Effectiveness of Health Coaching in Diabetes Control and Lifestyle Improvement: A Randomized-Controlled Trial

Abstract

Background: The study aimed to look into the effectiveness of a 6-month health coaching intervention for HbA1c and healthy diet in the treatment of patients with type 2 diabetes. Methods: The study was carried out via a two-armed, randomized controlled trial that included 114 diabetic patients at a medical center in Taiwan. During the 6-month period, the intervention group had health coaching and usual care for 6 months, and the control group had usual care only. The outcome variables were HbA1c level and healthy diet for follow-up measurement in the third and sixth month. Results: The study discovered a significant decrease in HbA1c and health diet improvement after the 6-month health coaching. Patients in the intervention group decreased their daily intake of whole grains, fruits, meats and protein, and fats and oils while increasing their vegetables intake. Conclusions: Health coaching may be conducive to the blood sugar control and healthy diet of patients with type 2 diabetes. Further study on health coaching with higher-quality evidence is needed.

Medical Nutrition Therapy in Diabetes Mellitus: New Insights to an Old Problem

“…These findings highlight the need for improved patient education concerning the optimal MNT. Indeed, according to a randomized controlled trial (RCT) conducted in Taiwan [ 4 ], an intensive and comprehensive health-coaching intervention for 6 months improved diet quality and glycemic control (assessed as HbA 1c concentrations) among patients with T2DM. Thus, the delivery of nutrition education should be considered a priority and an investment for improved outcomes among patients with DM.…”

Behavioural Change Techniques in Health Coaching-Based Interventions for Type 2 Diabetes Patients: A Systematic Review

“…Interventions were delivered by different personnel, ranging from trained undergraduate students [40] to certi ed professional health coaches [47]. Only ve out of 21 included studies relied on trained health coaches to deliver the interventions [32,34,35,37,47] while the rest were provided by people with different backgrounds including exercise physiology [44], community health [36], dentistry [28], nutrition [42], medicine [30,39,45], nursing [30,31,33,36,38,43], pharmacy [29], psychology [46] social science [46], undergraduate students [40], and patients' peers [41]. This may explain why coaching protocols are inconsistent or unstandardised, contributing to intervention variation and unpredictable outcomes, even while there was no conclusive evidence that interventions delivered by certain personnel were more or less effective.…”

“…Due to the inconsistent reporting of other demographic and socioeconomic characteristics, such as education, ethnicity and income status, across the 21 papers we were unable to report them here. The recruitment of participants was varied and drawn from different communities including ethnic community centres [36], community health centres [30,31,33,44], community advertisement [33,35,46,48], primary care or hospital clinics [28,39,42,43,47] and databases [29,34,38,41]. For clinical factors, including HbA1c, there were no discernible changes between the intervention and control groups at baseline.…”

“…The remaining 15 were grounded in different theories or frameworks. Most studies employed motivational interviewing [28, 32,33,36,38,41,44,45,47,48], two studies used cognitive-behavioural therapy [40,44], two studies used the transtheoretical model [33,39], and self-e cacy theory and social-cognitive theory were each used once [28]. The median effect size of MI-based interventions was d=0.4 with a range of 1.2 (1.3-0.1).…”

“…Although some studies showed good methodological quality due to their low bias [29,34,35,38,47], the majority were weak because of either high or unclear risk of bias [28, 30-33, 37, 39-46, 48]. Twelve of the 21 studies 21 [29, 31, 33-35, 38, 40, 42, 44, 45, 47, 48] described the method of randomization generation and 11 studies [29,31,34,35,38,41,42,44,45,47,48] used a concealed allocation schedule. The methodological quality of blinding participants and personnel on the assignment of participants to study groups were generally low due to either high or unclear bias in procedures across most studies and insu cient detail.…”