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Systematic Review
To examine the effectiveness of health coaching on changes in clinical health outcomes, health behaviors, and other key outcomes of interest to stakeholders.
Overall results suggest that self-identified health coaching interventions have the potential to produce small positive, statistically significant effects on HbA1c decreases, BMI reductions, physical activity increases, dietary fat reductions, and self-efficacy improvements when compared with inactive controls. This trend did not extend to studies with more robust comparators. The authors also saw a small positive, qualitative trend toward impact on total calorie reductions; however, they found only two studies that assessed this outcome. Some of these findings may result in effects that cross the clinically significant threshold. However, the relatively large number of studies at high or unclear risk of bias and the moderate to high heterogeneity in pooled estimates limit certainty about the interpretation of the findings and the conclusions that may be drawn.
Prior to conducting additional studies evaluating the effectiveness of health coaching, some foundational steps should be considered. First, both clinical and research fields would benefit from a consensus definition of health coaching. Next, training and/or credentialing required to become a certified health coach should be codified. Third, more stringent application of publication guidelines requiring full descriptions of study procedures, including randomization, blinding, and analytic methods, would allow for greater transparency and evaluation around risk of bias of complex behavioral interventions. Together, these steps would promote greater consistency in health coaching interventions, allow for more direct comparisons across studies, and promote more accurate evaluation of risk of bias.