Health Coaching for Cancer Survivorship

(HealthScore Trial)

Overseen By Carly Bailey, MA

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: UNC Lineberger Comprehensive Cancer Center

Disqualifiers: Moderate dementia, Uncontrolled schizophrenia, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 3

140 Participants Needed

Trial Summary

What is the purpose of this trial?

Purpose: The HealthScore Health Coaching Program aims to deliver 6-months of 1:1 home-based health coaching to cancer patients receiving treatment and survivors of any diagnosis at UNC Cancer Hospital. This study hopes to preserve physical function, address unmet physical, nutritional, psychological, social and other needs. Procedures: This will be done through individualized health coaching, weekly symptom survey administration, monthly supportive care questionnaires, and physical assessments at baseline, 3 months and 6 months. Participants: All cancer patients with appointments at UNC Cancer Hospitals.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It seems likely that you can continue your medications, but you should confirm with the trial coordinators.

What data supports the effectiveness of the treatment Health Coaching for cancer survivors?

Research shows that health coaching can improve the quality of life, mood, and physical activity in cancer survivors. It helps them manage fatigue and pain, which are common issues after cancer treatment. ^{1 2 3 4 5}

Is health coaching safe for humans?

Health coaching has been used safely in various studies for different conditions, including cancer survivorship and type 2 diabetes, focusing on behavior change and health improvement without reported safety concerns. ^{2 4 6 7 8}

How is the Health Coaching treatment for cancer survivorship different from other treatments?

Health Coaching for cancer survivorship is unique because it focuses on improving patients' quality of life and capacity to manage their health through personalized support, goal-setting, and behavior change, rather than directly targeting the cancer itself. This approach helps cancer survivors enhance their physical activity, mood, and overall well-being, making it distinct from traditional medical treatments that focus on the disease. ^{2 3 4 8 9}

Research Team

William A Wood, MD, MPH

Principal Investigator

UNC Lineberger Comprehensive Cancer Center

Eligibility Criteria

This trial is for cancer patients and survivors at UNC Cancer Hospital who can participate in a 6-month health coaching program. They must be over 15, able to use email, provide electronic survey responses, wear a sensor device at home, and their insurance must allow research study participation.

Inclusion Criteria

I am over 15 and have a cancer center appointment.

Patients must have a working email address and have the ability to check and respond to email

I am currently in treatment or have completed cancer treatment with no time restrictions.

Exclusion Criteria

The patient has concurrent medical or psychiatric conditions that may preclude participation (i.e. moderate to severe dementia, uncontrolled schizophrenia, or other conditions that would render them unable to provide informed consent or complete questionnaires)

I can read and speak English.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Health Coaching

Participants receive 1:1 home-based health coaching to improve physical function and address unmet needs

6 months

Weekly symptom surveys, monthly supportive care questionnaires, and physical assessments at baseline, 3 months, and 6 months

Follow-up

Participants are monitored for safety and effectiveness after the health coaching intervention

4 weeks

Treatment Details

Interventions

• Health Coaching

Trial Overview The HealthScore Program provides personalized health coaching to cancer patients and survivors. It includes weekly symptom surveys, monthly care questionnaires, and physical assessments at the start, middle, and end of the six-month period.

Participant Groups

Group I: Health Coaching Experimental Treatment 1 Intervention

All participants will be in the health coaching group. Participants on study will receive a health coach for 6 months.

Who Is Running the Clinical Trial?

UNC Lineberger Comprehensive Cancer Center

Lead Sponsor

Trials

377

Recruited

95,900+

Findings from Research

A telephone health coaching intervention significantly improved enrollment in prevention programs and patient activation among 417 Veterans, regardless of their health literacy levels.

The intervention was particularly effective for patients with low numeracy, showing a greater increase in enrollment compared to those with high numeracy, suggesting that health coaching can be especially beneficial for individuals struggling to interpret health information.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Health Coaching Has Differential Effects on Veterans with Limited Health Literacy and Numeracy: a Secondary Analysis of ACTIVATE. Nouri, SS., Damschroder, LJ., Olsen, MK., et al.[2020]

A 1-year randomized controlled trial involving cancer survivors showed that both a web-based program and a combination of health coaching with the web program significantly improved physical activity, weight management, and psychological distress compared to a control group.

The combination of health coaching and the web program led to a notable improvement in psychological well-being, as measured by the Post Traumatic Growth Inventory, indicating its effectiveness in reducing distress among cancer survivors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of health coaching and a web-based program on physical activity, weight, and distress management among cancer survivors: A multi-centered randomised controlled trial. Yun, YH., Lim, CI., Lee, ES., et al.[2020]

Health coaching interventions for cancer survivors showed significant improvements in quality of life, mood, and physical activity among 1038 participants across 12 studies, indicating its efficacy in enhancing patient capacity.

