The Effect of a Group Lifestyle Coaching Model on HbA1c and Psychosocial Constructs in Low-Income Patients with Type 2 Diabetes
This scholarly project has been submitted in partial fulfillment of requirements for a doctor of nursing practice degree at Southern Adventist University and is deposited in the McKee Library to be made available to borrowers under rules of the Library. Brief quotations from this manuscript are allowable without special permission, provided that the work is properly cited, the use is educational and not for profit, and the work is not altered. Requests for permission for extended quotation from or reproduction of this manuscript in whole or in part may be granted by the Dean of the School of Nursing when in his or her judgment the proposed use of the material is in the interests of scholarship. In all other instances, however, permission must be obtained from the author.
Abstract
The epidemic of diabetes and its complications is concerning, and new approaches need to be explored for fostering better patient outcomes in a cost effective way. This exploratory study examined the effectiveness of a group coaching model on glycemic control, diabetes knowledge, diabetes empowerment, and diabetes self-management compared to usual care or participation in a 90-minute diabetes education class. A convenience sample of 34 patients with type 2 diabetes mellitus was recruited at a clinic providing services to the uninsured. Participants self-selected into the coaching group (n = 12), class group (n = 10), or control group (n = 12). HbA1c and four psychosocial questionnaires were used in a repeated measures pre-test/post-test design. ANOVA, Kruskal-Wallis, paired-samples t test, Wilcoxon signed-rank test, ANCOVA, Pearson's product-moment correlation, and hierarchical multiple regression were used to examine relationships among the variables. Although results suggest that the coaching model did not improve glycemic control or the psychosocial indices measured, the coaching group had the least weight gain over the course of the study (.55 lbs ± 5.55). The contribution of the intervention group to the change in body weight remained significant even after adjusting for age, medication changes, and years with diabetes (R2 = .416, F(4,18) = 3.201, p < .0005; adjusted R2 = .286). A post-program evaluation completed by the coaching group revealed a positive group experience and several positive health behavior changes. Further research with a larger sample and longer time-frame would be beneficial to expand on this approach to diabetes care and diabetes self-management education.