Health Coaching Program Research Articles

A community health-coaching referral program following discharge from treatment for chronic low back pain – a qualitative study of the patient’s perspective

BackgroundGlobal policy and guidelines for low back pain (LBP) management promote physical activity and self-management yet adherence is poor and a decline in outcomes is common following discharge from treatment. Health coaching is effective at improving exercise adherence, self-efficacy, and social support in individuals with chronic conditions, and may be an acceptable, cost-effective way to support people in the community following discharge from treatment for LBP.AimThis qualitative study aimed to understand which aspects of a community over-the-phone health-coaching program, were liked and disliked by patients as well as their perceived outcomes of the service after being discharged from LBP treatment.MethodsA purposive sampling approach was used to recruit 12 participants with chronic LBP, from a large randomised controlled trial, who were randomly allocated to receive a health coaching program from the Get Healthy Service® in Australia. Semi-structured interviews were conducted, and a general inductive thematic analysis approach was taken.ResultsThe main themes uncovered regarding the intervention included the positive and negative aspects of the health coaching service and the relationship between the participant and health coach. Specifically, the participants spoke of the importance of the health coach, the value of goal setting, the quality of the advice received, the benefits of feeling supported, the format of the coaching service, and LBP-specific knowledge. They also reported the health coach and the coaching relationship to be the primary factors influencing the program outcomes and the qualities of the coaching relationship they valued most were connection, communication, care, and competence. The sub-themes uncovered regarding the outcomes of the intervention included positive impacts (a greater capacity to cope, increased confidence, increased motivation and increased satisfaction) and negative impacts (receiving no personal benefit).Clinical implicationsIn an environment where self-management and self-care are becoming increasingly important, understanding the patient’s experience as part of a coaching program is likely to lead to improved quality of health coaching care, more tailored service delivery and potentially more effective and cost-effective community-based care for individuals with chronic LBP in the community after being discharged from treatment.Trial RegistrationThe GBTH trial was prospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN12620000889954) on 10/9/2020. Ethical approval was prospectively granted by the Western Sydney Local Health District Human Research and Ethics Committee (2020/ETH00115). Written informed consent was obtained from all participants. The relevant sponsor has reviewed the study protocol and consent form.

A randomized clinical trial testing a health literacy intervention to reduce disparities in access to care among Justice-Impacted Adults (JIA)

BackgroundLow health literacy is costly and observed among justice-impacted adults (JIA), a group that often faces numerous barriers in accessing healthcare and a disproportionate burden of illness. Health literacy interventions for JIA are critically needed to improve healthcare access and related outcomes.MethodsThis manuscript describes the protocol for a longitudinal mixed-methods randomized clinical trial that assesses the effectiveness of a coach-guided health literacy intervention on JIA’s healthcare access. The intervention was previously piloted with justice impacted adults. We will recruit 300 JIA ages 18 + in San Diego, California. Participants will be randomized 1:1 to the Treatment Group (i.e., coach-guided intervention providing 12 sessions of individualized health coaching and service navigation over 6 months) or the Control Group (i.e., self-study of the health coaching program, and brief service navigation support). We will quantitatively assess JIA’s healthcare access defined as: use of healthcare, health insurance status, and regular source of care at 6-months as the primary outcomes. Participants will also be surveyed at 12-months. Statistical analyses will incorporate the intent-to-treat (ITT) principle and we will estimate mixed-effects logistic regression for the primary outcomes. We will also conduct qualitative interviews at 6 and 12-months with 40 purposively sampled participants, stratified by study arm, who reported healthcare access barriers at baseline. Interviews will explore participants’ satisfaction with the intervention, healthcare attitudes, self-efficacy for and barriers to healthcare access over time, perceived contribution of the intervention to health and well-being, and diffusion of intervention-related information within participants’ social networks. We will conduct deductive thematic analyses of qualitative data.DiscussionLow health literacy among JIA is a foundational challenge requiring tailored intervention strategies. Findings from this trial may inform policies and the structure of service delivery models to build health literacy among JIA in institutional and community settings throughout the United States and elsewhere.Trial registrationThis study is registered with the United States’ ClinicalTrials.gov registry under protocol # 161,903.

