Tennessee Medicine E-Journal


Background: Obesity is a leading driver of preventable chronic disease and Tennessee has some of the highest overweight and obesity rates in the nation. Among the BlueCare Tennessee Medicaid population, obesity is a top 10 chronic condition in both incidence and cost. In response, BlueCareSM implemented an interactive health education program to address lifestyle behaviors for overweight and obese members.

Objectives: To assess the impact of a health education program on BMI and confidence levels for making healthy lifestyle choices in a Medicaid population.

Methods: Health Educators provide individual education and coaching utilizing the New Leaf… Choices for Healthy Living curriculum. The program addresses healthy eating, physical activity, preventing and treating diabetes and other diseases, achieving a healthy weight, and tobacco cessation. Participants receive a toolkit including a workbook, cookbook, and supportive cooking and exercise tools. Behavior change data is collected through assessments upon enrollment into the program and at case closure.

Results: Comparison of pre/post weight management responses using the Wilcoxon signed rank test shows a significant difference (α=0.05) in reported confidence level for achieving recommended amounts of exercise, managing reasons for eating, and ability to purchase healthy food options, where participating members reported an average increase of approximately .5 on the Likert scale. Members who participated in the program had a significant BMI change (α=0.05), with an average reduction of 0.94 per member.

Conclusion: Early results indicate individual health coaching positively impacts BMI and confidence levels for making healthy lifestyle choices in the BlueCare Medicaid population.