Efficacy of Health Coaching and an Electronic Health Management Program: Randomized Controlled Trial

Health Coaching Enhanced Older Adults' Self-Efficacy in Managing Their Chronic Diseases: A Randomized Controlled Trial

Although health coaching is a well-known self-management intervention for individuals with chronic diseases, the research on its effect on older adults is limited. A total of 414 older Hong Kong adults were randomly assigned to the intervention group, which received 12-week health coaching sessions, and the control group without intervention. Participants in the intervention group completed assessments at three time points (baseline, postintervention, and three-month follow-up), and those in the control group completed baseline and three-month follow-up assessments. Generalized estimating equations first revealed a significant improvement in self-efficacy and blood pressures among the intervention group participants, and such improvements were maintained at follow-up. In addition, the self-efficacy of the intervention group significantly increased while that of the control group significantly decreased from baseline to follow-up. Thus, the overall results demonstrate the effectiveness of the health coaching intervention in improving the self-efficacy of older adults in managing their chronic diseases and health risks.

Digital Health Literacy: A systematic review of interventions and their influence on healthcare access and sustainable development Goal-3 (SDG-3)

This study explores how interventions focused on digital health literacy (DHL) can improve access to healthcare and contribute to achieving Sustainable Development Goal-3 (SDG- 3). We scrutinized information from PubMed (MEDLINE), Scopus, and Web of Science released search articles from March 1, 2020 to January 31, 2024. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the review concentrated only on experimental studies that assessed how DHL initiatives have influenced enhancing patient health outcomes and access to healthcare. Research that did not cover DHL or the availability of healthcare, was not included. The analysis was primarily qualitative, focusing on thematic patterns and insights rather than statistical outcomes. Our results showed that DHL interventions typically result in enhanced health literacy, improved medication adherence, and higher self-confidence, particularly benefiting marginalized communities. Limitations to safe & accessible healthcare underscore the need for more focused and culturally appropriate strategies. This review shows that interventions by DHL can greatly enhance healthcare results, highlighting the need to tackle inequalities to ensure marginalized communities also benefit.

Assessing the Impact of Community Health Coaching on Self-Management of Chronic Illness Among Older Adults: A Cross-Sectional Approach

Background

Chronic illnesses among older adults require effective self-management strategies. Community health coaching, which provides personalized guidance and support, has shown promise in improving self-management behaviors and patient activation. This study examines the impact of health coaching on self-management among older adults and investigates the mediating role of patient activation.

Methods

A cross-sectional study was conducted with 200 older adults with chronic illnesses attending primary healthcare centers in Riyadh, Saudi Arabia. Data were collected using the Patient Activation Measure (PAM-13), Self-Management Behavior Scale (SMBS), and Health Coaching Perception Questionnaire (HCPQ). Multiple regression and mediation analyses were conducted to assess the relationships between health coaching, patient activation, and self-management behaviors.

Results

Health coaching was significantly associated with improved self-management behaviors (β = 0.42, p < 0.001). Higher satisfaction with coaching was related to better medication adherence and dietary modification. Patient activation partially mediated the relationship between health coaching and self-management, with an indirect effect coefficient of 0.22 (p < 0.01). The results highlight the role of activation in enhancing health coaching effectiveness.

Conclusion

Community health coaching positively influences self-management behaviors in older adults, with patient activation serving as a critical mediator. Integrating health coaching into primary care could improve chronic illness management and support healthy aging.

Application of artificial intelligence in the health management of chronic disease: bibliometric analysis

Background

With the rising global burden of chronic diseases, traditional health management models are encountering significant challenges. The integration of artificial intelligence (AI) into chronic disease management has enhanced patient care efficiency, optimized treatment strategies, and reduced healthcare costs, providing innovative solutions in this field. However, current research remains fragmented and lacks systematic, comprehensive analysis.

Objective

This study conducts a bibliometric analysis of AI applications in chronic disease health management, aiming to identify research trends, highlight key areas, and provide valuable insights into the current state of the field. Hoping our findings will serve as a useful reference for guiding further research and fostering the effective application of AI in healthcare.

