# Effectiveness of referral to a population-level telephone coaching service for improving health risk behaviours in people with a mental health condition: a randomised controlled trial

## TL;DR

A study found that referring people with mental health conditions to a telephone coaching service did not significantly improve health behaviors but increased attempts to make changes.

## Contribution

This study evaluates the effectiveness of telephone coaching for health behavior change in people with mental health conditions.

## Key findings

- Referral to the coaching service did not significantly improve health risk behaviors or weight/BMI.
- Per-protocol analysis showed increased attempts to improve health behaviors among program enrollees.
- Low program completion and the impact of COVID-19 may have influenced the results.

## Abstract

Telephone support services are a viable means of providing population-level support to reduce health risk behaviours. While research exists on the effectiveness of Quitlines to reduce smoking, there is limited other research investigating whether telephone services can provide effective behaviour change support for people with a mental health condition for behaviours including physical activity, healthy eating, and weight management. The aims of this trial were to evaluate the effectiveness of referral of people with a mental health condition to a population-level telephone coaching service to improve health risk behaviours and increase attempts to do so.

A parallel-group randomised controlled trial was conducted. Participants with a mental health condition (N = 681) were assigned to a control (health information pack) or intervention group (information pack and referral by the research team to a coaching program). Data were collected via telephone surveys at baseline and six months post-recruitment. Primary outcomes were: (1) weekly minutes of moderate-to-vigorous physical activity, (2) daily fruit serves, (3) daily vegetable serves, and (4) attempted behaviour change/weight loss (yes/no; composite measure). Secondary outcomes included weight, Body Mass Index (BMI), and attempts to change each health behaviour individually.

Intention-to-treat analyses found no significant differential change between groups from baseline to six months for primary or secondary outcomes. By follow-up, 242/549 (44%) of intervention participants had enrolled in coaching and completed at least one call, with 16/242 having completed the program, 79 ongoing, and 147 withdrawn. Per-protocol analyses found attempting to improve at least one health behaviour/lose weight was significantly greater in enrolees (OR = 3.7, 95% CI 1.03—13.23) than the control group.

Referral to the program did not improve risk behaviours or weight/BMI but did support behaviour change attempts. Contributing factors may include low program completion by follow-up and impact of COVID-19. Further research is required to better understand participation in and benefits of telephone coaching services for people with a mental health condition.

Registered retrospectively with the Australian New Zealand Clinical Trials Registry (ACTRN12620000351910).

The online version contains supplementary material available at 10.1186/s12889-025-21614-w.