Sustainable chronic disease prevention at scale: Evaluation of the Get Healthy Service, a telephone and online coaching service.

Abstract

The Get Healthy Service (GHS) is a free telephone and online health coaching service for adults delivered across New South Wales, Australia, since 2009. The GHS was first evaluated over 10 years ago and was shown to be effective. Using recent data, we investigated characteristics conducive to program completion and whether program impact has been sustained at scale. This evaluation used data collected during program delivery between December 2017 and May 2023. Descriptive and inferential analysis was used to measure program completion, and pre-post health risk behaviour change. Of 53,566 participants enrolled in the GHS, 34 % completed the program. Multivariable analyses showed that men, people aged 50+ years, and those who did not identify as Aboriginal were more likely to complete the program. Program completers showed increased physical activity (43.5 mins/week; 95 % CI 40.55, 46.49), fruit intake (IRR 1.011; 95 % CI 1.08, 1.14) and vegetable intake (IRR 1.3; 95 % CI 1.27, 1.32); improvements in their BMI score (-0.51 kg/m²; 95 % CI -0.56, -0.45) and waist circumference (-2.74 cm; 95 % CI -2.96, -2.52); and improvements in sweet drink and takeaway food consumption. Compared to earlier evaluations, the impact of the GHS on health risk behaviours had decreased. Since its launch almost 15 years ago, GHS continues to confer improved anthropometric and lifestyle risk factors in adults, however the magnitude of effect has decreased since earlier evaluations. Efforts to sustain and improve the impact of the program, particularly amongst participants from most disadvantaged backgrounds, is needed.