Methods

The Web of Science Core Collection database was utilized as the source. All relevant publications from inception to August 2024 were retrieved. The external characteristics of the publications were summarized using HistCite. Keyword co-occurrences among countries, authors, and institutions were analyzed with Vosviewer, while CiteSpace was employed to assess keyword frequencies and trends.

Results

A total of 341 publications were retrieved, originating from 775 institutions across 55 countries, and published in 175 journals by 2,128 authors. A notable surge in publications occurred between 2013 and 2024, accounting for 95.31% (325/341) of the total output. The United States and the Journal of Medical Internet Research were the leading contributors in this field. Our analysis of the 341 publications revealed four primary research clusters: diagnosis, care, telemedicine, and technology. Recent trends indicate that mobile health technologies and machine learning have emerged as key focal points in the application of artificial intelligence in the field of chronic disease management.

Conclusion

Despite significant advancements in the application of AI in chronic disease management, several critical challenges persist. These include improving research quality, fostering greater international and inter-institutional collaboration, standardizing data-sharing practices, and addressing ethical and legal concerns. Future research should prioritize strengthening global partnerships to facilitate cross-disciplinary and cross-regional knowledge exchange, optimizing AI technologies for more precise and effective chronic disease management, and ensuring their seamless integration into clinical practice.

Lay health coaching intervention for older adults with chronic diseases: study protocol for a pragmatic randomised controlled trial

BACKGROUND

A large proportion of older adults suffer from chronic diseases. Health coaching is a promising intervention that enhances individuals' health knowledge and supports changes in health behaviours. Even though health professionals usually conduct health coaching interventions, lay health workers from different backgrounds account for a growing segment of health coaches over the years. The planned study's main objective is to investigate whether health coaching by lay health workers is as effective as that by health professionals.

METHODS

The effects of health coaching intervention by lay health workers will be examined in comparison with that by health professionals within a single-blind, multi-centre, randomised controlled trial with a follow-up assessment after 3 months. A total of 380 community-dwelling older adults with chronic diseases will be recruited and randomly assigned using a 1:1 ratio into the intervention and control groups. The intervention group will receive a 3-month health coaching intervention delivered by lay health workers, whereas the control group will receive the intervention delivered by health professionals. Primary outcomes include patient activation, physical activity and nutrition behaviours.

DISCUSSION

The expected findings of this study will advance the health coaching literature, research and practice by determining whether health coaching by lay health workers is as effective as that by health professionals in enhancing older adults' knowledge, skills and confidence in chronic disease self-management and promoting changes in health behaviours. If proven effective, the inclusion of lay health workers in delivering effective self-management interventions should be advocated to reduce the over-reliance on health professionals in the primary healthcare system.

TRIAL REGISTRATION

ISRCTN, ISRCTN73836238 . Registered 8 November 2023.

An Evidence Based Rationale for Health and Wellness Coaching as a Complementary Certification in Undergraduate Health Education

Health and wellness coaching (HWC) is an effective intervention for many chronic lifestyle diseases. Chronic diseases represent a majority of our severe national healthcare burden. Yet, HWC certification programs vary in delivery method and degree awarded. The purpose of this paper is to provide an evidence based rationale for HWC as a complementary area of study to non-licensure granting, undergraduate health degrees in higher education. A comprehensive review of the literature related to the efficacy of HWC was completed. In addition, the national program directory was mined for descriptive data for approved HWC programs. Given the growing body of support for HWC as an effective intervention, we recommend that institutions deliver HWC curricula as an academic minor for undergraduate students in non-licensure granting health-related degrees to position graduates for entry level careers in HWC. Evidence from the successful deployment of an undergraduate program in HWC supports our contention that HWC be delivered as an academic minor in support of lifestyle health and wellness education. In doing so, the field can offer HWC in a way that is widely accessible to the undergraduate population, while providing a mechanism for direct employment as a professional health and wellness coach.

