Chronic medical conditions such as diabetes, cardiovascular disease (CVD), and hypertension are highly prevalent among VA healthcare system users. Among VA patients, 72% have one or more chronic medical conditions (compared with 40% to 50% of other U.S. adults), and more than half have at least 2 chronic conditions. The management of chronic medical conditions is a time-consuming process for primary care physicians. One study found that it would take 828 hours per year to provide the required care for the top 10 chronic diseases. Thus, patients are increasingly being asked to take an active role in the self-management of their chronic medical conditions. Yet many patients leave a physician encounter confused about what to do to manage their own health due to conflicting and contradictory information.

Contents

• PREFACE
• ABSTRACT
• INTRODUCTION
• METHODS
  • TOPIC DEVELOPMENT
  • SEARCH STRATEGY
  • STUDY SELECTION
  • DATA ABSTRACTION
  • QUALITY ASSESSMENT
  • DATA SYNTHESIS
  • PRIORITIZATION OF HEALTH COACHING KEY ELEMENTS
  • RATING THE BODY OF EVIDENCE
  • PEER REVIEW
• RESULTS
  • LITERATURE FLOW
  • CHARACTERISTICS OF INCLUDED STUDIES
  • KEY QUESTION 1. Among adults, what is the effectiveness of health coaching on: a. Clinical health outcomes (eg, HbA1c, blood pressure): b. Patient health behaviors (eg, physical activity, weight management, diet, smoking, medication adherence): c. Self-efficacy
  • KEY QUESTION 2. Among adults, does the impact of health coaching vary by: a. Characteristics of the population (eg, type of chronic medical illnesses): b. Dose of the intervention (eg, number and frequency of sessions, minutes of contact): c. Mode of delivery (eg, individual visits vs group visits, face-to-face vs telephone): d. Types of individuals conducting coaching interventions (eg, peers, nurses, health educators, health coaches): e. Concordance with key elements of health coaching (ie, patient-centeredness, patient identification of goals, self-discovery process)
• SUMMARY AND DISCUSSION
  • STRENGTH OF EVIDENCE
  • SUMMARY OF EVIDENCE BY KEY QUESTION
  • CLINICAL IMPLICATIONS
  • LIMITATIONS
  • RESEARCH GAPS/FUTURE RESEARCH
  • CONCLUSIONS
• REFERENCES
• APPENDIX A. SEARCH STRATEGY
• APPENDIX B. STUDY CHARACTERISTICS TABLE
• APPENDIX C. STUDY QUALITY ASSESSMENT
• APPENDIX D. PEER REVIEW COMMENTS

Research Associate: Avishek Nagi, MS, Medical Editor: Liz Wing, MA

Suggested citation:

Gierisch JM, Hughes JM, Edelman D, Bosworth HB, Oddone EZ, Taylor SS, Kosinski AS, McDuffie JR, Swinkels C, Razouki Z, Masilamani V. The Effectiveness of Health Coaching. VA ESP Project #09-010; 2017.

This report is based on research conducted by the Evidence-based Synthesis Program (ESP) Center located at the Durham VA Medical Center, Durham, NC, funded by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Quality Enhancement Research Initiative. The findings and conclusions in this document are those of the author(s) who are responsible for its contents; the findings and conclusions do not necessarily represent the views of the Department of Veterans Affairs or the United States government. Therefore, no statement in this article should be construed as an official position of the Department of Veterans Affairs. No investigators have any affiliations or financial involvement (eg, employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties) that conflict with material presented in the report.