Health Coaching for Limited Mobility in Aging Adults

Overseen By Nathan Wei, B.Sc.

Age: 65+

Sex: Any

Trial Phase: Academic

Sponsor: University of British Columbia

Disqualifiers: Dementia, Stroke, MVPA, others

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

Compensation: Varies

Number of Visits: 39

Duration: 26 weeks

290 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if health coaching can help older adults with limited mobility become more active. Participants will either receive personalized coaching to set and track fitness goals or attend general health education sessions on topics like sleep and healthy eating. Ideal candidates have mobility challenges but can still walk 400 meters without assistance and live in the community. This study does not include those who are already regularly active, diagnosed with dementia, or have had a stroke. As an unphased trial, it offers a unique opportunity for participants to contribute to research that could improve health outcomes for older adults with mobility challenges.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this health coaching intervention is safe for older adults with limited mobility?

Research shows that health coaching programs are generally safe for older adults. Studies have found that these programs can boost confidence, improve quality of life, and enhance mental health without causing harm. For instance, one study discovered that health coaching increased satisfaction with health and improved physical and mental well-being.

Another study found that health coaching helped patients with long-term conditions feel better in the short term. These findings suggest that health coaching is well-tolerated and usually doesn't cause negative side effects. Therefore, for those considering a trial involving health coaching, current evidence supports its safety and potential benefits for improving quality of life and mental well-being. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Health Coaching Program for aging adults with limited mobility because it uses a personalized and proactive approach to behavior change. Unlike traditional treatments that often focus on medication or physical therapy alone, this program incorporates Brief Action Planning (BAP) principles, which involve goal-setting, action planning, self-monitoring, and feedback. By empowering participants to set and track their own physical activity goals with the help of trained kinesiologists, the program aims to enhance motivation and adherence, potentially leading to better mobility and overall health outcomes.

What evidence suggests that this trial's treatments could be effective for improving physical activity in older adults with limited mobility?

Research shows that health coaching, one of the treatment arms in this trial, can help older adults become more active and improve their overall well-being. Studies have found that these programs can change habits and improve health issues like high blood pressure and cholesterol. Health coaching also enhances short-term quality of life and boosts confidence in managing personal health. For older adults, especially those living alone with several health problems, these sessions can be very beneficial. The process usually includes setting goals, making plans, and receiving feedback, which helps participants stay motivated and track their progress. Meanwhile, the Health Education Program, another arm of this trial, provides general health education on topics such as falls prevention, sleep, healthy eating, cognitive health, and mental and emotional health. ^{1 2 3 4 6}

Who Is on the Research Team?

Teresa Liu-Ambrose, Ph.D, PT

Principal Investigator

University of British Columbia

Are You a Good Fit for This Trial?

This trial is for older adults with limited mobility who can walk 400 meters in under 15 minutes using a cane if needed, score well on mental and physical assessments, and don't have dementia. Participants should be living independently, able to consent, and not currently doing moderate exercise.

Inclusion Criteria

I can perform most daily activities without help.

My physical ability score is 9 or less out of 12.

Scored 22/30 or higher on the Mini-Mental State Examination (MMSE)

Exclusion Criteria

Unable to understand, speak, and read English proficiently

Self-report engaging in MVPA ≥ 10 minutes per week in the prior 3 months

I have been diagnosed with dementia or have had a stroke.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants are randomized to a 26-week health coaching or health education program

26 weeks

Regular sessions (in-person or virtual)

Follow-up

Participants are monitored for safety and effectiveness after treatment

26 weeks

Assessments at 39 and 52 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Health Coaching Program
• Health Education Program

Trial Overview The study compares two programs: one where participants receive health coaching aimed at increasing their physical activity levels versus another where they get general health education. The effectiveness of these interventions on improving mobility is being tested.

How Is the Trial Designed?

