Integrative health coaching for patients with type 2 diabetes: a randomized clinical trial.
The purpose of this study was to evaluate the effectiveness of integrative health (IH) coaching on psychosocial factors, behavior change, and glycemic control in patients with type 2 diabetes.



Fifty-six patients with type 2 diabetes were randomized to either 6 months of IH coaching or usual care (control group). Coaching was conducted by telephone for fourteen 30-minute sessions. Patients were guided in creating an individualized vision of health, and goals were self-chosen to align with personal values. The coaching agenda, discussion topics, and goals were those of the patient, not the provider. Preintervention and postintervention assessments measured medication adherence, exercise frequency, patient engagement, psychosocial variables, and A1C.



Perceived barriers to medication adherence decreased, while patient activation, perceived social support, and benefit finding all increased in the IH coaching group compared with those in the control group. Improvements in the coaching group alone were also observed for self-reported adherence, exercise frequency, stress, and perceived health status. Coaching participants with elevated baseline A1C (>/=7%) significantly reduced their A1C.



A coaching intervention focused on patients' values and sense of purpose may provide added benefit to traditional diabetes education programs. Fundamentals of IH coaching may be applied by diabetes educators to improve patient self-efficacy, accountability, and clinical outcomes.
The Duke Integrative Medicine, Duke University Medical Center, Durham, North Carolina (Dr Wolever, Mr Dreusicke, Dr Fikkan, Ms Hawkins, Ms Yeung, Ms Wakefield, Ms Duda)
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Wolever
The Duke Integrative Medicine, Duke University Medical Center, Durham, North Carolina (Dr Wolever, Mr Dreusicke, Dr Fikkan, Ms Hawkins, Ms Yeung, Ms Wakefield, Ms Duda)
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Dreusicke
The Duke Integrative Medicine, Duke University Medical Center, Durham, North Carolina (Dr Wolever, Mr Dreusicke, Dr Fikkan, Ms Hawkins, Ms Yeung, Ms Wakefield, Ms Duda)
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Fikkan
The Duke Integrative Medicine, Duke University Medical Center, Durham, North Carolina (Dr Wolever, Mr Dreusicke, Dr Fikkan, Ms Hawkins, Ms Yeung, Ms Wakefield, Ms Duda)
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Hawkins
The Duke Integrative Medicine, Duke University Medical Center, Durham, North Carolina (Dr Wolever, Mr Dreusicke, Dr Fikkan, Ms Hawkins, Ms Yeung, Ms Wakefield, Ms Duda)
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Yeung
The Duke Integrative Medicine, Duke University Medical Center, Durham, North Carolina (Dr Wolever, Mr Dreusicke, Dr Fikkan, Ms Hawkins, Ms Yeung, Ms Wakefield, Ms Duda)
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Wakefield
The Duke Integrative Medicine, Duke University Medical Center, Durham, North Carolina (Dr Wolever, Mr Dreusicke, Dr Fikkan, Ms Hawkins, Ms Yeung, Ms Wakefield, Ms Duda)
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Duda
Health Management Innovations, GlaxoSmithKline, Research Triangle Park, North Carolina (Ms Flowers, Dr Cook, Dr Skinner)
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Flowers
Health Management Innovations, GlaxoSmithKline, Research Triangle Park, North Carolina (Ms Flowers, Dr Cook, Dr Skinner)
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Cook
Health Management Innovations, GlaxoSmithKline, Research Triangle Park, North Carolina (Ms Flowers, Dr Cook, Dr Skinner)
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Skinner
D000284:Administration, Oral; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000523:psychology / Q000534:rehabilitation*; D004522:Educational Status; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007182:Income; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D010353:Patient Education as Topic; D018579:Patient Selection; D011584:Psychology; D012922:Social Change; D012945:Social Values; D013663:Teaching / Q000379:methods*
D007004:Hypoglycemic Agents