Assessing the effectiveness of “BETTER Women”, a community-based, primary care-linked peer health coaching programme for chronic disease prevention: protocol for a pragmatic, wait-list controlled, type 1 hybrid effectiveness-implementation trial

IntroductionThe Building on Existing Tools to Improve Cancer and Chronic Disease Prevention and Screening in Primary Care (BETTER) programme trains allied health professionals working in primary care settings to develop...

Implementation of Coaching to Address Burnout in Emergency Clinicians

BackgroundFactors including sleep disturbances, shift work, secondary traumatization, and workplace violence make emergency nurses uniquely susceptible to burnout. A recent study cited nearly half of emergency registered nurses (49.3%) experienced moderate to severe burnout. There is an urgent need for evidence-based solutions to address burnout and turnover in emergency nurses. The objective of this quality improvement project was to determine the effectiveness of a wellness coaching program for reducing burnout and turnover in emergency nurses and advanced practice providers. MethodsBaseline assessments of burnout and turnover intention were measured at the beginning of the coaching program and measured again upon completion of the coaching program. InterventionEight registered nurses and 2 advanced practice providers from an emergency department in a west coast community hospital completed 6 to 8 weeks of wellness coaching led by a board-certified nurse coach. The wellness coaching program was an evidence-based, modular curriculum in which participants chose the number and length of sessions. ResultsAn average of 6 hours of individualized, 1-on-1 wellness coaching was completed over 7.5 weeks. The project resulted in a large reduction in emotional exhaustion and turnover intention, no effect on depersonalization, and a small reduction in lack of personal achievement (Cohen’s d = 0.79, 1.53, −0.18, and −0.35). Ninety percent of clinicians agreed or strongly agreed that coaching helped improve their burnout and said they would consider it again in the future. ConclusionThis quality improvement project demonstrates wellness coaching was an evidence-based solution for improving burnout and turnover in emergency nurses. More investigation is needed to determine duration of reduction of these outcomes.

“Veteran to Veteran, There's Automatically a Trust”: A Qualitative Study of Veterans’ Experiences in a Peer Health-Coaching Program for Hypertension

IntroductionVeteran peer Coaches Optimizing and Advancing Cardiac Health (VetCOACH) was a randomized controlled trial to test the effectiveness of a peer support intervention to reduce blood pressure among Veterans with hypertension and one or more cardiovascular risks. We studied participant perceptions of the intervention, including barriers and facilitators to participation, factors promoting behavior change, and disease self-management practices. MethodsWe enrolled participants at their exit visit for the VetCOACH study. Participants received primary care at the Veterans Administration health care system and had multiple cardiovascular disease risks, including a diagnosis of hypertension. We conducted a qualitative content analysis of semi-structured interviews about their experience with the VetCOACH intervention. ResultsInterview participants (n=29) were 60 years of age on average (SD 8.6), 71% male, and 55% White. They had mean systolic blood pressure of 138 mmHg (SD 18) at baseline. We identified themes across three major categories, which follow the general progression of the intervention: participation, relationship-building, and behavior change. Scheduling flexibility, shared identity and experiences with the coach, acquisition of new knowledge and skills, and goal-setting were important determinants of participants’ experiences in the program. In the participation category, the themes were scheduling, visit modality, life circumstances, and staffing. In the relationship category, the themes were the coach's professional role, shared identity and experiences, and social support. In the behavior change category, the themes were memory, attention, decision-processes; goal-setting; skills and knowledge; and environmental context and resources. We report differences across patients varying by blood pressure reduction following the intervention and number of coaching visits. ConclusionsParticipants generally reported positive experiences in a peer support intervention for Veterans with hypertension. Participant perceptions provide important insights to the intervention design and implementation. These findings may inform future implementation of peer support among Veterans in hypertension and chronic disease self-management more generally.

Does Health Coaching Reduce the Risk of Type 2 Diabetes?

