Health-Wellness Coaching Can Lower Stroke Risk

Health-wellness coaching (HWC) has grown as a useful tool to motivate individuals to adopt healthier lifestyles. For example, Lifestyle Change Coaching, which is a form of HWC, is an integral part of the CDC Diabetes Prevention Program. Healthy lifestyle changes can prevent type 2 diabetes. And healthy lifestyle changes can reduce the risk of stroke.

In order for HWC to be successful as a stroke-prevention intervention, a person must understand the factors that encourage and hinder long-term behavior change. A New Zealand study investigated the motivators and barriers to long-term behavior change among persons at risk of stroke after they received HWC for stroke prevention.

“Stroke is a leading cause of death and a major cause of disability in the United States. A stroke occurs when the blood supply to part of the brain is blocked, or when a blood vessel in the brain bursts, causing damage to a part of the brain.” Some health, behavioral, and lifestyle factors can put individuals at a high risk for stroke. Important risk factors include high blood pressure, heart disease, diabetes, and cigarette smoking. So, individuals can help prevent a stroke by making behavioral and lifestyle changes.

A health and wellness coach can help individuals identify those unique strengths that can enhance the individuals' current lifestyle patterns. Becoming aware of the need for health-behavior modification is often the first step to making lasting lifestyle changes. A person must understand health risks and how the risks can lead to conditions that affect quality of life, independence, and cause disabilities. Focusing on the risks may help to induce long-term behavior change.

In the New Zealand study, the researchers indicated that the purpose of HWC interventions should be to increase a person’s understanding of a disease’s impact, and the personal risk of not making a long-term lifestyle change. And this is true for stroke prevention. Some individuals who gained an understanding of how to lower the risk of strokes had a brighter outlook and a stronger feeling of self-efficacy, which is an essential element of lifestyle transformation.

Methods to make long-term health behavior change can be addressed by HWC. And HWC is being utilized more frequently in primary care to promote healthy lifestyle change. Lifestyle change can be prescribed in conjunction with prescription drugs. Future HWC programs for stroke prevention may be informed by the findings of the New Zealand study, particularly with regard to the motivators and inhibitors of long-term behavior change.

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Using Questionnaires to Predict Prediabetes and Diabetes Risk

Since prediabetes often leads to type 2 diabetes, a screening test, in the form of a questionnaire, is often used to identify individuals who are at risk for prediabetes and diabetes. Such a questionnaire, endorsed by the CDC and the ADA (American Diabetes Association), is used in the CDC National Diabetes Prevention Program. The questionnaire consists of five questions, some of which are related to cardiovascular health (CVH). And a recent study, examining the use of a questionnaire similar to the CDC/ADA questionnaire, has shown that there is a positive correlation between a high score on a CVH-related questionnaire and the development of prediabetes or diabetes.

An individual’s risk of prediabetes or diabetes increases with age, so a question requesting the individual’s age is on the CDC/ADA prediabetes-diabetes-risk questionnaire. Men have a higher risk of prediabetes and diabetes than women, so a gender-related question is on the questionnaire.

The risk of prediabetes and diabetes increases for women who experienced gestational diabetes, so a gestational-diabetes question is on the questionnaire. Questions are also asked about immediate family members who have had diabetes, since an immediate-family-history of diabetes can raise a person’s risks of diabetes and prediabetes.

Questions about weight and physical activity are also part of the questionnaire, since excess body fat and a lack of adequate physical activity can raise the risk of prediabetes and diabetes. A question concerning a diagnosis of high blood pressure is also on the questionnaire, since people with hypertension are at a high risk of diabetes.

The CDC/ADA questionnaire is a good predictor of prediabetes and diabetes risk. It is derived from a questionnaire the ADA published in 1995. And a recently developed questionnaire, using slightly different CVH metrics, also gives good indications of prediabetes and diabetes risk.

The more recent questionnaire is based on a CVH-related study investigating the use of a questionnaire to identify individuals with a high risk of acquiring prediabetes or diabetes. The study consisted of 403,857 participants who were 18-71 years of age. The researchers looked at fasting plasma glucose (FPG) data over a period of five consecutive years. And the researchers concluded that a group of CVH markers can be used to predict prediabetes and diabetes. Researchers, using the questionnaire, asks questions to determine if a person smokes, engages in physical activity, is overweight or obese, has untreated total cholesterol, high blood pressure or eats breakfast infrequently.

The researchers concluded that “The ideal CVH metrics were as follows: BMI of <25 kg/m2; non-smoking; 30 min of physical activity ≥twice weekly or ≥1 h of walking per day; ... skipping breakfast <3 times per week; systolic untreated blood pressure/diastolic blood pressure of <120/80 mmHg; and total cholesterol of <200 mg/dL”

Furthermore, the probability of acquiring prediabetes or diabetes increased as the number of non-ideal CVH metrics increased over a period of one year. And the association between a non-ideal BMI and the likelihood of prediabetes or diabetes was the strongest among the metrics.

Hence, healthcare providers should consider the use of questionnaires to help identify clients or patients who are at a high risk of prediabetes and diabetes.

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Tags: environmental scanning, balanced scorecard, business planning, strategic management, bariatric industry analysis, weight loss industry analysis, weight management industry analysis, prediabetes