--- title: "Effectiveness of a group-based lifestyle change program | Sutter Health" description: "This study examines the effectiveness of a CDC and prevention-aligned lifestyle change program relative to usual care in clinical practice." url: "https://www.sutterhealth.org/research/publications/effectiveness-of-a-group-based-lifestyle-change-program-1055312802" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Effectiveness of a group-based lifestyle change program # Effectiveness of a group-based lifestyle change program versus usual care: an electronic health record, propensity score-matched cohort study Robert J. Romanelli, Hsiao-Ching Huang, Sylvia Sudat, Alice R. Pressman, & Kristen M. J. Azar _Am J Prev Med. 2020 Dec;59(6):850-859. doi: 10.1016/j.amepre.2020.07.002. Epub_ 2020-11-18 ## Abstract Introduction: Translational lifestyle change programs for community and clinical settings have been available for a decade, yet there are limited data on their comparative effectiveness. This study examines the effectiveness of a Centers for Disease Control and Prevention-aligned lifestyle change program relative to usual care in clinical practice. Methods: This was an electronic health record-based retrospective cohort study conducted in a community-based healthcare system. Investigators identified adult program participants and usual-care patients in the electronic health record between 2010 and 2018 and defined their index date (baseline) as the first lifestyle change program encounter or a random encounter date, respectively. Participants were matched 1:2 to usual-care patients on baseline demographics and clinical characteristics using propensity-score methods. Changes in body weight and blood pressure were examined from baseline through 24 months. Results: The authors identified 2,833 program participants and 438,432 usual-care patients meeting study eligibility criteria. A total of 2,833 program participants were matched to 4,776 usual-care patients; the average age was 54 years, and 80% of the participants were female. Program participation was associated with a 1.9- and 1.6-fold higher prevalence of clinically meaningful (≥5%) weight loss at 12- and 24-month follow-up than usual care and a higher prevalence of blood pressure control at 12 months but not at 24 months. Patients without type 2 diabetes at baseline had more pronounced outcomes than those with type 2 diabetes. Conclusions: This study demonstrates the effectiveness of an evidence-based, Centers for Disease Control and Prevention-aligned lifestyle change program in reducing cardiometabolic risk factors compared with usual care in clinical practice, with long-term reductions in weight and transient reductions in blood pressure. [PubMed abstract](https://pubmed.ncbi.nlm.nih.gov/33220755/) ![Kristen M J Azar, RN, MSN, MPH](https://dyn.mktgcdn.com/p/rFmyR1kiX8JzE5-XNwup0gVC1GRaVTlH7oSDlG0Tr5A/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) Kristen M J Azar, RN, MSN, MPH Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/kristen-m-j-azar-rn-msn-mph-1049680985) ![Sylvia Sudat, Ph.D.](https://dyn.mktgcdn.com/p/2AHRaDJwevdbwzC2ecrwY3nYIxbiqxd9NbpxBlI8Kpk/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) Sylvia Sudat, Ph.D. Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/sylvia-sudat-phd-1049681027) ## Research topics - [Comparative Effectiveness](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Comparative+Effectiveness%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Should we reconsider the routine use of placebo controls in clinical research?](https://www.sutterhealth.org/research/publications/reconsider-placebo-controls-in-clinical-research-1055312728) Avins AL, Cherkin DC, Sherman KJ, Goldberg H, Pressman A. Trials. 13:44. doi: 10.1186/1745-6215-13-44. 2012 Apr 27 - Publication ### [Selection bias modeling using observed data augmented with imputed record-level probabilities.](https://www.sutterhealth.org/research/publications/selection-bias-modeling-using-observed-data-1055312921) Thompson CA, Arah OA. Ann Epidemiol. pii: S1047-2797(14)00364-0. doi: 10.1016/j.annepidem.2014.07.014. \[Epub ahead of print\] 2014 Aug 12 - Publication ### [Behavioral therapy and serotonin reuptake inhibitor pharmacotherapy in the treatment of obsessive compulsive disorder: a systematic review and meta-analysis of head-to-head randomized controlled trials.](https://www.sutterhealth.org/research/publications/behavior-tx-and-sris-in-tx-of-ocd-review-of-trials-1055312711) Romanelli RJ, Wu FM, Gamba R, Mojtabai R, Segal JB. Depress Anxiety. 31(8):641-52. doi: 10.1002/da.22232. Epub 2014 Jan 3. 2014 Aug 01 - Publication ### [Minimran: a robust online system to implement minimization in randomized clinical trials.](https://www.sutterhealth.org/research/publications/minimran-online-do-minimization-rct-1055312971) Xiao L, Ma J. JSM Proc Biopharm Section. Alexandria VA: American Statistical Association 2014; 1094-1100. 2014 Aug 06 - Publication ### [Meta-analysis 101: what you want to know in the era of comparative effectiveness.](https://www.sutterhealth.org/research/publications/understand-meta-analyses-in-comparative-effectiveness-1055312642) Jones JB, Blecker S, Shah NR. Am Health Drug Benefits. 1(3):38-43. 2008 Apr 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/effectiveness-of-a-group-based-lifestyle-change-program-1055312802#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Effectiveness of a group-based lifestyle change program"}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/effectiveness-of-a-group-based-lifestyle-change-program-1055312802#medicalscholarlyarticle","name":"Effectiveness of a group-based lifestyle change program versus usual care: an electronic health record, propensity score-matched cohort study","headline":"Effectiveness of a group-based lifestyle change program","abstract":"Introduction: Translational lifestyle change programs for community and clinical settings have been available for a decade, yet there are limited data on their comparative effectiveness. This study examines the effectiveness of a Centers for Disease Control and Prevention-aligned lifestyle change program relative to usual care in clinical practice. Methods: This was an electronic health record-based retrospective cohort study conducted in a community-based healthcare system. Investigators identified adult program participants and usual-care patients in the electronic health record between 2010 and 2018 and defined their index date (baseline) as the first lifestyle change program encounter or a random encounter date, respectively. Participants were matched 1:2 to usual-care patients on baseline demographics and clinical characteristics using propensity-score methods. Changes in body weight and blood pressure were examined from baseline through 24 months. Results: The authors identified 2,833 program participants and 438,432 usual-care patients meeting study eligibility criteria. A total of 2,833 program participants were matched to 4,776 usual-care patients; the average age was 54 years, and 80% of the participants were female. Program participation was associated with a 1.9- and 1.6-fold higher prevalence of clinically meaningful (≥5%) weight loss at 12- and 24-month follow-up than usual care and a higher prevalence of blood pressure control at 12 months but not at 24 months. Patients without type 2 diabetes at baseline had more pronounced outcomes than those with type 2 diabetes. 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