Personal Health Coaching as a Type 2 Diabetes Mellitus Self-Management Strategy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

Objective: Personal health coaching (PHC) programs have become increasingly utilized as a type 2 diabetes mellitus (T2DM) self-management intervention strategy. This article evaluates the impact of PHC programs on glycemic management and related psychological outcomes.

Data sources: Electronic databases (CINAHL, MEDLINE, PubMed, PsycINFO, and Web of Science).

Study inclusion and exclusion criteria: Randomized controlled trials (RCT) published between January 1990 and September 2017 and focused on the effectiveness of PHC interventions in adults with T2DM.

Data extraction: Using prespecified format guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework.

Data synthesis: Quantitative synthesis for primary (ie, hemoglobin A1c [HbA1c]) and qualitative synthesis for selected psychological outcomes.

Results: Meta-analyses of 22 selected publications showed PHC interventions favorably impact HbA1c levels in studies with follow-ups at ≤3 months (-0.32% [95% confidence interval, CI = -0.55 to -0.09%]), 4 to 6 months (-0.50% [95% CI = -0.65 to -0.35%], 7 to 9 months (-0.66% [95% CI = -1.04 to -0.28%]), and 12 to 18 months (-0.24% [95% CI = -0.38 to -0.10%]). Subsequent subgroup analyses led to no conclusive patterns, except for greater magnitude of effect size in studies with conventional (2-arm) RCT design.

Conclusions: The PHC appears effective in improving glycemic control. Further research is required to assess the effectiveness of specific program components, training, and supervision approaches and to determine the cost-effectiveness of PHC interventions.

Keywords: health behavior change; personal health coaching; self-management support; type 2 diabetes.