Group I: Health Coaching (HC) Experimental Treatment 1 Intervention

The health coaching program will be delivered by trained and certified kinesiologists utilizing Brief Action Planning (BAP) principals. The BAP behavior change approach utilizes the following 4 techniques: 1) goal-setting; 2 )action planning; 3) self-monitoring; and 4) feedback. Participants will utilize daily physical activity diaries to enable self-monitoring, and BAP coaches will provide feedback on progress toward individualized physical activity goals.

Group II: Health Education Program (ED) Active Control 1 Intervention

This program is an attention control group, which consists of general health education. Education sessions will be delivered either by zoom or in person. The education sessions will cover the following topics: 1) falls prevention; 2) sleep; 3) healthy eating; 4) cognitive health; and 5) mental and emotional health.

Who Is Running the Clinical Trial?

University of British Columbia

Lead Sponsor

Trials

1,506

Recruited

2,528,000+

Canadian Institutes of Health Research (CIHR)

Collaborator

Trials

1,417

Recruited

26,550,000+

Published Research Related to This Trial

The My Health, My Life, My Way study is a 6-month randomized controlled trial involving 200 individuals with chronic conditions and physical disabilities, designed to assess the feasibility and preliminary efficacy of a web-based self-management program that combines health coaching and telehealth technology.

The study aims to determine the most effective combination of scheduled coaching calls and gamified rewards to enhance participation in self-management, potentially leading to a scalable solution for managing chronic conditions in people with disabilities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

My Health, My Life, My Way-An Inclusive Web-Based Self-management Program for People With Disabilities Living With Chronic Conditions: Protocol for a Multiphase Optimization Strategy Study. Evans, E., Zengul, A., Knight, A., et al.[2023]

Wellness promotion programs for elderly adults should focus on a holistic approach that includes not just health, but also lifestyle, physical, psychological, and sociocultural factors.

These programs must respect the elderly's ability and right to take responsibility for their own well-being, considering their unique characteristics and historical context.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Relevance of health promotion programs for the elederly]. Sánchez-Ayéndez, M.[2006]

A health coaching self-management program significantly improved various health outcomes in older adults with multimorbidity, including exercise behaviors, cognitive symptom management, and self-rated health, over an 8-week period with 43 participants total.

Participants in the intervention group also reported reduced depression and limitations in social activities, indicating that the program effectively enhanced their overall well-being and self-efficacy in managing their health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of a health coaching self-management program for older adults with multimorbidity in nursing homes. Park, YH., Chang, H.[2021]

This review analyzed five studies on life coaching interventions in healthcare, finding that while the evidence is limited, some patients, particularly those who typically do not respond well to standard interventions, showed promising improvements in health outcomes like HbA1c levels.

The studies suggest that life coaching may enhance self-efficacy and self-empowerment, indicating that alternative communication and approaches in patient care can lead to better engagement and outcomes for disadvantaged patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Can life coaching improve health outcomes?--A systematic review of intervention studies. Ammentorp, J., Uhrenfeldt, L., Angel, F., et al.[2022]

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]

A 12-week health coaching program for 54 employees with cardiovascular disease risk factors led to significant weight loss (average of 7.2 pounds) and increased exercise frequency, indicating its efficacy in promoting healthier lifestyles.

Participants also reported reduced perceived stress and trends toward improved sleep, suggesting that health coaching not only aids in physical health but also enhances overall well-being.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Health coaching for healthcare employees with chronic disease: A pilot study. Edman, JS., Galantino, ML., Hutchinson, J., et al.[2019]

The comprehensive lifestyle health coaching (LHC) program has been successfully implemented in various settings, including large employers and healthcare facilities, using technology to deliver services primarily via telephone and the Internet.

Outcomes from published studies and clinical trials demonstrate that the LHC program effectively modifies multiple health risk factors in both healthy individuals and those with chronic diseases, showcasing its clinical effectiveness and integration with traditional medical care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Clinical Effectiveness of Lifestyle Health Coaching: Case Study of an Evidence-Based Program. Gordon, NF., Salmon, RD., Wright, BS., et al.[2020]

There is a growing demand for health and wellness coaches in workplace health promotion, leading to many training programs that vary widely in their definitions and content.

