ABSTRACT
Health coaching has emerged as a potential supporting tool for health professionals to overcome behavioral barriers, but its efficacy in weight management remains unclear. We conducted a systematic review and meta-analysis to synthesize and evaluate the quality of evidence supporting the use of self-reported health coaching for weight loss. Seven electronic databases (PubMed, Web of Science, Scopus, Cochrane, Psyinfo, Virtual Health Library, and Scielo) were independently searched from inception to May 2020. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation recommendations. Any study that investigated a self-reported health coaching intervention with the goal of inducing weight loss in individuals of any age, health, or training status was considered for inclusion. Quantitative data were analyzed using multilevel hierarchical metaregression models conducted within a Bayesian framework. A total of 653 studies were screened and 38 were selected for inclusion. The quality of evidence supporting outcomes based on the entire evidence base was very low and studies were deemed to have high risk of bias. Meta-analysis of controlled studies provided evidence of an effect favoring coaching compared with usual care but was trivial in magnitude [effect size (ES)0.5: -0.09; 95% credible interval (CrI): -0.17, -0.02]. The multilevel extension of Egger's regression-intercept test indicated the existence of publication bias, whereas a sensitivity analysis based only on those studies deemed to be of high quality provided no evidence of an effect of coaching on weight loss (ES0.5: -0.04; 95% CrI: -0.12, 0.09). Considered collectively, the results of this investigation indicate that the available evidence is not of sufficient quality to support the use of self-reported health coaching as a health care intervention for weight loss. This trial was registered at Prospective Register of Systematic Reviews (PROSPERO) as CRD42020159023.
Subject(s)
Mentoring , Weight Loss , Bayes Theorem , Health Personnel , HumansABSTRACT
RESUMEN La mayoría de las áreas del campo laboral del nutricionista, involucran en algún momento ya sea directa o indirectamente, estimular, guiar o inducir el cambio de conductas ligadas a la alimentación, proceso que se realiza a través de la enseñanza y el aprendizaje. Sin embargo, en la actualidad, esto se reduce en muchas ocasiones a la transmisión del conocimiento de manera unidireccional, donde la persona a cargo de realizar los cambios en realidad es un sujeto pasivo a cargo de seguir indicaciones. Por el contrario, el Coaching Nutricional (CN), es un proceso a través del cual la persona es totalmente activa en su cambio, identifica y vence sus obstáculos, crea el entorno adecuado, adopta una actitud y determinación necesarias para conseguir adaptar su alimentación, logrando a su vez mejorar otros aspectos de su persona y de su estilo de vida. En esto es clave evaluar el grado de motivación del sujeto, estableciendo estrategias específicas de acuerdo a los intereses y factores que motivan su cambio de conducta, de manera de favorecer la adherencia terapéutica y el cambio real de conductas en salud.
ABSTRACT Most of the areas of the nutritionist's labor field involve directly or indirectly stimulating, guiding or inducing the change of behaviors linked to food, a process that is carried out through teaching and learning. However, at present, this is often reduced to the transmission of knowledge in a unidirectional manner, where the person in charge of making the changes is actually a passive subject in charge of following directions. On the contrary, nutritional coaching is a process through which the person is active in their change, identifies and overcomes their obstacles, creates the appropriate environment, adopts the attitude and determination necessary to adapt their diet, and, in turn, improves other aspects of his/her person and lifestyle. Thus, it is key to evaluate the degree of motivation of the subject, establishing specific strategies according to the interests and factors that motivate their behavior change, in order to favor therapeutic adherence and a real change in health behaviors.
Subject(s)
Humans , Diet , Feeding Behavior , Treatment Adherence and Compliance , Motivation , MentoringABSTRACT
De acordo com o último relatório da Vigitel 2017 as Doenças Crônicas Não Transmissíveis (DCNT) são responsáveis por 68% de um total de 38 milhões de mortes ocorridas no mundo em 2012. No Brasil, esse cenário não é diferente: em 2011 as DCNT foram responsáveis por 68,3% do total de mortes. Milhares de dólares são gastos hoje com políticas que estimulam hábitos de vida mais saudável, mas essa estratégia, por si só, tem continuamente falhado em produzir resultados consistentes e duradouros. É necessário uma nova abordagem, que promova mudanças no estilo de vida, possibilitando a melhora dos parâmetros de saúde das pessoas. O processo de coaching apoia o desenvolvimento de um relacionamento de ajuda, incentivando o paciente a identificar sua visão, necessidades e objetivos. Além disso, o coaching visa ajudar na organização de rotinas e prioridades, enquanto coloca o paciente no controle de seu destino de saúde.
According to the latest Vigitel 2017 report, non-communicable chronic diseases accounted for 68% of a total of 38 million deaths worldwide in 2012. In Brazil, the scenario is no different; in 2011 the non communicable diseases were responsible for 68.3% of all deaths. Thousands of dollars are spent today on policies that encourage healthier living habits, but this strategy, by itself, has continually failed to produce consistent and long-lasting results. A new approach is needed that promotes lifestyle changes, making it possible to improve people's health parameters. The process of coaching supports the development of a helporiented relationship, encouraging patients to identify their vision, needs and goals. In addition, coaching aims to assist in the organization of routines and priorities, while putting patients in control of their health endgoal.
