Coach to cope: feasibility of a life coaching program for young adults with cystic fibrosis

Figures & data

Figure 1 Participant flow chart.

Table 1 Baseline demographics and clinical characteristics

	Total	Intervention group	Control group	P-value
Number	38	18	20
Age, mean (range)	23.7 (18–30)	23.6 (18–30)	23.7 (18–29)	NS
Females, n (%)	27 (71)	12 (67)	15 (75)	NS
BMI (kg/m^2), mean (SD)	22.1 (3.8)	21.7 (3.9)	22.5 (3.9)	NS
FEV1 % predicted, mean (SD)	73.4 (23)	71.3 (24.7)	75.5 (21.9)	NS
FEV1 (≤40%), n (%)	5 (13)	3 (17)	2 (10)
FEV1 (41%–70%), n (%)	14 (37)	7 (39)	7 (35)
FEV1 (>71%), n (%)	19 (50)	8 (44)	11 (55)
HbA1C%, mean (SD)	6.15 (1.50)	6.42 (1.69)	5.86 (1.23)	NS
CFTR mutation classes 1 or 2	36 (95)	18 (100)	18 (90)	NS
Chronic pulmonary infection,a n (%)	21 (55)	10 (56)	11 (55)	NS
CFRD, n (%)	12 (32)	8 (44)	4 (20)	NS
Single,b n (%)	19 (58)	10 (56)	9 (45)	NS
Lower education, n (%)	11 (29)	5 (28)	6 (30)	NS
High school, n (%)	12 (32)	5 (28)	7 (35)	NS
College/university, n (%)	15 (39)	8 (45)	7 (35)	NS
Employed or studying, n (%)	33 (87)	15 (83)	18 (90)	NS
Incapacitated to work/study, n (%)	3 (8)	2 (11)	1 (5)	NS

Notes:

a Pseudomonas aeruginosa, Achromobacter xylosoxidans, and Burkholderia species.

b Single status is self-reported and defined as not having a romantic partner.

Abbreviations: FEV₁, forced expiratory volume in 1 second; HbA1C, glycated hemoglobin; CFTR, cystic fibrosis transmembrane regulator protein; CFRD, cystic fibrosis-related diabetes; NS, nonsignificant; SD, standard deviation; BMI, body mass index.

Table 2 Means and standard deviations of health-related quality of life scores from the CFQ-R at baseline, midway, post-intervention, and follow-up

Measured outcome	Treatment	Baseline		Midway (5 months)		Post-intervention (11 months)		Follow-up (1 year post-intervention)
		Mean (SD)	n	Mean (SD)	n	Mean (SD)	n	Mean (SD)	n
Physical Functioning	Coaching	75 (31.6)	18	74.4 (35.1)	13	81.9 (23.1)	9	68.2 (36.8)	12
	Control	80.2 (19.7)	20	76 (26)	17	80.3 (21)	18	78.5 (30.6)	12
Role Limitations	Coaching	82.5 (15.8)	18	80.6 (16.8)	12	78.1 (19.9)	8	81.1 (13.5)	11
	Control	77.9 (20.3)	20	73.4 (25.3)	17	83.8 (16.0)	18	87.9 (14.6)	11
Vitality	Coaching	46.8 (21.8)	18	51.8 (21)	13	49.1 (16.4)	9	46.5 (22.6)	12
	Control	48.5 (18.9)	20	50.8 (16.0)	17	63.9 (18.5)	18	57.2 (21.2)	12
Emotional Functioning	Coaching	67.7 (19.2)	18	69.5 (20.7)	13	68.1 (17.2)	9	67.8 (21.6)	12
	Control	71 (21.2)	20	72.5 (17.1)	17	76.9 (11.3)	18	76.7 (19.2)	12
Social Functioning	Coaching	67.9 (22.0)	18	72.2 (20.9)	13	67.9 (28.6)	9	67.1 (22.2)	12
	Control	70.7 (18.2)	20	70.7 (16.8)	17	75.9 (15.2)	18	70.8 (24.4)	12
Body Image	Coaching	73.5 (25.3)	18	75.4 (18.6)	13	72.8 (26.1)	9	69.4 (25.6)	12
	Control	76.1 (25.8)	20	84.3 (20.1)	17	79.6 (21)	18	86.1 (15.8)	12
Eating Disturbance	Coaching	89.5 (21.7)	18	88.9 (23.9)	13	90.1 (15.2)	9	93.5 (11.1)	12
	Control	89.4 (22.9)	20	88.2 (21.7)	17	90.4 (15.2)	18	86.1 (19.0)	12
Treatment Burden	Coaching	52.5 (20.8)	18	52.4 (24.8)	13	51.9 (18.4)	9	51.9 (16.6)	12
	Control	47.9 (21.9)	20	52.3 (22.5)	17	56.8 (22.2)	18	57.4 (25.4)	12
Health Perception	Coaching	58.6 (25.5)	18	57.9 (29)	13	51.9 (26.1)	9	48.1 (26.1)	12
	Control	58.3 (24.9)	20	56.9 (20)	17	60.5 (23.9)	18	58.3 (29.3)	12
Weight Problems	Coaching	77.8 (37.9)	18	88.1 (28.1)	13	77.8 (33.3)	9	80.6 (26.4)	12
	Control	83.3 (36.7)	20	80.4 (35.5)	17	83.3 (30.8)	18	80.6 (38.8)	12
Respiratory Symptoms	Coaching	65.6 (19.6)	18	61.5 (18.7)	13	60.5 (16.5)	9	60.2 (23.9)	12
	Control	67.2 (25)	20	73.3 (21.6)	17	70.1 (22.6)	18	70.8 (20.3)	12
Digestive Symptoms	Coaching	74.1 (25.2)	18	65.9 (20.7)	13	67.9 (23.9)	9	61.1 (23.5)	12
	Control	71.1 (27.1)	20	81.3 (15.0)	16	75.7 (18.7)	16	73.7 (25.5)	11

