What's an evidence-based dose of coaching in healthcare?

Updated: Apr 29




In February 2022, the American Journal of Lifestyle Medicine published our article entitled “Dosing of Health and Wellness Coaching for Obesity and Type 2 Diabetes: Research Synthesis to Derive Recommendations.”


The primary purpose of our study was to determine an effective initial amount (or dose) of health and wellness coaching to recommend to patients with obesity and/or type 2 diabetes (T2D). To make this determination, we closely examined the health and wellness (HWC) coaching literature using the previously published Compendium papers. After identifying 88 peer-reviewed articles (51 obesity; 37 T2D), we synthesized the amount of HWC effectively applied in this literature. We defined and quantified HWC programming using five variables:


1. session duration

2. session number

3. session frequency

4. program length

5. total HWC dose

The general dosing recommendations we derived for HWC are shown here:




This programming information can serve as a guideline for coaches when a patent asks, “How long will this take?” Now, the coach can provide an evidence-based answer to that important question.


Another important function of these HWC dose recommendations is to provide physicians a starting place when referring patients to coaching treatment or intervention. All treatments have initial dosing recommendations (e.g., 8 sessions of physical therapy, 16 weeks of cardiac rehabilitation, or 10 mg of a statin). Such prescriptions allow for patient planning while also enabling appropriate billing practices to be understood and arranged. Underlying all initial prescriptions, is the fact that every prescription is adaptable to accommodate patient needs. Everything from a medication to an exercise prescription, can be adjusted to fit an individual patient.


Flexibility is most certainly true for these HWC dosing recommendations. HWC is a patient-centric process, and these guidelines are in no way meant to change or violate this critical concept. All programming variables (from single session duration to program length and total HWC load) are ultimately determined by a patient and coach working together to determine how to best serve a patient.


The recommendations provided in this study provide a reasonable and initial coaching dose that would be effective in most circumstances. If you are practicing coach, use these guidelines to best suit your needs and the needs of your patients. These recommendations were derived from studies involving obese and diabetic patients. It is reasonable to extend these findings to other patient groups, awaiting more data.


HWC is a fast-evolving profession with need for science-based guidelines that support best practice guidelines. The recommendations in this article are appropriate for initial HWC programming guidelines. Dosing guidelines are sign of a maturing health profession. Check out the full paper to learn more about our investigation.

References

1. Sforzo GA, Kaye MP, Faber A, Moore M. Dosing of Health and Wellness Coaching for Obesity and Type 2 Diabetes: Research Synthesis to Derive Recommendations. American Journal of Lifestyle Medicine. 2022. On-line First. doi:10.1177/15598276211073078


2. Sforzo GA, Kaye MP, Todorova I, et al. Compendium of the Health and Wellness Coaching Literature. American Journal of Lifestyle Medicine. 2018;12(6):436-447. doi:10.1177/1559827617708562


3. Sforzo GA, Kaye MP, Harenberg S, et al. Compendium of Health and Wellness Coaching: 2019 Addendum. American Journal of Lifestyle Medicine. 2020;14(2):155-168. doi:10.1177/1559827619850489


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