Subject(s)
Humans , Male , Female , Health-Disease Process , Chronic Disease , Public Health Systems , Life StyleABSTRACT
ABSTRACT Objective: To evaluate the introduction of coaching in the interdisciplinary care of individuals with type 1 diabetes mellitus in the public health care system. Subjects and methods: Ten patients routinely attending a public health care service and with a glycated hemoglobin (HbA1c) level above 75% participated in eight coaching sessions. This study evaluated the patients' self-management of the disease and personal behavior. The participants were assessed at the beginning of the program and on two occasions after the intervention, with evaluation of biochemical and anthropometric data, and frequency of self-monitoring of blood glucose (SMBG). Questionnaires were applied during these evaluations to analyze emotional burden (B-PAID), medication adherence (Morisky Adherence Scale), and self-efficacy (IMDSES). Results HbA1c had a median level of 8.0% (range 76-10.3%) at the beginning of the study and reduced significantly 3 months after initiation of the intervention (7.78% [6.5-10%], p = 0.028), with no significant increase at 6 months (8.3% [713-9.27%], p = 0.386). SMBG improved significantly from the beginning to the end of the study, with the median number of glucose tests per week varying from 16.5 (range 0-42) at baseline to 29.0 (7-42) at 3 months and 27.5 (10-48) at 6 months (p = 0.047). No significant differences were observed in anthropometric parameters or in the scores of the instruments between the three measurements. Conclusion: A coaching intervention focused on patients' values and sense of purpose may provide added benefit to traditional diabetes education programs and could be an auxiliary method to help individuals with type 1 diabetes achieve their treatment goals.
Subject(s)
Humans , Male , Female , Adult , Young Adult , Diabetes Mellitus, Type 1/psychology , Diabetes Mellitus, Type 1/therapy , Mentoring/methods , Self-Management/psychology , Glycated Hemoglobin/analysis , Blood Glucose Self-Monitoring/psychology , Pilot Projects , Patient Education as Topic/methods , Surveys and Questionnaires , Longitudinal Studies , Treatment OutcomeABSTRACT
BACKGROUND: Physical activity plays an important role in the management of chronic low back pain (LBP). Engaging in an active lifestyle is associated with a better prognosis. Nevertheless, there is evidence to suggest that patients with chronic LBP are less likely to meet recommended physical activity levels. Furthermore, while exercise therapy has been endorsed by recent clinical practice guidelines, evidence from systematic reviews suggests that its effect on pain and disability are at best moderate and not sustained over time. A limitation of current exercises programmes for chronic LBP is that these programmes are not designed to change patients' behaviour toward an active lifestyle. Therefore, we will investigate the short- and long-term efficacy of a multimodal intervention, consisting of supervised exercises, health coaching and use of an activity monitor (i.e. Fitbit Flex) compared to supervised exercises plus sham coaching and a sham activity monitor on physical activity levels, pain intensity and disability, in patients with chronic, nonspecific LBP. METHODS: This study will be a two-group, single-blind, randomised controlled trial. One hundred and sixty adults with chronic, nonspecific LBP will be recruited. Participants allocated to both groups will receive a group exercise programme. In addition, the intervention group will receive health coaching sessions (i.e. assisting the participants to achieve their physical activity goals) and an activity monitor (i.e. Fitbit Flex). The participants allocated to the control group will receive sham health coaching (i.e. encouraged to talk about their LBP or other problems, but without any therapeutic advice from the physiotherapist) and a sham activity monitor. Outcome measures will be assessed at baseline and at 3, 6 and 12 months post randomisation. The primary outcomes will be physical activity, measured objectively with an accelerometer, as well as pain intensity and disability at 3 months post randomisation. Secondary outcomes will be physical activity, pain intensity and disability at 6 and 12 months post randomisation as well as other self-report measures of physical activity and sedentary behaviour, depression, quality of life, pain self-efficacy and weight-related outcomes at 3, 6, and 12 months post randomisation. DISCUSSION: This study is significant as it will be the first study to investigate whether a multimodal intervention designed to increase physical activity levels reduces pain and disability, and increases physical activity levels compared to a control intervention in patients with chronic LBP. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT03200509 . Registered on 28 June 2017.
Subject(s)
Chronic Pain/therapy , Exercise Therapy , Exercise , Low Back Pain/therapy , Adolescent , Adult , Chronic Pain/physiopathology , Data Analysis , Humans , Low Back Pain/physiopathology , Middle Aged , Outcome Assessment, Health Care , Randomized Controlled Trials as Topic , Single-Blind Method , Young AdultABSTRACT
Se describe el coaching de salud como nueva tendencia en la promoción y educación sanitarias en el nivel primario de atención, tendiente a lograr el empoderamiento y autocontrol de pacientes con enfermedades crónicas no transmisibles. Se exponen las limitantes en la educación para la salud tradicional y las funciones del profesional en el citado nivel que decida ser coach; también se ofrecen ejemplos de técnicas de coaching, se evalúan las evidencias científicas de efectividad, así como se valoran la posibilidad de la intersectorialidad para apoyar los cambios conductuales y la necesidad de entrenar a los profesionales del sector para tales fines.
Health coaching is described as a new tendency in the health promotion and education in the primary health care, aimed at achieving the empowerment and self-control of patients with non-communicable chronic diseases. Restrictions in the education are exposed for the traditional health and the professional's activities in the mentioned level in which to be a coach; examples of coaching techniques are also offered, the scientific evidences of effectiveness are evaluated, and the possibility of intersectors participation to support the behavioral changes and the necessity of training the professionals of the Branch for such aims are evaluated as well.