Integrative Health Coaching for Patients With Type 2 Diabetes

Abstract Context In this systematic review, we focus on the clinical impact of digital tools for providing health coaching, education, and facilitating behavior in patients with prediabetes or type 2 diabetes. Our approach was designed to provide insights for clinicians and health care systems that are considering adopting such digital tools. Evidence Acquisition We searched the CINAHL, Scopus, and Ovid/MEDLINE databases using PRISMA guidelines for studies that reported digital coaching strategies for management and prevention of type 2 diabetes published from January 2014 to June 2019. Articles were reviewed by 2 independent blinded reviewers. Twenty-one articles met inclusion criteria. Evidence Synthesis We found that 20 of 21 studies in our analysis showed statistically significant improvements in at least one measure of diabetes control including HbA1c, weight loss, fasting blood glucose, and BMI. Studies that reported weight loss percentage from baseline at 1 year reported values ranging from −3.04% to −8.98%, similar to outcomes with traditional coaching in the Diabetes Prevention Program (N = 4). Additionally, all studies that included a comparison group of in-person or telephone-based coaching showed statistically better or similar outcomes in the digital coaching group (N = 5). Conclusions The evidence reported in this systematic review suggests that digital health coaching offers a promising strategy for long-term management and prevention of type 2 diabetes in diverse populations with similar benefits to in-person or telephone-based health coaching. We argue that, with the potential to treat large numbers of individuals in diverse geographic locations, digital coaching offers a promising solution to the rapid increase in diabetes prevalence.

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Dietary Intervention for Glucose Tolerance In Teens (DIG IT): Protocol of a randomized controlled trial using health coaching to prevent youth-onset type 2 diabetes

Contemporary Clinical Trials ◽

10.1016/j.cct.2016.12.018 ◽

2017 ◽

Vol 53 ◽

pp. 171-177 ◽

Cited By ~ 1

Author(s):

Kelly A Wagner ◽

Ethan Braun ◽

Seth M Armah ◽

Diarmuid Horan ◽

Lisa G Smith ◽

...

Keyword(s):

Type 2 Diabetes ◽

Randomized Controlled Trial ◽

Glucose Tolerance ◽

Dietary Intervention ◽

Controlled Trial ◽

Health Coaching ◽

Onset Type ◽

Randomized Controlled

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Outcomes of a health coaching intervention delivered by medical students for older adults with uncontrolled type 2 diabetes

Gerontology & Geriatrics Education ◽

10.1080/02701960.2015.1018514 ◽

2015 ◽

Vol 38 (3) ◽

pp. 257-270 ◽

Cited By ~ 6

Author(s):

Jessica L. Krok-Schoen ◽

Rosemary Shim ◽

Rollin Nagel ◽

Jennifer Lehman ◽

Michelle Myers ◽

...

Keyword(s):

Type 2 Diabetes ◽

Older Adults ◽

Medical Students ◽

Health Coaching ◽

Coaching Intervention

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mHealth Technology and Nurse Health Coaching to Improve Health in Diabetes: Protocol for a Randomized Controlled Trial (Preprint)

10.2196/preprints.9168 ◽

2017 ◽

Author(s):

Sheridan Miyamoto ◽

Madan Dharmar ◽

Sarina Fazio ◽

Yajarayma Tang-Feldman ◽

Heather M Young

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Randomized Controlled Trial ◽

Self Efficacy ◽

Daily Activity ◽

Controlled Trial ◽

Health Coaching ◽

Patient Centered ◽

Randomized Controlled

BACKGROUND Chronic diseases, including diabetes mellitus, are the leading cause of mortality and disability in the United States. Current solutions focus primarily on diagnosis and pharmacological treatment, yet there is increasing evidence that patient-centered models of care are more successful in improving and addressing chronic disease outcomes. OBJECTIVE The objective of this clinical trial is to evaluate the impact of a mobile health (mHealth) enabled nurse health coaching intervention on self-efficacy among adults with type-2 diabetes mellitus. METHODS A randomized controlled trial was conducted at an academic health system in Northern California. A total of 300 participants with type-2 diabetes were scheduled to be enrolled through three primary care clinics. Participants were randomized to either usual care or intervention. All participants received training on use of the health system patient portal. Participants in the intervention arm received six scheduled health-coaching telephone calls with a registered nurse and were provided with an activity tracker and mobile application that integrated data into the electronic health record (EHR) to track their daily activity and health behavior decisions. All participants completed a baseline survey and follow-up surveys at 3 and 9 months. Primary and secondary outcomes include diabetes self-efficacy, hemoglobin A1c (HbA1c), and quality of life measures. RESULTS Data collection for this trial, funded by the Patient-Centered Outcomes Research Institute, will be completed by December 2017. Results from the trial will be available mid-2018. CONCLUSIONS This protocol details a patient-centered intervention using nurse health coaching, mHealth technologies, and integration of patient-generated data into the EHR. The aim of the intervention is to enhance self-efficacy and health outcomes by providing participants with a mechanism to track daily activity by offering coaching support to set reasonable and attainable health goals, and by creating a complete feedback loop by bringing patient-generated data into the EHR. CLINICALTRIAL ClinicalTrials.gov NCT02672176; https://clinicaltrials.gov/ct2/show/NCT02672176 (Archived by WebCite at http://www.webcitation.org/6xEQXe1M5)

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Effects of health coaching on health understanding and quality of life for type 2 diabetes patients

http://isrctn.com/ ◽

10.1186/isrctn15141896 ◽

2021 ◽

Author(s):

Deni Purnama ◽

Hadi Pratomo ◽

Rita Damayanti

Keyword(s):

Quality Of Life ◽

Type 2 Diabetes ◽

Health Coaching ◽

Diabetes Patients

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Process evaluation of a medical assistant health coaching intervention for type 2 diabetes in diverse primary care settings

Translational Behavioral Medicine ◽

10.1093/tbm/ibab144 ◽

2021 ◽

Author(s):

Taylor L Clark ◽

Addie L Fortmann ◽

Athena Philis-Tsimikas ◽

Thomas Bodenheimer ◽

Kimberly L Savin ◽

...

Keyword(s):

Type 2 Diabetes ◽

Primary Care ◽

Process Evaluation ◽

Health Coaching ◽

Adherence Rate ◽

Protocol Adherence ◽

Primary Care Settings ◽

Patient Reported ◽

Health Coaches

Abstract Team-based models that use medical assistants (MAs) to provide self-management support for adults with type 2 diabetes (T2D) have not been pragmatically tested in diverse samples. This cluster-randomized controlled trial compares MA health coaching with usual care in adults with T2D and poor clinical control (“MAC Trial”). The purpose was to conduct a multi-method process evaluation of the MAC Trial using the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. Reach was assessed by calculating the proportion of enrolled participants out of the eligible pool and examining representativeness of those enrolled. Key informant interviews documented adoption by MA Health Coaches. We examined implementation from the research and patient perspectives by evaluating protocol adherence and the Patient Perceptions of Chronic Illness Care (PACIC-SF) measure, respectively. Findings indicate that the MAC Trial was efficient and effective in reaching patients who were representative of the target population. The acceptance rate among those approached for health coaching was high (87%). Both MA Health Coaches reported high satisfaction with the program and high levels of confidence in their role. The intervention was well-implemented, as evidenced by the protocol adherence rate of 79%; however, statistically significant changes in PACIC-SF scores were not observed. Overall, if found to be effective in improving clinical and patient-reported outcomes, the MAC model holds potential for wider-scale implementation given its successful adoption and implementation and demonstrated ability to reach patients with poorly controlled T2D who are at-risk for diabetes complications in diverse primary care settings.

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