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


METHODS
Secondary data analyses of a randomized controlled trial.


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


METHODS
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.


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


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


METHODS
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.
Meng
Hongdao
H
Stony Brook University, Stony Brook, New York, USA. hongdao.meng@stonybrook.edu
Wamsley
Brenda R
BR
Friedman
Bruce
B
Liebel
Dianne
D
Dixon
Denise A
DA
Gao
Song
S
Oakes
David
D
Eggert
Gerald M
GM
D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D006233:Persons with Disabilities; D019468:Disease Management; D005260:Female; D006293:Health Promotion / Q000191:economics / Q000379:methods*; D006296:Health Services; D006801:Humans; D008297:Male; D012648:Self Care