Even with decades of medical advancements and the National Diabetes Prevention Program, the incidence obesity and type 2 diabetes mellitus (T2DM) continues to rise. This pilot study explored the effect of lifestyle coaching on weight and engagement in care among adults with or at risk for prediabetes. It used a virtual, group health coaching program called Aligning Nutrition, Exercise and Wellbeing (ANEW-AP), facilitated by board-certified health coaches. Weight loss varied, yet no participants gained weight, and overall engagement in care slightly increased.

652-P: Impact of a Six-Month Digital Health Coaching Program on Individuals with Type 2 Diabetes Mellitus Experiencing Food Insecurity in Rural Areas

652-P: Impact of a Six-Month Digital Health Coaching Program on Individuals with Type 2 Diabetes Mellitus Experiencing Food Insecurity in Rural Areas

Insights Into the Use of a Digital Healthy Aging Coach (AGATHA) for Older Adults From Malaysia: App Engagement, Usability, and Impact Study.

Digital inclusion is considered a pivotal social determinant of health, particularly for older adults who may face significant barriers to digital access due to physical, sensory, and social limitations. Avatar for Global Access to Technology for Healthy Aging (AGATHA) is a virtual healthy aging coach developed by the World Health Organization to address these challenges. Designed as a comprehensive virtual coach, AGATHA comprises a gamified platform that covers multiple health-related topics and modules aimed at fostering user engagement and promoting healthy aging. The aim of this study was to explore the perception and user experience of Malaysian older adults in their interactions with the AGATHA app and its avatar. The focus of this study was to examine the engagement, usability, and educational impact of the app on health literacy and digital skills. We performed a qualitative study among adults 60 years and older from suburban and rural communities across six states in Malaysia. Participants were purposefully recruited to ensure representation across various socioeconomic and cultural backgrounds. Each participant attended a 1-hour training session to familiarize themselves with the interface and functionalities of AGATHA. Subsequently, all participants were required to engage with the AGATHA app two to three times per week for up to 2 weeks. Upon completion of this trial phase, an in-depth interview session was conducted to gather detailed feedback on their experiences. Overall, the participants found AGATHA to be highly accessible and engaging. The content was reported to have a comprehensive structure and was delivered in an easily understandable and informative manner. Moreover, the participants found the app to be beneficial in enhancing their understanding pertaining to health-related issues in aging. Some key feedback gathered highlighted the need for increased interactive features that would allow for interaction with peers, better personalization of content tailored to the individual's health condition, and improvement in the user-experience design to accommodate older users' specific needs. Furthermore, enhancements in decision-support features within the app were suggested to better assist users in making health decisions. The prototype digital health coaching program AGATHA was well received as a user-friendly tool suitable for beginners, and was also perceived to be useful to enhance older adults' digital literacy and confidence. The findings of this study offer important insights for designing other digital health tools and interventions targeting older adults, highlighting the importance of a user-centered design and personalization to improve the adoption of digital health solutions among older adults. This study also serves as a useful starting point for further development and refinement of digital health programs aimed at fostering an inclusive, supportive digital environment for older adults.

Peer health coach experiences promoting a nondiet approach in a university health coaching program

PurposeResearch shows peer health education programs on university campuses can support students in pursuing sustainable health-related behavior changes. However, few programs deliver peer health education through a nondiet, weight-inclusive framework. Research shows that health educators who challenge the status quo of diet culture and weight-focused health interventions may face unique challenges when sharing this perspective with others. Thus, the purpose of this study was to examine the experiences of peer educators who provided critical health education by introducing a nondiet, weight-inclusive approach to health.Design/methodology/approachFive health coaches from a university health coaching program at a mid-sized southwestern university participated in a semi-structured interview. The data were analyzed through interpretative phenomenological analysis.FindingsPeer educators faced numerous challenges when introducing nondiet, weight-inclusive approaches such as lacking credibility as a peer to challenge weight-centric messages, feeling conflicted about honoring clients’ autonomy when clients are resistant to a weight-inclusive approach and feeling uncomfortable when discussing client vulnerabilities. Peer educators also identified several strategies that helped them navigate these challenges such as being intentional with social media, using motivational interviewing to unpack clients’ concerns about weight, and seeking group supervision.Originality/valueGiven the reality that health coaches will face challenges sharing weight-inclusive health approaches, educators and supervisors should explicitly incorporate strategies and training methods to help peer health coaches prepare for and cope with such challenges. More research is also needed to examine effective ways to introduce weight-inclusive approaches to college students.

