Learning Objectives:
- Define health and wellness coaching (HWC) program load.
- List the initial HWC programming guidelines.
- Discuss limitations of the proposed HWC programming guidelines.
- Apply the HWC guidelines to a patient scenario.
“Health and well-being coaching (HWC) is an effective tool for assisting patients with obesity and/or diabetes manage disease. The purpose of this CME/CE is to provide physicians, and other clinicians, a better understanding of coaching thereby facilitating incorporation of a HWC strategy into practice to benefit their patients. Understanding dosing, and general guidelines for practice, is important for any treatment and HWC is no exception.”
Dosing of Health and Wellness Coaching for Obesity and Type 2 Diabetes: Research Synthesis to Derive Recommendations
Health and wellness coaching (HWC) is an effective intervention for lifestyle disease such as obesity and type 2 diabetes. The evolving HWC profession needs recommendations to guide clinical practice, particularly the appropriate dose of coaching.
The purpose of this paper was to systematically review and synthesize HWC literature to derive HWC programming recommendations. Of 102 papers retrieved, 88 were retained with data extracted determining HWC session number, frequency, duration, program length, and total coaching load. Differential analysis yielded no statistical difference in programming variables for randomized control trials and other designs, nor for studies with significant findings v. those not finding statistical significance, allowing these data to be pooled.
The HWC intervention for obesity was slightly more intense (15 sessions over 7-8 mo) than the diabetes programming (12 sessions over 9-10 mo). On average, HWC programming applied in the peer-reviewed literature was 12-15 sessions of 35-40 min duration over 7-9 months. These recommendations for HWC programming variables are put forth as initial practice guidelines and should be examined with comparative effectiveness study for optimization. HWC best practice guidelines for other patient groups (e.g., heart disease, cancer, and chronic pain) should also be studied once an adequate literature data base is available.