| Problem statement. Health care providers are challenged to assist people with type 2 diabetes and obesity to manage their health. The distinct role of the health care provider as a coach in promoting health outcomes has not been previously tested. This study investigated the effect of perceived coaching on metabolic control and weight loss in a sample of people with type 2 diabetes and obesity who participated in a case management program for six months. Procedures. Sample participants enrolled in a study called Improving Control with Activity and Nutrition (NIDDK-NIH, DK 062942), and received three individual case manager visits, one fitness instructor session, and three support group sessions over six months. Baseline and six month measures included health behaviors, health perception, body weight, and glycosylated hemoglobin, and demographic information. Six month follow up data also included the perception of the case manager as a coach using the Perceived Coaching Scale (PCS). Results. The sample (N = 88) was 66% female, 78% Caucasian, and 80% married. All but one completed a high school diploma or equivalent. After six months, participants improved moderate and vigorous activity (t = -3.655, p = .000 t = -2.495, p = .015, respectively) and overall health perception (t = 2.78, p = .008), as well as reduced fast food meals consumed each week (t = 2.71, p = .008), glycosylated hemoglobin (t = 2.36, p = .021), body weight (t = 3.897, p = .000), and body mass index (t = 3.914, p = .000), indicating the desired effect of the case management intervention. Cronbach's alpha reliability of the PCS was maintained at .982 (as compared to .975 in the pilot study). Perceived coaching was mildly correlated with improvements in moderate activity and metabolic control (p = .002, and p = .004, respectively), but not with weight loss. Perceived coaching did not have an effect on weight loss. Regression analysis revealed perceived coaching to be a significant predictor of metabolic control, accounting for 9.2% of the variance in the model (sig. F change .020). Moderate activity mediated the effect of perceived coaching on metabolic control. Limitations. This study is limited by a small and homogenous sample. Repeat data collection after twelve months of ICAN case management participation will further evaluate the sustained effect of perceived coaching on health outcomes. |
