目的:评估并综合有关健康教练作为主要干预措施对中年人心脏代谢健康的影响的证据。
方法:六个电子数据库(MEDLINE,Embase,PsycINFO,CINAHL,PubMed,和Cochrane图书馆)从开始到2021年7月进行搜索。
方法:随机对照试验和对照临床试验以英文发表,纳入了旨在促进行为改变以改善中年人心脏代谢健康的健康指导报告.将健康教练作为辅助干预措施的研究排除在外。
方法:两位审阅者选择了文章,评估了研究质量,并独立提取数据。与心脏代谢健康相关的各种结果,包括健康行为,心理和生理结果,包括在内。
结果:如果三个或更多研究报告的结果相同,则进行Meta分析。如果汇总用于荟萃分析的数据不可行,则进行叙事综合。
结果:对8项研究进行了综述。大多数研究涉及很大的偏倚风险。大多数参与者是女性(99.1%)。荟萃分析显示,健康教练对增加身体活动的影响很小,但很重要(SMD=.34,95%CI=.08-.60,p=.01,I2=0%);但是,其对身体活动障碍感知和抑郁症状的影响不显著.叙事合成在饮食上产生了不一致的结果,吸烟,焦虑,行为改变的目标成就和自我效能感,生理结果,和代谢综合征的严重程度,对饮酒的影响不显著,睡眠质量,身体活动的感知益处,和心血管症状。
结论:健康教练对增加中年人的身体活动有显著影响;然而,其对健康行为和与心脏代谢健康相关的危险因素的影响尚无定论。有必要进一步努力研究健康教练如何改善中年人的心脏代谢健康。
To appraise and synthesize evidence on the effects of health coaching as the primary intervention on cardiometabolic health among middle-aged adults.
Six electronic databases (MEDLINE, Embase, PsycINFO, CINAHL, PubMed, and the Cochrane library) were searched from inception until July 2021.
Randomized controlled trials and controlled clinical trials published in English, reporting health coaching aimed to promote behavioral changes for improving cardiometabolic health among middle-aged adults were included. Studies on health coaching as secondary intervention were excluded.
Two reviewers selected the articles, appraised the study quality, and extracted data independently. All kinds of outcomes related to cardiometabolic health, including health behaviors, psychological and physiological outcomes, were included.
Meta-analysis was performed if three or more studies reported the same outcomes. Narrative synthesis was performed if pooling of data for meta-analysis was not feasible.
Eight studies were reviewed. Most studies involved substantial risk of bias. The majority of the participants were women (99.1%). Meta-analysis showed a small but significant effect of health coaching on increasing physical activity (SMD = .34, 95% CI = .08-.60, p = .01, I2 = 0%); however, its effect on perceived barriers to physical activity and depressive symptoms was nonsignificant. Narrative synthesis yielded inconsistent results on diet, smoking, anxiety, goal achievement and self-efficacy for behavioral change, physiological outcomes, and metabolic syndrome severity, and nonsignificant effects on alcohol consumption, sleep quality, perceived benefits of physical activities, and cardiovascular symptoms.
Health coaching has significant effects on increasing physical activity among middle-aged adults; however, its effects on health behaviors and risk factors related to cardiometabolic health are inconclusive. Further efforts are warranted to examine how health coaching can improve cardiometabolic health among middle-aged adults.