1. Effect of a Health Coach on A1c Levels
Amanda J. Ferguson, BSN, RN; Abigail A. Kremer, BSN, RN; Anna C. Namey, BSN, RN & Jill M. Strahm, BSN, RN
Kim S. Hawkins, PhD, APRN, FNP-C
College of Nursing, Creighton University
Omaha, Nebraska
Background
Measures
Discussion
Diabetes affects over 29 million Americans and each year another 1.7 million individuals are diagnosed.
Diabetes leads to complications such as cardiovascular disease, stroke, peripheral vascular disease, neuropathy, and nephropathy.
It costs more than $245 billion each year to care for diabetic patients.
Disease management can be overwhelming to patients but a review of the literature demonstrates improved outcomes with diabetic health coaching.
To assess the effectiveness of the health coach, this study used the direct biochemical measurement of the Hgb A1c level.
Data was analyzed using a paired t-test method to determine statistical significance of Hgb A1c levels before and after diabetes health coach interventions.
Although this study did not show a statistically significant reduction in Hgb A1c after health coaching, it found that the majority of subjects did improve their Hgb A1c with an average improvement of 0.94%.
Further data needs to be gathered in order to improve the reliability of the convenience sample and to assess the impact of diabetic health coaches on glycemic control.
Limitations included small convenience sample at one Midwestern primary care clinic.
Purpose
The purpose of this MSN quality improvement scholarly project was to review Hgb A1c levels of adult patients with type II diabetes before and after consultation with a diabetic health coach to evaluate outcome improvement.
Methods
Results
54% had a reduction in Hgb A1c levels post diabetic health coaching.
Of the patients who reduced their Hgb A1c levels, the average hemoglobin A1c decline was as high as 0.94%.
Only 7% had no change in Hgb A1c.
39 patients had an increase in Hgb A1c values with an average increase of 0.83%.
There was not a significant difference in the Hgb A1c levels before diabetic education (M= 7.71, SD= 1.52) and after diabetic education (M=7.53, SD= 1.45); t(99)=1.36, p=0.18.
While there was not statistically significant findings from this study, there was still clinical significance, as the majority of patients showed improvement in their Hgb A1c values.
This study was a retrospective chart review of adult patients with type II diabetes at an urban Midwest primary care clinic.
The Hgb A1c levels of adults with type II diabetes who met inclusion criteria were recorded before they met with a diabetes health coach and after.
Acknowledgements
We would like to thank the providers, staff, and patients at the clinic where this project took place.
We would also like to thank Dr. Kim Hawkins for her guidance throughout this research study.