Abbreviations: SD, standard deviation; CFQ-R, Cystic Fibrosis Questionnaire revised version.

Table 3 Means and standard deviations of secondary outcomes at baseline, midway, post-intervention, and follow-up

Measured outcome	Treatment	Baseline		Midway (5 months)		Post-intervention (11 months)		Follow-up (1 year post-intervention)
		Mean (SD)	n	Mean (SD)	n	Mean (SD)	n	Mean (SD)	n
Dornase alfaa	Coaching	4.25 (2.43)	16	4.45 (2.44)	13	4.67 (2.37)	9	4.70 (1.87)	11
	Control	3.86 (2.73)	18	3.72 (2.33)	15	3.53 (2.67)	15	2.98 (1.77)	10
Pancreatic enzymesa	Coaching	5.11 (2.19)	18	4.88 (1.95)	12	5.53 (1.99)	9	5.23 (2.15)	12
	Control	6.08 (1.56)	18	5.88 (1.66)	17	6.32 (1.49)	17	5.39 (2.12)	11
Vitamins supplementa	Coaching	5.14 (2.56)	18	5.13 (2.19)	13	5.94 (2.06)	9	5.04 (2.30)	12
	Control	4.93 (2.56)	20	5.24 (2.70)	17	5.69 (2.51)	18	5.69 (2.51)	11
Inhaled antibioticsa	Coaching	4.50 (2.45)	14	4.52 (2.45)	13	4.97 (2.47)	8	4.40 (2.46)	8
	Control	5.04 (2.54)	18	5.03 (2.48)	16	5.30 (2.31)	15	4.39 (2.32)	11
PEPa	Coaching	3.81 (2.66)	16	3.92 (2.84)	13	4.17 (2.50)	9	3.79 (2.55)	12
	Control	3.62 (2.96)	19	3.36 (2.55)	16	3.36 (2.76)	16	2.78 (1.34)	10
GSE	Coaching	32.1 (5.71)	18	33.2 (5.27)	13	32.9 (6.58)	9	30.4 (6.44)	11
	Control	32.9 (4.12)	20	34.1 (4.63)	16	34.9 (4.39)	18	34.6 (4.32)	11
MDI	Coaching	13.6 (7.82)	18	13.4 (11.2)	13	11.9 (7.03)	9	12.9 (8.67)	12
	Control	13.3 (10.7)	20	10.9 (6.95)	17	9.18 (6.00)	17	10.9 (9.76)	12
CES-D	Coaching	7.89 (10.8)	18	11.3 (11.4)	13	9.71 (7.11)	7	13.3 (10.3)	12
	Control	9.10 (9.85)	20	12.5 (8.94)	16	10.1 (8.51)	18	12.8 (10.8)	12
FEV1	Coaching	71.3 (24.7)	18	74.4 (27.9)	18	69.9 (25.3)	18	71.0 (23.0)	17
	Control	75.5 (21.9)	20	73.9 (22.5)	20	73.5 (19.2)	19	75.2 (23.2)	19
BMI	Coaching	21.7 (3.91)	18	22.5 (4.59)	18	22.0 (4.23)	18	22.2 (3.78)	17
	Control	22.5 (3.93)	20	22.7 (4.06)	20	22.1 (3.48)	19	23.2 (4.53)	19
HbA1c	Coaching	6.41 (1.69)	17	5.99 (2.31)	14	6.65 (1.76)	13	6.31 (1.53)	16
	Control	5.86 (1.24)	16	6.11 (1.13)	14	5.96 (1.31)	10	5.96 (0.87)	19

Notes:

a Scores accessed by MMAS-8. The MMAS (8-item) content, names and trademarks are protected by US copyright and trademark laws. Permission for use of the scale and its coding is required. A license agreement is available from: Donald E. Morisky, ScD, ScM, MSPH,14725 NE 20th St Bellevue, WA 98007, USA; [e-mail].

