Researchers motivate diabetics to adopt healthy lifestyle
By means of so-called health coaching, researchers at the University of Copenhagen have helped a large group of diabetics to markedly improve their oral health. The patients assume responsibility for their own bodies and boost their self-efficacy through motivational health coaching, taking a different approach to conventional health campaigns and one-way communication. The research findings have just been published in the Clinical Oral Investigations.
Brochures with information about dental health or healthy living are fine. Motivational health coaching by professionals is far better and reaches out to high-risk groups.
Diabetics are at a higher risk of suffering oral health problems. Not just the most serious problems like periodontitis and caries, but also other issues such as dry mouth, fungal infections and poor wound healing. One hundred and eighty-six patients with Type II diabetes participated in a study – the first in the world – to demonstrate the role of health coaching in improving dental health and empowering patients. The patients with diabetes were divided into two groups. One group was given traditional health information, for example a brochure on good dental hygiene. The other group was offered motivational health coaching in the form of 3-6 sessions over a six-month period, focusing on personal guidance on, for example, diet, stress management and dental care:
"In the group of patients who were given personal health coaching, biological markers for periodontitis , also known as ‘loose teeth disease’ were reduced by as much as 50% over a six-month period. The patients in the trial group saw a significant decline in long-range blood sugar levels, whereas figures for the control group were unchanged. Moreover, the patients in the coaching group expressed markedly increased self-efficacy in relation to handling illness and health issues," explains Assistant Professor and authorised coach Ayse Basak Cinar from the Department of Odontology at the University of Copenhagen.
The long-range blood sugar, also known as HbA1c, is an expression of the average glucose level in the blood over the past approx. three months. For the coaching group, this fell from 7.5% to 6.9%.
The new research findings may change the way we think about health campaigns in future.
"Health coaching is a resource-intensive intervention. However, dishing out a brochure to patients with diabetes and thinking that that will do it, is also a costly approach for society. Ineffective health communication due to a lack of creativity results in massive and costly problems for society. The patients we are in contact with are often both socially and financially vulnerable, and for them health coaching and follow-up can make a considerable and marked difference, both to their physical and mental health. It is also about equality in the health care system – both globally and nationally," says head of section Lone Schou from the Department of Odontology.
The results are not only interesting because health coaching seems to make a huge difference compared with conventional health campaigns.
"It is also exciting that we are combining biological examinations of BMI, long-range blood sugar and bacterial markers with qualitative data obtained through interviews. All the biological examinations indicate better results for the trial group," says Ayse Basak Cinar.
Danish-Turkish research with a global dimension
Assistant Professor Ayse Basak Cinar, head of section at the Department of Odontology Lone Schou and Professor Maximilian de Courten from Copenhagen School of Global Health are behind the new research results which have been published in Clinical Oral Investigations. The study involving 186 patients was conducted in Turkey, but Ayse Basak Cinar has received a grant from the Danish foundation TrygFonden which moves the trial to Denmark and secures Ayse’s employment in the coming year.
"I am keen to see how closely the Danish results will resemble those from Turkey, but I expect to see many similarities. Often, the most high-risk Type II diabetes patients in Denmark are of non-Danish ethnicity, so in that respect the studies will not be affected by marked cultural differences. The complications of Type II diabetes are a global concern which is monitored closely by the International Diabetes Federation," says Ayse Basak Cinar.
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Health Coaching stands for the main core of WHO European 2020 Health Policy Framework, which suggests patient-empowerment based health care systems must be established and the better management of chronic diseases can only be achieved by empowered patients, thereby empowered societies.
The project is supported by BRIDGES, International Diabetes Foundation, World Dental Federation and TRYG-Fonden.