Abstract PS02-08: The Effect of a Digital Health Coaching Program on Patient Reported Outcomes of Women with Breast Cancer

Abstract Background Understanding the impact of a digital health coaching (DHC) program on patient-reported outcomes in women with breast cancer is imperative as web-based platforms and mobile phone applications to address health care needs flood the marketplace. This study evaluated the effect of a DHC program on patient-reported outcomes, including global health (primary outcome), symptom burden, quality of life, healthcare utilization, and financial toxicity among women undergoing active treatment for breast cancer. Methods English-speaking adult women undergoing active treatment for breast cancer were randomized to receive usual care or a 6-month DHC program, consisting of weekly telephone calls from a Health Advisor, unlimited patient-initiated communication via phone, text, or email, and digital delivery of additional health-behavior content. Patient-reported outcomes (PROs) were collected using validated measures at baseline, and 1, 3, and 6 months. Summary statistics were used to describe participant characteristics. Linear mixed models were used to assess the effect of the intervention on outcomes. Results Participants (n=254, planned enrollment=440) were enrolled from August 2019 to December 2022 and randomized equally to the control and intervention groups (n=127 each). Demographic data are presented in Table 1. Participants had a mean age of 48 (SD =10.15) years; 74% were White; 19.7% were Hispanic. In both groups, several PRO scores changed over time with some improving (quality of life and symptom severity) and others worsening (symptom interference and financial toxicity) compared to baseline (time effects). Of those enrolled in the intervention group 69% were retained in the DHC program, with an overall average of 4.6 months of engagement for all participants. There were no significant group (intervention versus control) effects or group by time interaction effects observed. Trends within and between groups are presented in Table 2. Though not statistically significant, there were fewer ER visits in the intervention group at each timepoint. Conclusions: While differential improvements in the DHC group were not observed, interesting trends in PROs over the 6-month enrollment period were observed in both groups. Participants reported improvements in quality of life and worsening of financial toxicity. Interestingly, slight improvements in symptom severity over time were observed in both groups while symptom interference worsened. Potential reasons for failure to detect a treatment effect for DHC may include ineffectiveness of DHC on the selected outcomes, the intervention not being strong enough as currently delivered to detect a treatment effect, varying uptake of DHC in the intervention group, heterogeneity of the sample, or the study being underpowered due to COVID restrictions affecting enrollment. Table 1. Demographic and clinical characteristics of the study population (n = 254) Table 2. Trends in Patient Reported Outcomes and Healthcare Utilization Citation Format: Meagan Whisenant, Eileen Hacker, Loretta Williams, Joyce Dains, Bryan Fellman, Trinity Isaac, Valerie Shelton, Austin Barr, Carolyn Harty, Mazi Rasulnia, Kelly Brassil. The Effect of a Digital Health Coaching Program on Patient Reported Outcomes of Women with Breast Cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PS02-08.

Abstract P242: The Effects of Wellness Coaching on Lowering Stroke Risk Factors in a Wisconsin Native American Population