While health coaching positively impacted various aspects of patient capacity, it did not significantly improve self-efficacy, highlighting the need for future interventions to focus on enhancing self-efficacy and the patient's environment of care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Does Health Coaching Grow Capacity in Cancer Survivors? A Systematic Review. Barakat, S., Boehmer, K., Abdelrahim, M., et al.[2018]

A coaching intervention for cancer survivors, involving trained nurses, provided significant emotional support by allowing survivors to discuss their existential concerns and worries after treatment.

The qualitative study revealed that these coaching conversations helped survivors move forward in life by addressing deeper issues beyond just treatment and symptoms, highlighting the importance of holistic care in post-cancer recovery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Person-centred communication with cancer survivors: Exploring the meaning of follow-up coaching conversations. Timmermann, C., Ammentorp, J., Birkelund, R.[2023]

The UNC HealthScore intervention, a six-month health coaching program for cancer patients, demonstrated high feasibility with 66% enrollment and 71% completion rates among 50 participants, indicating strong interest and engagement.

Participants showed significant improvements in physical function, with scores increasing by 4.3 points from baseline to 6 months, surpassing the minimal clinically important difference, along with notable reductions in anxiety and depression.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Piloting HealthScore: Feasibility and acceptability of a clinically integrated health coaching program for people living with cancer. Wood, WA., Bailey, C., Castrogivanni, B., et al.[2023]

Health coaching significantly reduced outpatient and total healthcare expenditures for high-risk participants, with estimated savings of $286 and $412 per person per month, respectively.

While health coaching did not impact emergency room costs, it did lead to a significant decrease in the probability of incurring inpatient expenditures, highlighting its potential effectiveness in managing healthcare costs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

How effective is health coaching in reducing health services expenditures? Jonk, Y., Lawson, K., O'Connor, H., et al.[2022]

A 12-month telephone diabetes health coaching (DHC) intervention significantly improved glycemic control in adults with type 2 diabetes, reducing A1C levels by 1.8% compared to 1.3% in the usual diabetes education group.

Participants receiving DHC also reported better quality of life, as indicated by improved scores on the Audit of Diabetes-Dependent Quality of Life (ADDQoL-19), with no increase in emergency department visits or hospitalizations, suggesting the intervention is safe.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of Diabetes Health Coaching on Glycemic Control and Quality of Life in Adults Living With Type 2 Diabetes: A Community-Based, Randomized, Controlled Trial. Sherifali, D., Brozic, A., Agema, P., et al.[2021]

A review of 13 studies on health coaching combined with telehealth for older adults showed that 10 of these studies reported effective outcomes, such as reduced hospital admissions and improved quality of life.

While telehealth health coaching is a promising method for managing chronic conditions in older adults, most interventions still rely on human coaches, indicating a potential for further development of automated coaching technologies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Use of Telehealth Technology to Support Health Coaching for Older Adults: Literature Review. Markert, C., Sasangohar, F., Mortazavi, BJ., et al.[2021]

Breast cancer survivors using a health and wellness coaching app showed significant weight loss and a greater reduction in body mass index compared to those using a self-guided toolkit, indicating the app's effectiveness in promoting healthier lifestyles.

The app users also reported improvements in physical activity and dietary patterns, suggesting that access to live coaching can enhance adherence to wellness plans, although long-term app usage declined after 12 months.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluation of a Mobile Health Intervention to Improve Wellness Outcomes for Breast Cancer Survivors. Cairo, J., Williams, L., Bray, L., et al.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

Health Coaching Has Differential Effects on Veterans with Limited Health Literacy and Numeracy: a Secondary Analysis of ACTIVATE. [2020]

2. England pubmed.ncbi.nlm.nih.gov

Efficacy of health coaching and a web-based program on physical activity, weight, and distress management among cancer survivors: A multi-centered randomised controlled trial. [2020]

3. United States pubmed.ncbi.nlm.nih.gov

Does Health Coaching Grow Capacity in Cancer Survivors? A Systematic Review. [2018]

4. Sweden pubmed.ncbi.nlm.nih.gov

Person-centred communication with cancer survivors: Exploring the meaning of follow-up coaching conversations. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

Piloting HealthScore: Feasibility and acceptability of a clinically integrated health coaching program for people living with cancer. [2023]

6. United States pubmed.ncbi.nlm.nih.gov

How effective is health coaching in reducing health services expenditures? [2022]

7. Canada pubmed.ncbi.nlm.nih.gov

Effect of Diabetes Health Coaching on Glycemic Control and Quality of Life in Adults Living With Type 2 Diabetes: A Community-Based, Randomized, Controlled Trial. [2021]

8. Canada pubmed.ncbi.nlm.nih.gov

The Use of Telehealth Technology to Support Health Coaching for Older Adults: Literature Review. [2021]

9. United States pubmed.ncbi.nlm.nih.gov

Evaluation of a Mobile Health Intervention to Improve Wellness Outcomes for Breast Cancer Survivors. [2022]