Health promotion for patients with diabetes: health coaching or formal health education?

PURPOSE: The purpose of this study was to determine if a Health Coaching (HC) approach compared with formal health education (HE) resulted in better health outcomes among type II diabetes (T2DM) patients in improving glycaemic control and oral health, by use of clinical and subjective outcome measures. METHODS: The study is part of a prospective intervention among randomly selected T2DM patients (n = 186) in Istanbul, Turkey. The data analysed were clinical [glycated haemoglobin (HbA(1C)), clinical attachment loss (CAL)] and psychological measures [tooth-brushing self efficacy (TBSES)]. Data were collected initially and at the end of intervention. Participants were allocated randomly to HC (intervention) (n = 77) and HE (control) (n = 111) groups. RESULTS: At baseline, there was no statistical difference between HC and HE regarding clinical and psychological measures, (P > 0.05). At post-intervention the HC group had significantly lower HBA(1C) and CAL (reduction: 7%, 56%) than the HE group (reduction: HbA(1C) 0%; CAL 26%), (P ≤ 0.01). Similarly, HC group, compared with HE group, had better TBSES (increase: 61% vs. 25%) and stress (reduction: 16% vs. 1%), (P ≤ 0.01). Among high-risk group patients, the HC patients had significant improvements compared with the HE group (reduction: HbA(1C) 16% vs. 5%; CAL 63% vs. 18%; stress 39% vs. 2%; fold increase: TBSES 6.6 vs. 3.6) (P ≤ 0.01). CONCLUSIONS: The present findings may imply that HC has a significantly greater impact on better management of oral health and glycaemic control than HE. It is notable that the impact was more significant among high-risk group patients, thus HC may be recommended especially for high-risk group patients.

Self-efficacy perspective on oral health among Turkish pre-adolescents.

OBJECTIVE: To assess the association between toothbrushing and dietary self-efficacy and oral health status and behaviour related to it among Turkish pre-adolescents. MATERIALS AND METHODS: A cross-sectional study of Turkish school pre-adolescents aged 10 to 12 (n = 611) by oral health examinations (OHE) and self-administered health behaviour questionnaire (PHBQ). The PHBQ, including new Toothbrushing (TBSES), and modified Dietary Self-Efficacy (DSES), was designed to survey pre-adolescents' oral, dietary and general hygiene behaviour by psychosocial factors. An OHE based on World Health Organization criteria was implemented. The participation rate was 97% (n = 591), and 95% (n = 584) for PHBQ and OHE. Multiple linear regression analysis, descriptive statistics, factor and item analysis, Pearson correlation coefficient, chi-square test, and Student t-test were applied. RESULTS: Pre-adolescents, mostly with regular toothbrushing habits (69% at least once a day) and high levels of irregular dental visits (79%) had as their mean DMFS figure 3.77 +/- 3.37. Principal component analysis for TBSES and DSES revealed that four factors met the Kaiser Criteria, accounting for 50.2% of total variance. Scales with good internal consistency and test-retest stability were associated with professionally (DMFS) and self-assessed dental health (p < 0.05). A similar tendency appeared between self-assessed gingival health and DSES (p < 0.05). CONCLUSION: Self-efficacy beliefs were associated with oral health and related behaviour among pre-adolescents. Further research is needed for implementation of scales to enhance oral health.