Abbreviations: SD, standard deviation; MMAS-8, Morisky Medication Adherence Scale-8; PEP, positive expiratory pressure; GSE, General Self-Efficacy; MDI, Major Depres sion Inventory; CES-D, Center for Epidemiologic Studies-Depression Scale; FEV₁, forced expiratory volume in 1 second; BMI, body mass index; HbA1c, glycated hemoglobin.

Table 4 Baseline and post-intervention distribution of adherence and depression scores

	Baseline			Post-intervention (11 months)		Follow-up (1 year post-intervention)
	Total group (n=38)	Coaching group (n=18)	Control group (n=20)	Coaching group (n=9)	Control group (n=18)	Coaching group (n=12)	Control group (n=12)
	%	%	%	%	%	%	%
Dornase alfa	76%	75%	78%	67%	80%	72%	90%
Low adherencea
Pancreatic enzymes	50%	67%	33%	67%	41%	67%	55%
Low adherencea
Vitamine supplements	58%	56%	60%	56%	39%	67%	64%
Low adherencea
Inhaled antibiotics	56%	64%	50%	63%	53%	64%	64%
Low adherencea
PEP	74%	75%	74%	78%	75%	83%	100%
Low adherencea
MDI	15.7%	17%	15%	22%	0	8.3%	8.3%
Mild depression
MDI	2.6%	0	5%	0	5.6%	0	17%
Moderate depression
MDI	7.9%	5.6%	10%	0	0	8.3%	0
Severe depression
CES-D depressionb	26%	22%	30%	22%	22%	25%	25%

Notes:

a Low adherence: Morisky Medication Adherence Scale-8 item scores <6.

b Depression: CES-D scores >16.

Abbreviations: PEP, positive expiratory pressure; MDI, Major Depression Inventory; CES-D, Center for Epidemiologic Studies-Depression Scale.

Table 5 The main effects between the intervention group and the control group over time (baseline, midway, post-intervention, and follow-up) on secondary outcomes

Measured outcomes	Factor	P-value	Partial η^2	Measured outcomes	Factor	P-value	Partial η^2
Physical Functioningc	Timea	0.10	0.132	Dornase alphad	Time	0.17	0.137
	Groupb	0.73	0.008		Group	0.62	0.210
Role Limitationsc	Time	0.41	0.058	Pancreatic enzymesd	Time	0.20	0.103
	Group	0.59	0.021		Group	0.68	0.012
Vitalityc	Time	0.16	0.303	Vitamins supplementd	Time	0.55	0.046
	Group	0.31	0.064		Group	0.44	0.044
Emotional Functioningc	Time	0.36	0.063	Inhaled antibioticsd	Time	0.79	0.024
	Group	0.52	0.027		Group	0.95	0.001
Social Functioningc	Time	0.67	0.138	PEPd	Time	0.08	0.186
	Group	0.91	0.001		Group	0.32	0.076
Body Imagec	Time	0.74	0.047	GSE	Time	0.31	0.094
	Group	0.26	0.078		Group	0.71	0.012
Eating Disturbancec	Time	0.43	0.049	MDI	Time	0.15	0.112
	Group	0.61	0.017		Group	0.35	0.059
Treatment Burdenc	Time	0.62	0.034	CES-D	Time	0.15	0.114
	Group	0.84	0.003		Group	0.94	0.00
Health Perceptionc	Time	0.03	0.177	FEV1	Time	0.40	0.035
	Group	0.36	0.053		Group	0.91	0.001
Weight Problemsc	Time	0.73	0.020	BMI	Time	0.73	0.007
	Group	0.91	0.001		Group	0.62	0.012
Respiratory Symptomsc	Time	0.18	0.096	HbA1C	Time	0.17	0.226
	Group	0.07	0.197		Group	0.56	0.051
Digestive Symptomsc	Time	0.69	0.032
	Group	0.68	0.013

Notes: Data were analyzed using a two-way repeated ANOVA.

a Within-subject factors: repeated time measures (baseline, midway, post-intervention, and follow-up).

b Between-subject factors: coaching group (n=7)/control group (n=11).

c Scores assessed by CFQ-R.

d Scores assessed by MMAS-8.

Abbreviations: CFQ-R, Cystic Fibrosis Questionnaire revised version; MMAS-8, Morisky Medication Adherence Scale-8; PEP, positive expiratory pressure; GSE, General Self-Efficacy; MDI, Major Depression Inventory; CES-D, Center for Epidemiologic Studies-Depression Scale; FEV₁, forced expiratory volume in 1 second; BMI, body mass index; HbA1c, glycated hemoglobin; ANOVA, analysis of variance.