Clinical Effectiveness of Lifestyle Health Coaching

Abstract

We have developed, tested, and successfully implemented an affordable, evidence-based, technology-enabled, data-driven, outcomes-oriented, comprehensive lifestyle health coaching (LHC) program. The LHC program has been used primarily to provide services to employees of larger employers (ie, with at least 3000 employees) but has also been implemented in a variety of other settings, including hospitals, cardiac rehabilitation centers, physician practices, and as part of multicenter clinical trials. The program is delivered mainly using the telephone and Internet. Health coaches are guided by a Web-based participant management and tracking system. Lifestyle management interventions are based on several behavior change models and strategies, especially adult learning theory, social learning theory, the stages of change model, single concept learning theory, and motivational interviewing. The program is administered by nonphysician health professionals whose services are integrated with the care provided by participants' physicians. Outcomes data from published studies, including randomized clinical trials and independent third-party conducted research, have documented the clinical effectiveness of this evidence-based approach in terms of modification of multiple risk factors in healthy persons as well as those with certain common chronic diseases.

Lifestyle Modification for Secondary Stroke Prevention

“…For busy clinical practices, the time required to implement intensive health behavior interventions may be a barrier. 64 Additional barriers include limited reimbursement for preventive services, low outcome expectations that patients will comply with behavior prescriptions, and lack of provider self-efficacy in providing lifestyle intervention counseling. 68 Even though these factors are real barriers for providers, clinical guidelines are explicit about lifestyle modification for the prevention of cardiovascular disease and stroke.…”

“…A comprehensive lifestyle health coaching program (ie, INTERVENT) administered in clinical and community-based settings has also been effective in cardiovascular disease risk reduction. 63,64 This program is delivered mainly over the telephone and internet and lasts for a minimum of 1 year. Trained health coaches follow a standardized program to help participants set behavior change goals, develop action plans, and implement action plans.…”

Health Coaching as an Intervention for Picky Eaters

“…The use of health coaching strategies in improving diet has already been the focus of some investigation 18,19,20 ; however, there does not appear to be any published work on the use of health coaching strategies for assisting adult patients to modify picky eating behaviors. Additionally, there is scant published research about effective interventions for the consequences of adult picky eating (which themselves are poorly understood beyond nutritional inadequacy and weight management difficulties).…”

“…28 Further research is needed to determine the optimal number of health coaching sessions. 19 There does appear to be a dose-response relationship between number of sessions and health outcomes using a schedule of 4 to 18 sessions dependent on patient need. 19 The coaching intervention may be provided either by a suitably trained primary care physician or trained allied health personnel.…”

“…19 There does appear to be a dose-response relationship between number of sessions and health outcomes using a schedule of 4 to 18 sessions dependent on patient need. 19 The coaching intervention may be provided either by a suitably trained primary care physician or trained allied health personnel. In the case of picky eating, it is recommended that coaching focus on 2 aspects of diet and nutrition: the range of foods the patient may be prepared to try and the use of culinary medicine-the skills of preparing and cooking food.…”