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INTRODUCTION: Coaching is proposed as a core enabling skill of occupational therapy and increasingly suggested for a diverse range of health populations. In recent years, research on coaching has proliferated, emerging from within and outside of occupational therapy. Yet, concern has been raised about the absence of theoretical underpinning and diversity of descriptions of coaching in occupational therapy, as well as low-quality evidence supporting its effectiveness. The aim of this study is to map the use of coaching by occupational therapists from 2007 to 2022 to identify the populations, settings and outcomes it is applied to, differences between coaching interventions and evidence supporting its use. METHODS: This systematic scoping review applied Arksey and O'Malley's five-stage methodological framework with further methodological direction using the Levac framework. There was no consumer involvement in undertaking this review. RESULTS: Findings from 60 research publications on coaching indicate its use with populations across the lifespan in primarily community settings to improve occupational performance, participation and self-efficacy. A wide range of coaching interventions are designed or used by occupational therapists, with Occupational Performance Coaching being the most researched (16/27, 59% of named interventions). Common elements of coaching interventions included collaborative goal setting and problem-solving; however, a lack of described theory or coaching methods persists. High-quality study designs indicate its effectiveness; however, an absence of fidelity definition or monitoring limits interpretation of many studies. CONCLUSION: The language of coaching is becoming common practice within occupational therapy, and evidence indicates effectiveness of some coaching interventions. Advances in coaching research and use by occupational therapists will be aided by an explicit statement of the theoretical basis for coaching interventions, with congruent coaching methods, mechanisms and outcomes stated. PLAIN LANGUAGE SUMMARY: This scoping review maps the use of coaching by occupational therapists in current published research. Key aspects of coaching examined include how coaching is defined, who it is used with and how effective it is. The kinds of outcomes that coaching is intended to improve are also reported. From 633 publications, 60 research publications were fully analysed. The use of coaching by occupational therapists has grown rapidly over the past 10 years. Strong evidence of its effectiveness exists for achieving the personal goals of people receiving occupational therapy when goals describe changes in everyday life activities. Coaching is being used with people across the lifespan with a variety of disabilities and chronic conditions and their caregivers/parents, most commonly parents of children with developmental issues. The key features of coaching interventions used by occupational therapists include collaborative goal setting, shared problem-solving and client-led action planning. Some elements of coaching are also used within other interventions with a wider range of methods. Coaching is believed to work by supporting an individual's self-belief that they can make changes. Theories that underpin coaching vary but commonly focus on self-determination, behaviour change and occupational therapy theory. However, many of the coaching interventions do not describe any theoretical basis nor coaching methods in detail. Future research on coaching in occupational therapy should ensure a clear explanation of the theory that underpins it, coaching methods and monitoring of how well coaching is applied.
RESUMO
The study aims to assess whether supplementation with the probiotic Lactobacillus rhamnosus HN001 (HN001) can reduce the prevalence of gestational diabetes mellitus (GDM). A double-blind, randomised, placebo-controlled parallel trial was conducted in New Zealand (NZ) (Wellington and Auckland). Pregnant women with a personal or partner history of atopic disease were randomised at 14-16 weeks' gestation to receive HN001 (6×109 colony-forming units) (n 212) or placebo (n 211) daily. GDM at 24-30 weeks was assessed using the definition of the International Association of Diabetes and Pregnancy Study Groups (IADPSG) (fasting plasma glucose ≥5·1 mmol/l, or 1 h post 75 g glucose level at ≥10 mmol/l or at 2 h ≥8·5 mmol/l) and NZ definition (fasting plasma glucose ≥5·5 mmol/l or 2 h post 75 g glucose at ≥9 mmol/l). All analyses were intention-to-treat. A total of 184 (87 %) women took HN001 and 189 (90 %) women took placebo. There was a trend towards lower relative rates (RR) of GDM (IADPSG definition) in the HN001 group, 0·59 (95 % CI 0·32, 1·08) (P=0·08). HN001 was associated with lower rates of GDM in women aged ≥35 years (RR 0·31; 95 % CI 0·12, 0·81, P=0·009) and women with a history of GDM (RR 0·00; 95 % CI 0·00, 0·66, P=0·004). These rates did not differ significantly from those of women without these characteristics. Using the NZ definition, GDM prevalence was significantly lower in the HN001 group, 2·1 % (95 % CI 0·6, 5·2), v. 6·5 % (95 % CI 3·5, 10·9) in the placebo group (P=0·03). HN001 supplementation from 14 to 16 weeks' gestation may reduce GDM prevalence, particularly among older women and those with previous GDM.