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

BMC Public Health

Research

Onur Cem Doğru¹  Paul Norman²  Samantha J. Caton³  Elizabeth Goyder³  Abdullah N. Almulhim⁴  Hannah Hartley⁵ 

[1] Department of Psychology, Afyon Kocatepe University, Gazlıgöl St, 03200, Afyonkarahisar, Turkey;Department of Psychology, The University of Sheffield, Cathedral Court, The University of Sheffield, Vicar Ln, S1 2LT, Sheffield, UK;School of Health and Related Research, The University of Sheffield, 30 Regent St, S1 4DA, Sheffield, UK;School of Health and Related Research, The University of Sheffield, 30 Regent St, S1 4DA, Sheffield, UK;Public Health Department, College of Health Sciences, Saudi Electronic University, 13316, Riyadh, Saudi Arabia;Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, BD9 6RJ, Bradford, UK;

关键词: Health behaviour change;    Health coaching;    Self-management;    Behaviour change techniques;    Type 2 diabetes;   

DOI  :  10.1186/s12889-022-14874-3

 received in 2022-08-16, accepted in 2022-12-15,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundGiven the high rates globally of Type 2 Diabetes Mellitus (T2DM), there is a clear need to target health behaviours through person-centred interventions. Health coaching is one strategy that has been widely recognised as a tool to foster positive behaviour change. However, it has been used inconsistently and has produced mixed results. This systematic review sought to explore the use of behaviour change techniques (BCTs) in health coaching interventions and identify which BCTs are linked with increased effectiveness in relation to HbA1C reductions.MethodsIn line with the PICO framework, the review focused on people with T2DM, who received health coaching and were compared with a usual care or active control group on HbA1c levels. Studies were systematically identified through different databases including Medline, Web of science, and PsycINFO searches for relevant randomised controlled trials (RCTs) in papers published between January 1950 and April 2022. The Cochrane collaboration tool was used to evaluate the quality of the studies. Included papers were screened on the reported use of BCTs based on the BCT taxonomy. The effect sizes obtained in included interventions were assessed by using Cohen’s d and meta-analysis was used to estimate sample-weighted average effect sizes (Hedges’ g).ResultsTwenty RCTs with a total sample size of 3222 were identified. Random effects meta-analysis estimated a small-sized statistically significant effect of health coaching interventions on HbA1c reduction (g+ = 0.29, 95% CI: 0.18 to 0.40). A clinically significant HbA1c decrease of ≥5 mmol/mol was seen in eight studies. Twenty-three unique BCTs were identified in the reported interventions, with a mean of 4.5 (SD = 2.4) BCTs used in each study. Of these, Goal setting (behaviour) and Problem solving were the most frequently identified BCTs. The number of BCTs used was not related to intervention effectiveness. In addition, there was little evidence to link the use of specific BCTs to larger reductions in HbA1c across the studies included in the review; instead, the use of Credible source and Social reward in interventions were associated with smaller reductions in HbA1c.ConclusionA relatively small number of BCTs have been used in RCTs of health coaching interventions for T2DM. Inadequate, imprecise descriptions of interventions and the lack of theory were the main limitations of the studies included in this review. Moreover, other possible BCTs directly related to the theoretical underpinnings of health coaching were absent. It is recommended that key BCTs are identified at an early stage of intervention development, although further research is needed to examine the most effective BCTs to use in health coaching interventions.Trial registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021228567.

【 授权许可】

CC BY   
© The Author(s) 2023

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