Impact of body mass index on the effectiveness of a disease management-health promotion intervention on disability status

Am J Health Promot. Jan-Feb 2010;24(3):214-22. doi: 10.4278/ajhp.081216-QUAN-306.


Purpose: To examine the impact of body mass index (BMI) on the effectiveness of a disease management-health promotion intervention among community-dwelling Medicare beneficiaries with disabilities.

Design: Secondary data analyses of a randomized controlled trial.

Settings: Nineteen counties in upstate New York and on the West Virginia-Ohio border.

Subjects: Four hundred fifty-two Medicare beneficiaries who participated in the Medicare Primary and Consumer-Directed Care Demonstration between August 1998 and June 2002 and completed the 22-month follow-up.

Intervention: Multicomponent disease management-health promotion intervention involving patient education, individualized health promotion coaching, medication management, and physician care management.

Measures: Body mass index and dependence in Activities of Daily Living (ADLs).

Analysis: Multivariate linear regression.

Results: The intervention resulted in significantly less worsening in ADLs dependence among normal-weight participants (coefficient, -.42; p = .04). However, the intervention did not have a significant effect for underweight participants (F test p = .33 vs. underweight participants in the control group) or overweight or obese participants (F test p = .78 vs. overweight or obese participants in the control group).

Conclusions: A positive effect of the intervention on disability was found among normal-weight participants but not among underweight or overweight or obese participants. Future health promotion interventions should take into consideration the influence of BMI categories on treatment effects.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Body Mass Index*
  • Disabled Persons*
  • Disease Management*
  • Female
  • Health Promotion / economics
  • Health Promotion / methods*
  • Health Services
  • Humans
  • Male
  • Self Care