 24 months. We conducted surveys after 12 months of participation. The System Usability Scale (SUS) and a team-developed survey on MyChart tracking tools and overall satisfaction were given to both groups, while questions adapted from the Measure of Coach and Teacher Alliance-Teacher Report (Alliance) were given to the coaching group only. The SUS and Alliance were analyzed using published methods, and the MyChart survey was analyzed descriptively. Results: Out of 163 participants completing 12 months in MAINTAIN PRIME, 65 (40 in coaching and 25 in tracking groups, 39.9% response rate) responded to at least 1 survey by time of analysis. At baseline, the mean age was 48.1 years, and females represented 64.6% (42/65) of responders. Demographics of responders were similar to non-responders across a range of characteristics (p&gt;0.05). Participants rated the program usability as “good” with mean SUS score 70.2 (SD 18.4). There was no significant difference in SUS score by intervention arm (p=0.52). Most participants (56.9%, 29/51) were satisfied with their experience in the program and 51.0% (26/51) were likely to recommend it to others. Participants rated tracking tools as helpful for daily weight (51.0%, 26/51), steps (37.3%, 19/51), physical activity minutes (33.3%, 17/51), calories (23.5%, 12/51), and fat grams (11.8%, 6/51); 41.2% (21/51) of participants reported no use of tracking methods. Overall, 39.5% (17/43) of participants found tracking tools helpful. On the Alliance questionnaire participants rated aspects of health coaching as 3.3, 3.6, and 2.8 (on a 5-point Likert scale) for the coaching relationship, coaching process, and investment, respectively. Conclusions: MAINTAIN PRIME participants rated the usability of MyChart positively for health coaching and tracking tools, though less than half found tracking tools helpful. Health coaching was rated neutrally, suggesting further evaluation of transferability into a primary care and patient portal-based format is needed. Participant interviews are planned to further assess the acceptability of MyChart for health tracking and coaching.