The National Society of Health Coaches, supported by the American Association of Occupational Health Nurses, emphasizes the need for clear standards and responsibilities in health coaching to ensure public safety and awareness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Advancing the Practice of Health Coaching: Differentiation From Wellness Coaching. Huffman, MH.[2017]

This systematic review aims to evaluate the effectiveness of health coaching (HC) interventions for adults with chronic conditions, synthesizing studies published in the last four years to assess patient improvement and coaching characteristics.

If health coaching is found to be effective, it could lead to broader public health applications and integration into current management strategies for chronic diseases, potentially improving patient outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Current trends in health coaching for chronic conditions: A systematic review and meta-analysis of randomized controlled trials. Yang, J., Bauer, BA., Lindeen, SA., et al.[2023]

Coaching, particularly through a combination of in-person and telecoaching sessions, has been shown to effectively reduce body measurements and enhance motivation and satisfaction in patients seeking weight loss, based on a review of 13 studies.

The study suggests that coaching is a cost-effective approach that integrates education and treatment for weight loss, but further randomized studies are necessary to confirm its impact on chronic disease indicators.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Coaching and barriers to weight loss: an integrative review. Muñoz Obino, KF., Aguiar Pereira, C., Caron-Lienert, RS.[2022]

The Healthy Lifetime (HL) health coaching program significantly improved health habits in participants aged 50 and older with chronic conditions after 8 weeks, and these improvements were maintained at 20 weeks, indicating its efficacy in promoting healthier lifestyles.

Participants in the HL group also showed improved self-care agency, particularly those with high blood pressure, although this improvement did not last beyond the initial 8 weeks, highlighting the need for ongoing support in managing chronic conditions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized trial of a theory-driven model of health coaching for older adults: short-term and sustained outcomes. Potempa, K., Calarco, M., Flaherty-Robb, M., et al.[2023]

Health and wellness coaching (HWC) is emerging as an effective method for promoting lifestyle changes to prevent and treat chronic diseases like diabetes and heart disease, based on a systematic review of 219 articles, 150 of which were data-based.

The review highlights the need for further research to establish consensus on HWC definitions and standards, as the current literature is scattered and lacks a comprehensive summary, making it challenging for practitioners and researchers to access relevant information.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Compendium of the Health and Wellness Coaching Literature. Sforzo, GA., Kaye, MP., Todorova, I., et al.[2020]

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]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6125027/

Clinical Effectiveness of Lifestyle Health Coaching The LHC program is effective in modifying multiple behaviors and improving risk factors, including blood pressure, cholesterol, and weight, in diverse ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC4545471/

Outcomes of a Health Coaching Intervention for Older ... A health coaching curriculum may improve patient outcomes and can provide medical students the skills needed to provide compassionate care for geriatric ...

3. sciencedirect.com sciencedirect.com/science/article/pii/S0197457225003520

Effectiveness of a digital health coaching self-management ... This study evaluated the effectiveness of a digital health coaching self-management program for older adults living alone with multiple chronic ...

4. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0738399123003555

The impact of health and wellness coaching on patient ... Health and Wellness Coaching (HWC) improved short-term quality of life, self-efficacy, and depression, but not anxiety, for chronic conditions.

5. journals.sagepub.com journals.sagepub.com/doi/abs/10.1177/07334648221135582

Holistic Wellness Coaching for Older Adults A novel, staff-led wellness coaching program consisting of resident-driven goals and individual and group coaching sessions.

6. ovid.com ovid.com/journals/joag/pdf/10.1177/07334648221135582~holistic-wellness-coaching-for-older-adults-preliminary

Holistic Wellness Coaching for Older Adults Repeated measures ANOVAs revealed positive changes in resident health satisfaction, physical quality of life (QOL), psychological QOL, loneliness, relatedness, ...