The Impact of Health Coaching on Weight and Physical Activity in Obese Adults: A Randomized Control Trial

Health Coaching (HC) is an evidence-based, patient-centered approach to assisting individuals in achieving their health-related goals. Studies have generally shown positive effects of HC on weight loss in obese adults. However, limitations do exist, that if addressed would further clarify HC's viability as a clinical, obesity treatment approach. To examine the effects of HC on weight loss, moderate-to-vigorous physical activity (MVPA), and psychosocial constructs in obese adults. A randomized control trial with 44 [Mean body mass index (BMI) 36.5] middle-aged, White adults. Participants were randomly assigned to HC (n = 22) or control (n = 22) groups. A certified health coach provided bi-weekly, in-person and telehealth HC for 12 weeks. Percent excess weight loss was 15.7% in HC vs. 2.5% in controls (p< .001). The change in MVPA was significantly greater in HC (+50.3 min/wk) vs controls (+7.1 min/wk). Psychosocial constructs also changed more favorably in HC than controls. Health coaching is an effective approach for weight loss in obese adults. The results of this study support the consideration of HC as a treatment option for obese adults looking to lose weight.

Application of E-coach chronic disease management model in rehabilitation management of patients with arteriosclerosis obliterans

OBJECTIVE

To explore the effect of a health (E)-coach chronic disease management model on the rehabilitation behaviour management of patients with arteriosclerosis obliterans (ASO).

METHODS

The E-coach chronic disease management model was constructed based on a literature review and expert interviews. The effect of the E-coach model on patients with ASO during hospitalisation was analysed by comparing the compliance rates of blood glucose control, blood pressure control, drug compliance, ankle-brachial index, 6-min walking test (6MWT) and pain-free walking distance (PFWD) scores between the E-coach and control groups.

RESULTS

In total, 212 patients with ASO were included in this study. After the intervention, the blood pressure compliance rate (44.8% vs. 65.7%) and blood glucose compliance rate (48.6% vs. 66.8%) were higher in the E-coach group than in the control group (p < 0.05). After intervention, compared with the control group, the patients in the E-coach group had better drug compliance (6.8 ± 1.9 vs. 7.9 ± 1.0), and the difference was statistically significant (p < 0.05). The scores for the 6MWT (329.19 ± 5.58 vs. 353.00 ± 9.76; 412.65 ± 12.59 vs. 499.16 ± 18.43) and PFWD (219.15 ± 11.96 vs. 225.36 ± 16.13; 331.62 ± 51.36 vs. 369.42 ± 75.71) tests were significantly higher in the E-coach group than in the control group at 1 and 6 months after intervention (p < 0.05).

CONCLUSION

The E-coach chronic disease management model can effectively improve the control rates of blood glucose and blood pressure and the behaviour management of patients with ASO and is thus worthy of clinical reference.

Performance Evaluation of Hospital Economic Management with the Clustering Algorithm Oriented towards Electronic Health Management

In order to study the clustering algorithm based on density grid, the performance evaluation index system of hospital economic management under the application of electronic health management system is constructed. Firstly, this work designs the basic architecture of electronic health management system, classifies and screens the process of index system of electronic health management system, compares the clustering algorithm based on density grid with the simple clustering algorithm based on density or grid, and then applies it to the performance evaluation index system of hospital economic management. According to the principle of Mitchell scoring method, the expert questionnaire of hospital economic management performance evaluation index system was designed, and Delphi method was used to evaluate the candidate indexes from the three dimensions of right, legitimacy, and urgency. The results show that, compared with simple network clustering algorithm and density clustering algorithm, the clustering algorithm based on density network produces higher purity (94% VS 73% VS 67%) and lower entropy (0.9 VS 1.4 VS 1.54), which effectively saves memory consumption, and the difference is statistically significant (P < 0.05). The core indicators with scores above 4.5 in both dimensions include budget revenue implementation rate, budget expenditure implementation rate, implementation rate of special financial appropriation, asset-liability ratio, hospitalization income cost rate, medical insurance settlement rate, average cost of discharged patients, and drug proportion. The coefficient of variation of the first grade index is between 0.05 and 0.14 and that of the second grade index is between 0.05 and 0.15. Clustering algorithm based on density network has higher purity and lower entropy, which can effectively save memory consumption. The performance evaluation index system of hospital economic management finally determines 6 first-level indexes: budget management, financial fund management, cost management, medical expense management, medical efficiency, medical quality, and 25 second-level indexes.