Objective: Native Americans are disproportionally affected by obesity, diabetes and stroke. This study tests the hypothesis that weight loss and change in BMI are related to coaching participation in the first 52 weeks of a two-year study. Methods: Participants of the “Stroke Prevention in the Wisconsin Native American Population” study age ≥55 years with three or more stroke risk factors were assigned to a High Risk-Intensive Coaching arm (n=49); informed consent was obtained for all participants. These participants engaged in routine wellness coaching visits centered around lifestyle modification in an effort to reduce risk factors for stroke. Data analysis was performed with SPSS (SPSS, IBM Corporation, Armonk, NY, US) and R (RStudio, PBC, Boston, MA, US). Continuous variables are reported with median and interquartile range (IQR). A participation score (total coaching sessions attended ÷ 52 weeks) was calculated for each participant and total weight loss for the first 52 weeks was also calculated (baseline weight in pounds - the weight in pounds at the last coaching session closest to week 52), (n=49). The Wilcoxon Signed Rank test was used to test the hypothesis that weight loss or change in BMI was significantly different than baseline. A smoothing spline was used to assess a potential dose-response relationship between participation score and weight loss and change in BMI. Results: Of the 49 participants examined, 36 were female and 13 were male, with a median age of 66 (IQR =10.0) years. Risk factors observed at baseline included smoking (n=11, 22.4%), median BMI of 31.6 lb/in 2 (IQR=7.7), and median physical activity of 90 minutes per week (IQR=210.0). Biometric measures were also recorded at baseline, with a median systolic blood pressure of 149 mmHg (IQR=26.0) and median diastolic of 80 mmHg (IQR=14.0), median total cholesterol of 156 mg/dL (IQR=57.0), median LDL of 87 mg/dL (IQR=57.0), median HDL of 46 mg/dL (IQR=16.0), median non-HDL of 110 mg/dL (IQR=61.0), and median hemoglobin A1C of 6.5 mg/dL (IQR=1.2). Participation score median of 0.33 (IQR=0.375) range 0.06-0.87. Weight loss median 3.6 (IQR=9.45) range -41 to 35 pounds. A spline analysis found a significant dose-response relationship between participation score in the first 52 weeks of the study and weight loss (r 2 =0.199 deviance 23%, p=0.006) and BMI (r 2 =0.145, deviance 16.7%, p=0.010). Conclusion: Preliminary results suggest that participation in a wellness coaching program may be associated with weight loss and change in BMI in this study population. Future work will continue to examine how coaching is related to weight loss and change in BMI in a larger cohort and with a wider age range.

Preliminary Findings From a Pilot Professional Coaching Program on the Components of Burnout in a Diverse Group of Physician Leaders.

Burnout impacts physicians at alarming rates; physician leaders are not immune. While burnout of physician leaders is associated with decreased leadership efficacy, physician coaching has been associated with reduced burnout. This study aimed to assess the effect of a physician-leader specific coaching program on the components of burnout. A 10-week Wellness Coaching Program for physician medical directors was conducted and burnout was measured pre and post intervention using the Maslach Burnout Inventory-General Survey (MBI-GS). All subscales of the MBI-GS trended towards a decrease in the components of burnout with a statistically significant decrease in Cynicism. Wellness coaching programs have the potential to positively impact the threat of burnout experienced by physician leaders in today's health care workforce.

Patient and Community Health Worker (CHW) Perspectives on a CHW-delivered Nutrition Intervention for Low-Income Adults with Hypertension: A Qualitative Study.

Adults with food insecurity (FI) face barriers to hypertension management, including difficulty adhering to diet recommendations. Few community health worker (CHW) interventions focus on diet to improve blood pressure. This qualitative study elicited patient and CHW perspectives on healthy eating and a future CHW nutrition intervention for patients with hypertension. Twenty-five patients with hypertension and FI and 5 CHWs participating in a hypertension health coaching program from 5 Boston-area health centers participated in semi-structured interviews from July to September 2023. Interviews were audio recorded, transcribed, and analyzed using the Framework Method. Themes included: 1) Variable patient knowledge about dietary patterns for hypertension management and low confidence in interpreting nutrition labels; 2) Culture influenced healthy food perception; and 3) Barriers to healthy eating included cost, limited cooking abilities/supplies, and competing demands. Patients and CHWs favored simple nutrition education materials (e.g., traffic light nutrition ranking, healthy meals on a budget). Patients had mixed opinions about CHW-accompanied supermarket visits. This study identified culture, knowledge gaps, and budget constraints as factors influencing diet among patients with hypertension and FI. A CHW-delivered intervention could include simplified nutrition education, strategies for healthy eating on a budget, and linkage to community-based food programs.

