For chronic disease management, self-management strategies are essential to achieve sustained improvement.
Our study evaluated the efficacy of health coaching and a self-management strategy–based electronic program on self-management strategies for patients with osteoporosis, chronic respiratory disease, or arthritis.
Three-arm randomized controlled trial, pilot study
The first intervention group (n = 53) received a self-management strategy–based electronic program and 12 weeks of health coaching (20 sessions). The second intervention group received the information and communications technology (ICT) program; the control group received usual care and an educational booklet about self-management of chronic diseases.
The primary outcome was the difference in the change of the mean of self-management strategy scores. Secondary outcomes included depression (PHQ-9), physical activity (Godin Leisure Exercise Questionnaire), and health habit maintenance (transtheoretical model) after 12 weeks in the program.
The combination of health coaching and ICT was superior to control group (change 18.5 vs. − 2.6, adjusted difference = 24.5, p < 0.001); however, the ICT alone group was not superior to the control group (change 8.0 vs. − 2.6, adjusted difference = 8.0, p = 0.156). As a result of evaluating the change in the percentage of people with positive stage changes in the transtheoretical model of health habits, regular exercise (p = 0.008), a balanced diet (p = 0.005), helping others (p = 0.001), and living with loved ones (p = 0.038) showed significant differences. There was no significant difference in the changes in percentage of patients with depressive symptoms in comparison with control group; however, there was in comparison with control group among groups (p = 0.033). Compared to the control group, the proportion of patients who achieved an exercise amount of 12.5 MET or higher was significantly higher (p = 0.028) in the health coaching and ICT group.
The combination of ICT + health coaching led to improvement in self-management as well as in increasing exercise, and several healthy behaviors.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
Bauer UE, Briss PA, Goodman RA, Bowman BA. Prevention of Chronic Disease in the 21st century: Elimination of the Leading Preventable Causes of Premature Death and Disability in the USA. Lancet. 2014;384(9937):45-52. doi:https://doi.org/10.1016/s0140-6736(14)60648-6
Prince MJ, Wu F, Guo Y, Gutierrez Robledo LM, O’Donnell M, Sullivan R, et al. The Burden of Disease in Older People and Implications for Health Policy and Practice. Lancet. 2015;385(9967):549-62. doi:https://doi.org/10.1016/s0140-6736(14)61347-7
An S, Song R. Effects of Health Coaching on Behavioral Modification Among Adults with Cardiovascular Risk Factors: Systematic Review and Meta-analysis. Patient Educ Couns. 2020. doi:https://doi.org/10.1016/j.pec.2020.04.029
Tornivuori A, Tuominen O, Salanterä S, Kosola S. A. Systematic Review on Randomized Controlled Trials: Coaching Elements of Digital Services to Support Chronically Ill Adolescents During Transition of Care. J Adv Nurs. 2020;76(6):1293-306. doi:https://doi.org/10.1111/jan.14323
McCorkle R, Ercolano E, Lazenby M, Schulman-Green D, Schilling LS, Lorig K, et al. Self-management: Enabling and Empowering Patients Living with Cancer as a Chronic Illness. CA Cancer J Clin. 2011;61(1):50-62. doi:https://doi.org/10.3322/caac.20093
Katon WJ, Lin EH, Von Korff M, Ciechanowski P, Ludman EJ, Young B, et al. Collaborative Care for Patients with Depression and Chronic Illnesses. N Engl J Med. 2010;363(27):2611-20. doi:https://doi.org/10.1056/NEJMoa1003955
Hanlon P, Daines L, Campbell C, McKinstry B, Weller D, Pinnock H. Telehealth Interventions to Support Self-Management of Long-Term Conditions: a Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer. J Med Internet Res. 2017;19(5):e172. doi:https://doi.org/10.2196/jmir.6688
Birkhoff SD, Smeltzer SC. Perceptions of Smartphone User-Centered Mobile Health Tracking Apps Across Various Chronic Illness Populations: an Integrative Review. J Nurs Scholarsh. 2017;49(4):371-8. doi:https://doi.org/10.1111/jnu.12298
Yun YH, Kang E, Cho YM, Park SM, Kim Y-J, Lee H-Y, et al. Efficacy of an electronic health management program for patients with cardiovascular risk: randomized controlled trial. J Med Internet Res. 2020;22(1):e15057.
