Health Coaching to Improve Glycemic Control Among Patients with Type 2 Diabetes Vivienne A Ayomanor Touro University, Nevada DNP Project III: In partial fulfillment of the requirements for the Doctor of Nursing Practice

1 Health Coaching to Improve Glycemic Control Among Patients with Type 2 Diabetes Vivienne A Ayomanor Touro University, Nevada DNP Project III: In partial fulfillment of the requirements for the Doctor of Nursing Practice DNP Project Team: Dr. Heidi Johnston, DNP, RN, CNE Dr. Bukola Olusanya, DNP, FNP-C, MSN, APRN February 20th, 2024 2 Abstract In the United States (US), Type 2 diabetes (T2DM) is a significant public health issue facing many patients in primary care settings. Diabetes in the US is classified as the seventh top root cause of mortality, and T2DM accounts for approximately 90-95% of diagnosed cases in adults. This DNP quality improvement project aimed to determine the efficacy of a health coaching intervention using the 2023 6th guideline of American Diabetes Association (ADA) Standards of Care to help improve glycemic levels from 22% to 37% over a 4-week time frame. Glucose level data was collected weekly, and SPSS version 29 software was used to analyze the data. A paired t-test showed a statistically significant difference in the glucose levels before and after implementing health coaching (t = 126.51, df = 9, p = 0.01, SD = 2.37). The mean difference between the pre-intervention and post-intervention glucose levels was 94.71 mmHg, implying a statistically significant decrease in blood glucose levels. There was an improvement in blood glucose control, represented by 34.13%, within the projected improvement in glycemic levels of 22.03% to 37%. The implementation of health coaching resulted in a decrease in average blood glucose levels, particularly evident in the third and fourth weeks. The statistical analysis suggests that health coaching significantly and positively affected average daily blood glucose levels. Key Terms: Type 2 diabetes (T2DM), health coaching American, Diabetes Association (ADA) Standards of Care, blood glucose control, quality improvement (QI), lifestyle modification strategies. 3 Table of Contents Abstract.............................................................................................................................................2 Introduction ......................................................................................................................................5 Significance of the Problem..............................................................................................................6 Background.......................................................................................................................................7 Project Question ...............................................................................................................................9 Search Methods ................................................................................................................................9 Review of Study Methods ..............................................................................................................10 Review Synthesis............................................................................................................................11 Impact of the Problem ....................................................................................................................12 Addressing the Problem with Current Evidence ............................................................................12 Project Aims...................................................................................................................................16 Project Objectives.....................................................................................................................16 Implementation Framework ...........................................................................................................17 Application to DNP Project............................................................................................................17 Population of Interest......................................................................................................................19 Setting.............................................................................................................................................19 Stakeholders....................................................................................................................................20 Intervention.....................................................................................................................................22 Tools...............................................................................................................................................23 Plan for Data Collection .................................................................................................................25 Plan for Analysis ............................................................................................................................26 Ethics/Human Subjects P