Abstract Body: Introduction: Health coaching can expand the capacity of primary care providers (PCPs) in supporting patient self-management of overweight and obesity. Current platforms for weight management health coaching include in-person meetings, phone calls, and asynchronous online messaging. We seek to understand patient perceptions and facilitators and barriers to engagement with asynchronous, online coaching through the patient portal of the electronic health record (EHR).

Hypothesis: Patients will find EHR- and primary care-integrated health coaching acceptable for weight management.

Methods: Participants in MAINTAIN PRIME were primary care patients with BMI ≥25 before intentional weight loss of ≥5%, randomized to health coaching with tracking tools (coaching) vs. tracking tools alone. Coaching was performed by trained primary care staff via EHR messaging. We are conducting semi-structured interviews at 24-months with active and inactive participants in the coaching arm (active defined as remaining enrolled in trial and responding to messages within 1 week). An interview guide includes the domains of EHR platform for health coaching, patient-coach relationship, and coaching integration with primary care. We analyzed interviews via thematic analysis.

Results: Six of 11 completed interviews have been analyzed. Half of participants (3/6) were active, 66.7% were female (4/6), and average age was 39.6 years. Results to date reveal positive perceptions of the EHR platform for health coaching. Most participants found the platform convenient and liked the integration with other health records. Others stated a preference for separating coaching from medical care. Participants liked engaging with coaches at the time of their choosing. Messages were overall helpful, though sometimes felt impersonal and templated. Participants felt coaches were professional but lacked a personal connection, which could have improved with an initial in-person or video meeting. Lastly, many participants were unaware of coaching integration with their PCP teams other than the initial referral to coaching.

Conclusions: Overall, participants had positive perceptions of the coaching experience though noted some areas for improvement such as adding a face-to-face meeting with the health coach and further personalizing messages to promote stronger coaching relationships. Discussions between PCPs and coaching participants regarding weight management could bolster a sense of integration and support.