Yun YH, Jung JY, Sim JA, Lee J, Noh D-Y, Han W, et al. Development and validation of the smart management strategy for health assessment tool-short form (SAT-SF) in cancer survivors. Qual Life Res. 2018;27(2):347-54.
Yun YH, Jung JY, Sim JA, Choi H, Lee JM, Noh DY, et al. Patient-reported assessment of self-management strategies of health in cancer patients: development and validation of the Smart Management Strategy for Health Assessment Tool (SAT). Psychooncology. 2015;24(12):1723-30.
Haluza D, Jungwirth D. ICT. and the Future of Health Care: Aspects of Health Promotion. Int J Med Inform. 2014;84. doi:https://doi.org/10.1016/j.ijmedinf.2014.09.005
Park S-J, Choi H-R, Choi J-H, Kim K-W, Hong J-P. Reliability and validity of the Korean version of the Patient Health Questionnaire-9 (PHQ-9). Anxiety and mood. 2010;6(2):119-24.
Shephard R. Godin leisure-time exercise questionnaire. Med Sci Sports Exerc. 1997;29(6):S36-S8.
Prochaska JO, Velicer WF. The transtheoretical model of health behavior change. Am J Health Promot. 1997;12(1):38-48.
Hersey JC, Khavjou O, Strange LB, Atkinson RL, Blair SN, Campbell S, et al. The efficacy and cost-effectiveness of a community weight management intervention: a randomized controlled trial of the health weight management demonstration. Prev Med. 2012;54(1):42-9.
Rimmer JH, Rauworth A, Wang E, Heckerling PS. Gerber BS. A randomized controlled trial to increase physical activity and reduce obesity in a predominantly African American group of women with mobility disabilities and severe obesity. Prev Med. 2009;48(5):473-9.
Selvaraj FJ, Mohamed M, Omar K, Nanthan S, Kusiar Z, Subramaniam SY, et al. The impact of a disease management program (COACH) on the attainment of better cardiovascular risk control in dyslipidaemic patients at primary care centres (The DISSEMINATE Study): a randomised controlled trial. BMC Fam Pract. 2012;13(1):97.
Wolever R, Dreusicke M, Fikkan J, Hawkins T, Yeung S, Wakefield J, et al. Integrative health coaching for patients with type 2 diabetes. The Diabetes Educator. 2010;36(4):629-39.
Thomas ML, Fahey KF, Christine Miaskowski R, editors. A randomized, clinical trial of education or motivational-interviewing-based coaching compared to usual care to improve cancer pain management. Oncol Nurs Forum; 2012: Oncology Nursing Society.
Sacco WP, Malone JI, Morrison AD, Friedman A, Wells K. Effect of a brief, regular telephone intervention by paraprofessionals for type 2 diabetes. J Behav Med. 2009;32(4):349.
Linden A, Butterworth SW, Prochaska JO. Motivational interviewing-based health coaching as a chronic care intervention. J Eval Clin Pract. 2010;16(1):166-74.
Bennett GG, Herring SJ, Puleo E, Stein EK, Emmons KM, Gillman MW. Web-based Weight Loss in Primary Care: a Randomized Controlled Trial. Obesity. 2010;18(2):308-13. doi:https://doi.org/10.1038/oby.2009.242
Kumar S, Moseson H, Uppal J, Juusola JL. A Diabetes Mobile App With In-App Coaching From a Certified Diabetes Educator Reduces A1C for Individuals With Type 2 Diabetes. Diabetes Educ. 2018;44(3):226-36. doi:https://doi.org/10.1177/0145721718765650
This study was supported by the Korea Health Technology R&D Project through the Korea Health Industry Development Institute and by the Ministry of Health and Welfare, Republic of Korea (grant number: HI16C0455).
Conflict of Interest
The authors declare that they do not have a conflict of interest.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Prior presentations: None.
About this article
Cite this article
Kang, E., Park, S.M., Lee, K. et al. Efficacy of Health Coaching and an Electronic Health Management Program: Randomized Controlled Trial. J GEN INTERN MED (2021). https://doi.org/10.1007/s11606-021-06671-2
- health coaching
- ICT program
- chronic disease