NORTH IDAHO ADVENTIST FREE CLINIC WEIGHT LOSS PROGRAM EVALUATION
Background: More than one-third of U.S. adults are obese and obesity is a primary risk factor for many leading causes of preventable death, including ischemic heart disease, stroke, type 2 diabetes and certain types of cancer. The annual healthcare cost of obesity in the U.S. is more than 150 billion dollars. Identifying and implementing effective weight loss interventions is imperative to improve the population health and decrease healthcare costs.
Process: The NIAFC weight loss program a spiritually-based, free of charge, four-month intervention. The program uses the workbook The Lord’s Table for spiritual content, and is grounded in the four foundational practices: Delighting in the Lord, Disciplined eating, Daily exercise, and Daily accountability (Cleveland, 2005). In addition to the workbook, the clinic physician provides four lectures on nutrition and exercise, and participants are paired with a volunteer accountability partner. Between 2008 and 2010, two to four participants went through the program offered one to two times each year. Only twelve participant records had sufficient data to be evaluated for changes in health outcomes. Variables extracted included weight, body mass index (BMI), lipids levels, and HgA1C, depending on individual health profile. Weight and BMI were measured four times and labs were measured zero to three times, with the goal of at least two times during the course of the program.
Outcomes: The 12 participant records included four men and eight women, ranging in age from 30 to 71 years. All but two participants had starting BMIs greater or equal to 30, ranging from 28 to 50. Participants lost between 4 to 34 lbs. Ten participants (83%) lost more than 9 lbs., and nine participants (75%) lost more than 15 lbs. Two participants had a net weight gain by the end of the program, 4 and 5 lbs. respectively. The four records reporting HgA1C showed a decrease. The five records reporting lipid levels showed a decrease in total cholesterol and LDL, and four of the five records showed a decrease in triglycerides. Three of the five records reported decrease in HDL over the course of the program. The NIAFC weight loss program incorporates four structured interventions and two types of behavioral interventions—daily accountability for four months and 60 lessons. The process evaluation found that the NIAFC spiritually-based weight loss program meets most of the evidence-based recommendations for effective weight loss programs.
Conclusions: The spiritually-based weight loss program offers evidence-based interventions that result in improved participant outcomes related to measurable indicators of obesity. Consistent and accurate documentation of participant data is needed to obtain accurate outcome measures and determine the effectiveness of the program. In addition, longitudinal data and participant perspectives would add rigor to the program evaluation process. Evaluation of spiritually-based weight loss programs are needed in order for providers to recommend their use.