Abstract 13093: Impact of Digital Health Coaching on Older Individuals With Cardiometabolic Conditions

Introduction: Cardiometabolic conditions are top contributors to low health-related quality of life and early mortality. The multi-faceted care needed to manage these conditions can become more challenging as patients age. This analysis aimed to identify if a digital health coaching (DHC) program can improve how older adults manage their cardiometabolic conditions. Methods: This retrospective analysis included adults 55 or older who participated in a DHC program for at least 3 months. Participants were referred by an employer/payor program or physician. Participants enrolled in 1 of 4 cardiometabolic condition-specific programs: Weight Management, Type 2 Diabetes, Hypertension, or Dyslipidemia. To assess outcomes and impact of participation in DHC, changes in psychosocial and cardiovascular-related quality of life measures collected at baseline and month 3 were evaluated. Results: Of 1,290 adults enrolled in a cardiometabolic DHC program, 639 remained engaged and completed outcome measure surveys. Most participants were female (80%), and the study population was racially diverse: 52% white, 48% nonwhite. At 3 months, self-reported diabetes distress scores (2.36 to 1.9, P<0.05) and weight (206.5 to 201.765, P<0.05) improved. Depression (2.36 to 1.9, P<0.05), stress (3.97 to 3.27, P<0.05), and anxiety (0.86 to 0.73, P<0.05) scores also improved. Conclusions: DHC participants improved clinical and psychosocial outcomes in 3 months in this outcome analysis. Engaging in DHC may help patients manage their cardiometabolic conditions and help improve their health-related quality of life.

Outcomes of a digital health coaching program for individuals with acute myeloid and chronic lymphocytic leukemia.

496 Background: Chronic lymphocytic leukemia (CLL) accounts for ~19,000 and acute myeloid leukemia (AML) accounts for ~20,000 new cases a year, according to SEER data. Individual management and overall survival rates vary by cancer type, each with unique and potentially long-term care needs. Digital interventions continue to expand, connecting with individuals beyond the clinical setting to support health self-efficacy and address overall wellness needs. However, data related to their application for hematologic malignancies is limited. Methods: The aim of this randomized, longitudinal cohort study was to evaluate the effect of a 3-month digital health coaching program on health self-efficacy, measured by the Cancer Behavior Inventory (CBI), and other patient reported outcomes (PROs) among individuals with AML or CLL. We aimed to enroll 500 participants, 250 each with CLL and AML, randomized to either the digital intervention or usual care. PROs were collected at baseline and up to once per month for 3 months via REDCAp. Clinical outcomes were tracked via electronic health record. The change in CBI scores from baseline to 3 months was calculated with 95% confidence intervals. A 2-sample t-test was used to compare change between intervention and control arms. PRO trends over time were analyzed using linear mixed models (LMMs). Results: The study enrolled 147 individuals from July 2020 through December 2022. Thirty-seven were enrolled in the AML group (19 control), and 110 in the CLL group (55 control). The mean change in CBI from baseline to 3 months in the AML control arm was -3.57 (95% CI: -17.30 – 10.15) and in the AML intervention arm was 7.03 (95% CI: -2.67 – 16.74), with higher scores indicating greater efficacy for coping. While not significant, mean change in CBI in the CLL control arm was 1.43 (95% CI: -3.45 – 6.31; p=0.556) and in the CLL intervention arm was 3.46 (95% CI: -1.44 – 8.37; p=0.219). In the CLL group, self-efficacy was associated with improved quality of life (p <0.001); For every unit increase in FACT-LEU-TOI, CBI increased on average by 0.81 units (95% CI: 0.62 – 1.00). Conclusions: Due to limited study enrollment during the COVID-19 pandemic, the study was not powered to detect a difference between groups. Data from the engaged cohort suggest a non-statistically significant trend over time in improvement in health self-efficacy for the participants engaged in digital health coaching. A recent meta-analysis suggests self-efficacy has a strong negative correlation with distress and positive correlation with quality of life and improved self-efficacy may mitigate negative effects of a cancer diagnosis and treatment. Data related to trends in PRO over time within and between AML and CLL cohorts provide further insights into physiologic and psychosocial outcomes for these populations. Clinical trial information: NCT04774744 .

