Thirty-seven percent of U.S. adults had pre-diabetes based on fasting glucose or hemoglobin A1C levels; about 70% are expected to develop diabetes within 10 years.  Progression of pre-diabetes to diabetes may be prevented or delayed with moderate (5-7%) weight loss achieved through positive lifestyle interventions. The challenge is to enable individuals to initiate and maintain healthy lifestyle changes.

Wellness coaching offers focused one-on-one self-management support program by a professional to enable a patient to be an active participant in self-care. It recognizes that self-management and health education alone are not sufficient to support and sustain long term behavioral change; there are situations where professionals can provide support, enhance motivation, build self-confidence and guide patients towards behavior change. As a newer intervention, it has not been as widely evaluated in the health care setting, or specifically among patients with pre-diabetes; however, preliminary data suggests that it may be successful in improving clinical outcomes.

This prospective study assessed whether an individualized 12 week wellness coaching intervention for primary care patients with pre-diabetes will improve self-care behaviors as measured by self-reported changes in physical activity level and food choices.  Ninety-eight ECH empanelled patients who met eligibility criteria participated in the wellness coaching program which consisted of 12 sessions conducted by certified wellness coaches in accordance with standard clinical practice. Pre- and post-study outcome measures in the form of questionnaires were collected and analyzed: the Stanford Patient Education Research Center's 6 item exercise behavior questionnaire was used to measure both aerobic and combination stretching/strengthening exercise; a 5 item questionnaire that asked patients to rate their current general health and confidence level in their ability to make healthy eating choices and exercise regularly; a validated 5 item self-efficacy scale; and a quality of life assessment tool. At 6 and 12 weeks, there was a significant difference noted in activity, eating habits, self-efficacy and quality of life measures from baseline.