New Patient Centered Approach to Unlock the Individual`s Potential to Adopt Healthy Lifestyles: Health Coaching
Keywords:Health coaching, person-centered approach, diabetes type 2, oral health, physical activity, toothbrushing, patient satisfaction, dental visit.
AbstractHealth Coaching (HC), a patient-empowerment focused approach, is guided and supported by the medical professional, to facilitate patient to explore, unlock and activate his/her self-potential to adopt healthy lifestyles. HC, a whole person and also a population-based approach, can be defined as a system-wide innovation aiming positive social change. A NHS review showed that there is promising evidence about HC, particularly for supporting behaviour change. HC in our international intervention project, to our knowledge, is used for the first time as a holistic health promotion approach for oral health and diabetes type 2 (T2DM) management; in line with IDF-FDI (2007) declaration stating that oral health promotion should be part of diabetes management. The aim of the present study is to assess the effectiveness of HC on oral health and T2DM management by use of clinical (HbA1c, periodontal health) and subjective measures (satisfaction with access to health care, frequency of physical activity, toothbrushing and dental visit) among T2DM patients. Our study`s preliminary results show that at post-intervention there was a significant reduction at HbA1c (Turkey:0.7%, Denmark:0.4%, p=0.001) in HC groups. The figures for HE groups were non-significant. Daily toothbrushing was correlated with change at HbA1c and regular physical activity in HC groups. Person-centered approach focusing on multidisciplinary collaboration is essential to improve the whole well-being of individual in daily life, and thereby the society, in line with WHO 2014 Geneva Declaration. HC, a promising new approach, can speak as one of the key implementations/approaches at health care-settings to meet this essentiality.
. 2014 Geneva Declaration on Person- and People centered Integrated Health Care for All. (2014) Available at: http://www.personcenteredmedicine.org/doc/2014_Geneva_Declaration_Released_May_27.pdf (last accessed 8 December 2015).
. Health. Available at:
. http://www.who.int/trade/glossary/story046/en/ (last accessed 8 December 2015)
. NHS. (2014). Does health coaching work? A rapid review of empirical evidence. Available at:https://www.eoeleadership.nhs.uk/ (last accessed 8 December 2015)
. WHO. (2015). WHO global strategy on people-centered and integrated health services Interim report Geneva, Switzerland: WHO Document Production Services. Available at: http://apps.who.int/iris/bitstream/10665/155002/1/WHO_HIS_SDS_2015.6_eng.pdf?ua=1&ua=1
. (WHO/HIS/SDS/2015.6 World Health Organization 2015) (last accessed 8 December 2015).
. Cinar, A.B., Oktay, I., Schou, L. (2014). Smile healthy to your diabetes: health coaching-based intervention for oral health and diabetes management. Clinical Oral Investigations 18:1793-801.
. Cinar, A.B., Schou, L. (2014). Health Promotion for Patients with Diabetes: Health Coaching or Health Education? International Dental Journal 64:20-28.
. Cinar, A.B., Schou, L. (2014). The role of self- efficacy in health coaching and health education for patients with type 2 diabetes. International Dental Journal 64:155-163.
. Cinar, A.B., Schou, L. (2014). Impact of empowerment on toothbrushing and diabetes management. Oral Health and Preventive Dentistry 12:337-344.
. Kernan, W.N., Viscoli, C.M., Makuch, R.W., Brass, L.M., Horwitz, RI. (1999). Stratified randomization for clinical trials. Journal of Clinical Epidemiology 52:19-26.
. Lambert, M.F., Wood, J. (2000). Incorporating patient preferences into randomized trials. Journal of Clinical Epidemiology 53:163-166.
. Kowalski, C.J., Mrdjenovich, A.J. (2013). Patient preference clinical trials: why and when they will sometimes be preferred. Perspectives in Biology and Medicine 56:18-35
. Chen, S.M., Creedy, D., Lin, H.S., Wollin, J. (2012). Effects of motivational interviewing intervention on self-management, psychological and glycemic outcomes in type2 diabetes: A randomized controlled trial.International Journal of Nursing Studies 49:637-44
. Miller, R., Rollnick, S. (2002). Motivational Interviewing – Preparing People for Change. New York: the Guilford Press, p. 428.
. Tosey, P., Mathison, J. (2006). Introducing Neuro-Linguistic Programming [online document], 2006. Centre for Management Learning & Development, School of Management, University of Surrey Available at: http://www.som.surrey.ac.uk/NLP/Resources/IntroducingNLP.pdf (accessed 07June 2015)
. Bandura A. (1997). Self-Efficacy: The Exercise of Control. New York:W.H. Freeman and Company, p. 604.
. WHO. (1997).Oral Health Surveys: Basic Methods.4th edition. Geneva.
. Cutress, T.W., Ainamo, J., Sardo-Infirri, J. (1987).The community periodontal index of treatment needs (CPITN) procedure for population groups and individuals. International Dental Journal 37:222-233.
. Winship, C., Radbill, L. (1994). Sampling Weights and Regression Analysis. Sociological Methods Research 23: 230-257
. Britt, H., Miller, G.C., Henderson, J., et al. (2013). General Practice Activity in Australia 2012-13: BEACH: Bettering the Evaluation and Care of Health. Australia: Sydney University Press, p. 134-135.
. Global Adult Tobacco Survey Collaborative Group. (2010). Global Adult Tobacco Survey (GATS): Sample Weights Manual, Version 2.0. Atlanta: GA, Centers for Disease Control and Prevention.
. Chromy, J.R., Abeyasekera, S. (2005). Chapter 19: Statistical analysis of survey data. In Household Sample Surveys in Developing and Transition Countries. United Nations, Department of Economic and Social Affairs.
. Alazri, M.H., Neal, R.D. (2003). The association between satisfaction with services provided in primary care and outcomes in Type 2 diabetes mellitus. Diabetes Medicine 20:486–90.
. Cecil, D.W, Killeen, I. (1997). Control, compliance and satisfaction in the family practice encounter. Family Medicine 29:653–657.
. Lee, Y.Y., Lin, J.L. (2011). How much does trust really matter? A study of the longitudinal effects of trust and decision-making preferences on diabetic patient outcomes. Journal of Patient Education and Counselling 85:406-412. doi: 10.1016/j.pec.2010.12.005.
. Lee, Y.Y., Lin, J.L. (2010). Do patient autonomy preferences matter? Linking patient-centered care to patient-physician relationships and health outcomes. Social Science and Medicine 71:1811-1818.
. Astrøm, A.N., Rise, J. (2001). Socio-economic differences in patterns of health and oral health behaviour in 25 year old Norwegians. Clinical Oral Investigations 5:122-128.
. Donovan, J.E., Jessor, R., Costa, F.M. (1993).Structure of health-enhancing behaviour in adolescence: a latent-variable approach. Journal of Health and Social Behaviour 34:346-362.
. Kiyak, H.A. (1993). Age and culture: influences on oral health behaviour. International Dental Journal 43:9–16.
. European Commission. (2009). Oral health. Available at:
. http://ec.europa.eu/public_opinion/archives/ebs/ebs_330_en.pdf (last accessed 8 December 2015
. McDonald, J., Jayasuriya, R., Harris, M.F. (2012). The influence of power dynamics and trust on multidisciplinary collaboration: a qualitative case study of type 2 diabetes mellitus. BMC Health Services Research 13; 12: 63 doi: 10.1186/1472-6963-12-63