Health coaching for undergraduate nursing students: a pilot study for an action research.

The Nursing undergraduate degree educational program represents an intensive and complex course, and includes a number of professionalizing practical internships, and for these reasons it requires an action to support and improve. Coaching is based on the premise that people have personal strengths and abilities which, through a interview, can be directed to solving their problems. Several studies demonstrate the efficacy of Health Coaching in different University, but never have been measured benefits regard skills improving. The objective of the study is to assess the impact of a health coaching program on the nursing students. A pre-post quasi-experimental study was conducted, involving the activation of a Health Coaching Program for 25 nursing students selected through convenience sampling, based on their fulfillment of the inclusion criteria. The Health Coaching Program was administered by the Health Coaching Academy. This study also evaluated parameters such as: level of concentration in study, motivation, problem solving and reorganization skills, study organization skills, psycho-physical-emotional state comprehension, decision-making skills and self-esteem, noting a statistically significant increase post-HC program. A statistically significant improvement was also found in the students' perception of their own stress management skills after the course. This study strengthens the hypothesis that HC programs contribute to improving performance of nursing students. Those conclusions need to be corroborated by future studies on the topic to further support the hypothesis that programs of HC within the learning nursing contexts can lead to a tangible benefit for students of the health professions.

Perception of a Peer Health Coaching Intervention Among College Students: Client Experience

ABSTRACT Background As health coaching is becoming more popular as a health promotion intervention tool, there is a lack of empirical evidence to understand the clients’ experience in the peer health coaching program among college students. Purpose This qualitative study explored the experiences and perceptions of the health coaching clients following an 8-week peer health coaching intervention in college. Method A total of 14 student clients (female, n = 9, 57% White) from the health coaching program participated in the focus group, following an 8-week peer health coaching program. The semi-structured focus group guide was developed to understand their experience. Results Clients’ positive experience in the health coaching program contributed to transformative outcomes, including behavioral outcomes and goal achievement, well-being and personal growth, and self-empowerment, with the coaching relationship mediating the relationship and the coaching modality moderating the relationship. Discussion The health coaching experience facilitated lifestyle changes, helped clients gain self-efficacy and confidence to manage their health and wellbeing and provided an overall caring, enjoyable, supportive experience. The bonding with the peer health coaches provided important social support for the student clients. Translation to Health Education Practice A peer health coaching program can be a cost-effective option for health promotion on college campuses. A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI) http://portal.shapeamerica.org/trn-Webinars

A randomized trial of a theory-driven model of health coaching for older adults: short-term and sustained outcomes

BackgroundHealthy Lifetime, a theoretically driven, personalized health coaching program delivered electronically, including face-to-face videoconferencing, was developed to intervene in early aging to stave off functional decline and minimize the onset/exacerbation of chronic conditions.ObjectiveTo determine the efficacy of a theoretically driven, personalized health coaching program in participants 50 years and older with one or more chronic conditions using a randomized, controlled, pragmatic clinical trial methodology.MethodsParticipants were randomly assigned to the HL (n = 59) or a usual care (n = 63) group. The HL group received health coaching from a trained nurse over eight weeks. Outcomes were measured at baseline, eight weeks, and 20 weeks (after the 12-week no-treatment phase). Regression modeling with fixed-effect repeated measures was used to account for the longitudinal data collection.ResultsFor the HL group, health habits increased at 8 weeks (3.1 units; SE = 1.0; p = .0005; effect size = .15). This difference was sustained at 20 weeks (2.4 units, SE = 0.2; p = .0005). Independent self-care agency improved at 8 weeks in individuals with high blood pressure (13.5 units; SE = 4.37; p = .0023; effect size = .3). However, that difference was not sustained at 20 weeks (p = .47). No significant improvements were shown in the usual care group at 8 weeks or 20 weeks.ConclusionsHL participants significantly improved their health habits at 8 weeks and sustained this improvement at week 20 (after a 12-week no-treatment phase) vs. the usual care group. Changing health habits alone has been shown to reduce all-cause morbidity and mortality in chronic disease. The high-functioning, community-dwelling older adults with chronic diseases we studied is an important target population for primary care practices to intervene early in aging to stave off the complications of chronic disease and functional decline.Trial registrationClinicalTrials.gov (record NCT05070923, 07/10/2021).

