The Motion Picture & Television Fund (MPTF) was motivated to implement a weight management program when disease management program participants across all disease states identified weight as a barrier to improvement. With health coaches already on staff and low program cost, MPTF found an effective way to reach a large population with their weight loss goals. The data suggests that participants achieved measurable weight loss with access to online resources and health coaching.

Key Strategies

Respond to identified needs of the population.
Evaluate resources and requirements before implementing a weight loss program.

Population

In 2005, Motion Picture Industry Pension & Health Plans (MPI) contracted with the MPTF to administer a disease management program for approximately 70,000 enrollees in the southern California region. For the past 89 years, MPTF, a non-profit organization, has provided health care, independent and assisted retirement care, memory care, childcare, financial support and social services to behind-the-scenes professionals in the entertainment industry. MPTF provides wellness health coaching to union workers in a variety of occupations, including for example, drivers, grips, and lighting technicians. Active participants (excludes retirees) are eligible for the health coaching.

Program Components

As more participants in the disease management program indicated weight as a barrier to improved health, MPTF added a weight management component to its program offerings. To initiate enrollment in the weight management program, the disease management health coach first encourages the participant to schedule a physician visit for clearance to exercise. Requirements to participate are minimal: BMI>=25, access to Internet connection, and basic computer skills.

The program consists of online lessons and health coach support. A total of 16 lessons provide weight management tools and last about 20 minutes each, and the participant is allowed to complete no more than one lesson per week. Weekly coaching is administered through the online system, via messaging or chat rooms. Health coaches are employees of MPTF, and the online program is provided by a third party software vendor.

Both online and physical tools and resources are provided to participants to support their weight management goals. Upon enrollment, the participant receives a calorie counter book that also includes fat grams. After completing the fourth lesson, the participant receives an accelerometer which measures steps and exercise. An online tracker provides information for both the participant and the coach on recommended activity levels, calorie and fat gram input and tracks the participant’s progress.

A Center for health and wellness adds to the offerings of MPTF. The Center features a warm water pool for aquatic therapy and exercise, a high-tech fitness gym, educational seminars and more to create a place for industry members 18 and older to improve their health and well-being. The staff of the Center includes physicians who specialize in the physical challenges of aging, health educators, physical therapists, occupational therapists, aquatic therapy experts and social workers.

Evaluation & Results

Out of 400 enrolled participants, 353 completed the orientation lesson and 31 percent completed the core curriculum of 16 lessons. The average initial weight was 203 pounds, and initial BMI was 32.13. Almost 79 percent of those enrolled in the program lost weight. The average change in BMI was -1.61. Twenty-two percent of the participants lost at least 7 percent of their initial body weight. In the group whose BMI was between 25 and 29.99, 30 percent had a final BMI less than 25, and for the BMI>40 group, 34 percent had a final BMI less than 40. Data also shows that weight loss increased with the number of completed lessons.

Challenges

The online system provided challenges for both the health coaches and the participants. The vendor was able to modify the system for some of the early problems identified. Health coaches were introduced to the system 3-4 months before the program launch to become familiar with the program.

Lessons Learned

Participants were very interested in an Internet based weight loss/weight management system. However, the participant’s level of computer skills affects program success. MPTF learned that communicating the computer requirement at the beginning of the program could help reduce problems down the road. Technical support was needed for some participants so that health coaches could devote their time to supporting program goals.
Sometimes, participants needed to try something several times before achieving success. The program drop-off rate, though anticipated, could have been an indication of dissatisfaction with the computer component but not lack of motivation to lose weight.
Program enrollment of smaller groups, on a monthly basis, was more manageable and avoided system overload.

Economy’s Effect on Program

An online weight management program can reach a large population in an inexpensive, accessible way. However, in spite of the low upfront cost, return on investment is not immediately realized; a minimum of one year is required to show measurable weight loss. A program’s ability to show sustainability and positive effect on disease prevention adds to its value.

Regulatory Issues

The online weight management program was compliant with HIPAA guidelines. To ensure secure messaging, the participants were required to establish a new email account within the program specifically for communication with the health coach.