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The effectiveness of health coaching intervention

on diabetic patients.

Submitted by: Haifa Hussain Hajlaa

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Chronic illnesses are becoming an increasingly serious public health issue

across the world. In the United States, almost half of individuals have at least

one chronic condition, and 26% have several chronic diseases ( Schuman.,

2017). Diabetes mellitus is an increasing global pandemic illness, with over

346 million people worldwide suffering from type 2 diabetes,

Diabetes mellitus is expected to become the world's sixth largest cause of

death by 2030 ( Sherifali et al.,2016). Diabetes mellitus has been on the rise

in recent years. Every year, seven million individuals are diagnosed with

diabetes, and one person dies from diabetes-related causes every ten

seconds ( Azar & Gabbay., 2019). Diabetes' high prevalence and its

accompanying comorbidities impose significant financial expenses on the

healthcare system, in addition to personal expenditures. Diabetes and its

complications cost Canada's healthcare system and economy more than

$11.7 billion in 2010, with that amount predicted to rise to $16 billion by 2020

(Doucet & Beatty., 2010). Patients' self-management support and participation

are required for education-based programs to modify their health habits

(Streisand et al., 2018).

Patients' knowledge and attitudes about self-care may improve with the use of

tools that give information about alternatives and consequences, but the

influence on behavior change is minimal. Improved self-efficacy methods

enhance the likelihood of behavior change, which leads to better health

outcomes and more appropriate healthcare usage ( Chapman et al., 2018). A

healthy lifestyle is important in patients care and help to prevent many lifestyle

diseases that are dramatically increasing during recent years ( Pronk et al.,

2014) Health coaching has become as a widely adopted intervention to help

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individuals with chronic conditions adopt health-supportive behaviors that

improve both the health outcomes and quality of life ( Ammentorp et al.,

2017).

Objective:

The aim of this study to examine the effectiveness health cotching

intervention to decrease (A1C) level among diabetes patients, in -----------,

Saudi Arabia.

Research questions:

Are the heath cotching interventions can reduce the level of (A1C) level

among diabetes patients?

PROBLEM STATEMENT

It is evident from the literature that the incidence of diabetes mellitus is

increasing and that although there is evidence that the complications of

diabetes can be prevented, there are still patients who lack the required

knowledge and skills to manage and control their condition. It is generally

accepted that diabetics must take responsibility for their own care and

treatment. Patients therefore have to acquire the relevant knowledge, skills

and attitudes for successful diabetes management. This implies adequate

diabetes education of patients as well as family members as a support group

(Chapman et al., 2018) This study is an attempt examine the effectiveness

health cotching intervention to decrease (A1C) level among diabetes patients,

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to make recommendations towards improved diabetic education which might

lead to improved adherence to the diabetic treatment regimen.

Literature review:

Health coaching is described as a healthcare professional providing health-

related information, behavior modification, and support; diabetic health

coaching provided by a healthcare professional with diabetes knowledge is

emerging as an effective intervention. Clinical health outcomes (such as

glycemic control), medication/treatment adherence, healthcare use (such as

emergency department visits), and adherence to evidence-based practices

have all been proven to improve with health coaching ( Streisand et al., 2018).

Health and wellness coaching have become a new strategy utilized in the

treatment and management of chronic diseases all around the world in recent

decades. Health coaching is a patient-centered, patient-driven illness

management method (Wolever et al., 2020). Despite the fact that there are no

gold standards for the definition of health coaches, standardized training

techniques and intensity, or intervention methodologies, some system-review

and meta-analysis research revealed that health coaching had a favorable

effect on type 2 diabetes treatment (Sherifali et al., 2016). Most diabetic

patients experienced excellent effects after participating in health coach

intervention, such as reduced hemoglobin A1c (HbA1c) values and lower

body mass index (BMI) (Blackberry et al., 2020) in numerous studies.

Patients' self-efficacy in diabetes self-management and leading a healthy

lifestyle increases with health coaching (Sherifali et al., 2016). The findings of
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the few published randomized controlled trials (RCTs) on the use of health

coaching for diabetic patients have been inconsistent. Evidence synthesis is

needed to assess the efficacy of health coaching, specifically to look at the

components that are required for it to work and the circumstances in which it

is most beneficial. As a result, it is in our best interests to perform testing in

areas where few study health coach clinical trials have been undertaken, as

well as to investigate the practicability and efficacy of health coaches in Saudi

Arabia.

Methodology

Ethical Approval:

Ethical Approvals: Approvals to conduct this study will obtained from the

Institute Review Board the ------------------ and Ministry of Health in Saudi

Arabia. Also, For the participants who agreed to participate in the study,

consent forms along with an explanation of the study purpose will be given to

the participant to be signed prior to the data collection date. Also, participant

will be informed that they can withdraw from the study at any time.

Search Strategy

Many studies have been published in the last ten years. The effect of

health catching and diabetes disease, to get the most relevant and recent

studies in this filed. Three databases PubMed, Google scholar and Science

direct, were searched. The search was limited to studies published between

2010 through2020. Due to the variety of term, used to health cotching, the
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following terms were used for this particular search, Diabetes Mellitus (DM),

Type 2 Diabetes Mellitus(T2DM), health cotching, intervention diabetes

disease, and reference lists of some key articles also yielded related studies.

A total of 324 studies were found. All abstract was reviewed. In addition,

studies that did not have an abstract also were reviewed. The studies were

included in this review if they met the inclusion criteria P: (Adults (aged> 18

years) with chronic disease, excluding mentally ill and disabled people ,I:

Health coaching by health care professional, C: Physiological, behavioral,

psychological and social outcomes, O: Original empirical studies: randomized

controlled trials or quasi-experimental studies published during 2010- 2021 in

English), based on the research question and PICO (the population (adults

with chronic disease excluding the mentally ill and disabled people),

intervention (health coaching by health care professionals), comparison of

types of outcomes (physiological, behavioral, psychological and social

outcomes) and the study design (randomized controlled trials or quasi-

experimental studies published during 2010-2021 in English)). Studies were

limited to those published from 2010 to 2021.

Inclusion criteria and study selection

The initial search process found a total of 1428 studies. The systematic

selection process was conducted in three phases to minimize the risk of

errors and bias and to ensure that all relevant studies were included. At first,

duplicate publications (n = 212) within the four different databases were

excluded from the review to reduce publication bias. In addition, studies not

published in English (n = 45) were excluded because of a lack of translation.

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Then, potentially relevant studies (n = 1321) were independently assessed by

the author by comparing the titles (n = 1276) and abstracts (n = 150) against

the predetermined inclusion criteria. Finally, the full texts (n = 58) were read

and screened to check if they met the inclusion criteria. In all cases,

consensus between reviewers was reached by discussion. ten studies were

included in the review before they were quality assessed.

Data extraction and synthesis

The following characteristics were recorded on a data extraction form: author

and year, study aim, design and sample, health coaching intervention (ways

of tailoring the intervention, duration, number of contacts and information

about the health care professional who delivered the health coaching),

outcome variables of the interventions and main findings (physiological,

behavioral, psychological and social outcomes). The data were synthesized in

a narrative way in relation to the study question. A meta-analysis was not

possible because of the differences in methods and results in the studies.