Impact of a pediatric primary care health-coaching program on change in health-related quality of life in children with mental health problems: results of the PrimA-QuO cohort study

Mental health problems (MHP) have a considerable negative impact on health-related quality of life (HRQoL) in children and their families. A low threshold Health Coaching (HC) program has been introduced to bring MH services to primary care and strengthen the role of pediatricians. It comprised training concepts as a hands-on approach for pediatricians, standardization of diagnosis and treatment, and extended consultations. The aim of this study was to evaluate the potential effects of the HC on HRQoL in children with MHP and their parents.We used data from the PrimA-QuO cohort study conducted in Bavaria, Germany from November 2018 until November 2019, with two assessments one year apart. We included children aged 17 years or younger with developmental disorder of speech and language, non-organic enuresis, head and abdominal pain, and conduct disorder. All included children were already part of the Starke Kids (SK) program, a more general preventive care program, which includes additional developmental check-ups for children enrolled in the program. In addition, treatment according to the HC guidelines can be offered to children and adolescents with mental health problems, who are already enrolled in the SK program. These children form the intervention group; while all others (members of BKK and SK but not HC) served as controls. HRQoL in children was assessed using the KINDL questionnaire. Parental HRQoL was measured by the visual analogue scale. To analyze the effects of the intervention on children´s HRQoL over the 1-year follow-up period, we used linear mixed effects models.We compared 342 children receiving HC with 767 control patients. We could not detect any effects of the HC on HRQoL in children and their parents. This may be attributed to the relatively high levels of children´s HRQoL at baseline, or because of highly motivated pediatricians for the controls because of the selection of only participant within the Starke Kids program. Generally, HRQoL was lower in older children (-0.42 points; 95% CI [-0.73; -0.11]) and in boys (-1.73 points; 95% CI [-3.11; -0.36]) when reported by proxy. Parental HRQoL improved significantly over time (2.59 points; 95% CI [1.29; 3.88]).Although this study was not able to quantitatively verify the positive impact of this HC that had been reported by a qualitative study with parents and other stakeholders, and a cost-effectiveness study, the approach of the HC may still be valid and improve health care of children with MHP and should be evaluated in a more general population.

Critical Lessons in Tailoring Interventions: Listening to WISEWOMAN Participants.

To explore perspectives of participants in the WISEWOMAN program in Pennsylvania (PA-WISE) on challenges and facilitators of reducing cardiovascular disease risk as low-income and un-/under-insured middle-aged women. Researchers conducted this 2year qualitative data collection as one component of a broader, 5year PA-WISE process and outcome evaluation. Women from across Pennsylvania, primarily from rural communities. Interviewees were low-income, un-/under-insured women aged 40-64years who had recently participated in PA-WISE-facilitated health coaching and lifestyle programs (HC/LSPs). Researchers conducted individual telephone interviews with 38 women from four discrete samples of PA-WISE participants at 4time points. Three researchers used grounded theory, and an iterative process of line-by-line coding, data display, and reanalysis to identify emerging themes, sub-themes, and their relationships. Participants shared the important benefits of specific PA-WISE program traits. However, participants described significant financial constraints, difficult schedules, caregiving responsibilities, and insufficient social support as persistent challenges in their lives, making lifestyle changes in general, and program participation specifically, difficult. The challenges that low-income and un-/under-insured women identified amplify the importance of having interventions that offer flexibility, options, and tailoring of supports and resources. The timeless challenges articulated by participants in this study completed just before the COVID-19 pandemic, remain relevant to be addressed through the pandemic and beyond.