ABSTRACT
As noncontact health interventions have become critical during the Covid-19 pandemic, our study aimed to systematically review the published literature for barriers and facilitators influencing the adoption and use of remote health intervention and technology, as perceived by adult patients with diabetes or cardiovascular diseases (CVD) belonging to groups that are socially/economically marginalized and/or medically under-resourced. We searched Medline, Embase, CINAHL, and PsychINFO for peer-reviewed articles published from 2010 to 2018. We employed content analysis to analyze qualitative patient feedback from the included studies. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A total of 42 studies met the inclusion criteria. The design of the remote health technology used was the most frequently mentioned facilitator and barrier to remote health technology adoption and use. Our results should draw the attention of technology developers to the usability and feasibility of remote technology among populations that are socially/economically marginalized and/or medically under-resourced.
ABSTRACT
BACKGROUND: Health coaching is an intervention process for driving behavior change through goal-setting, education, encouragement, and feedback on health-related behaviors. Telehealth systems that include health coaching and remote monitoring are making inroads in managing chronic conditions and may be especially suited for older populations. OBJECTIVE: This literature review aimed to investigate the current status of health coaching interventions incorporating telehealth technology and the associated effectiveness of this intervention to deliver health care with an emphasis on older adults (aged 65 and older). METHODS: A literature review was conducted to identify the research conducted on health coaching combined with remote monitoring for delivering health care to older adults. The Ovid MEDLINE and CINAHL databases were queried using a combination of relevant search terms (including middle aged, aged, older adult, elderly, health coaching, and wellness coaching). The search retrieved 196 papers published from January 2010 to September 2019 in English. Following a systematic review process, the titles and abstracts of the papers retrieved were screened for applicability to health coaching for older adults to define a subset for further review. Papers were excluded if the studied population did not include older adults. The full text of the 42 papers in this subset was then reviewed, and 13 papers related to health coaching combined with remote monitoring for older adults were included in this review. RESULTS: Of the 13 studies reviewed, 10 found coaching supported by telehealth technology to provide effective outcomes. Effectiveness outcomes assessed in the studies included hospital admissions/re-admissions, mortality, hemoglobin A1c (HbA1c) level, body weight, blood pressure, physical activity level, fatigue, quality of life, and user acceptance of the coaching program and technology. CONCLUSIONS: Telehealth systems that include health coaching have been implemented in older populations as a viable intervention method for managing chronic conditions with mixed results. Health coaching combined with telehealth may be an effective solution for providing health care to older adults. However, health coaching is predominantly performed by human coaches with limited use of technology to augment or replace the human coach. The opportunity exists to expand health coaching to include automated coaching.