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James G. Christian, MSW, MABS; Daniel H. Bessesen, MD; Tim E. Byers, MD, MPH; Kyle K. Christian, BA/ED; Michael G. Goldstein, MD; Beth C. Bock, PhD

Arch Intern Med. 2008;168(2):141-146.

Background  Our objective was to test the effect of physicians providing brief health lifestyle counseling to patients with type 2 diabetes mellitus during usual care visits.

Methods  We conducted a randomized controlled trial of a 12-month intervention at 2 large community health centers, enrolling 310 patients with a body mass index (calculated as weight in kilograms divided by height in meters squared) of 25 or greater. In the intervention group, self-management goals for nutrition and physical activity were set using a tailored computer program. Goals were then reviewed at each clinic visit by physicians. The control group received only printed health education materials. The main outcome measures included change in physical activity and body weight.

Results  In the intervention group, recommended levels of physical activity increased from 26% at baseline to 53% at 12 months (P < .001) compared with controls (30% to 37%; P = .27), and 32% of patients in the intervention group lost 6 or more pounds at 12 months compared with 18.9% of controls (odds ratio, 2.2; P = .006).

Conclusion  A brief intervention to increase the dialogue between patients and health care providers about behavioral goals can lead to increased physical activity and weight loss.

Author Affiliations: PHCC LP, Pueblo, Colorado (Mr J. G. Christian and Ms K. K. Christian); Departments of Medicine (Dr Bessesen) and Preventive Medicine and Biometrics and University of Colorado Comprehensive Cancer Center (Dr Byers), University of Colorado at Denver and Health Sciences Center, Denver; Department of Endocrinology, Denver Health Medical Center (Dr Bessesen); Department of Clinical Education and Research, Institute for Health Care Communication, New Haven, Connecticut (Dr Goldstein); and Department of Psychiatry & Human Behavior, Brown Medical School, and Department of Psychology, Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island (Dr Bock).

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