Determinants of Successful eHealth Coaching for Consumer Lifestyle Changes: Qualitative Interview Study Among Health Care Professionals

Abstract

BackgroundSuccess with lifestyle change, such as weight loss, tobacco cessation, and increased activity level, using electronic health (eHealth) has been demonstrated in numerous studies short term. However, evidence on how to maintain the effect long-term has not been fully explored, even though there is a pressing need for long-term solutions. Recent studies indicate that weight loss can be achieved and maintained over 12 and 20 months in a primary care setting using a collaborative eHealth tool. The effect of collaborative eHealth in promoting lifestyle changes depends on competent and skilled dieticians, nurses, physiotherapists, and occupational therapists acting as eHealth coaches. How such health care professionals perceive delivering asynchronous eHealth coaching and which determinants they find to be essential to achieving successful long-term lifestyle coaching have only been briefly explored and deserve further exploration.ObjectiveThe aim of this study is to analyze how health care professionals perceive eHealth coaching and to explore what influences successful long-term lifestyle change for patients undergoing hybrid eHealth coaching using a collaborative eHealth tool.MethodsA total of 10 health care professionals were recruited by purposive sampling. They were all women aged 36 to 65 years of age with a mean age of 48 years of age. A total of 8/10 (80%) had more than 15 years of experience in their field, and all had more than six months of experience providing eHealth lifestyle coaching using a combination of face-to-face meetings and asynchronous eHealth coaching. They worked in 5 municipalities in the Region of Southern Denmark. We performed individual, qualitative, semistructured, in-depth interviews in their workplace about their experiences with health coaching about lifestyle change, both for their patients and for themselves, and mainly how they perceived using a collaborative eHealth solution as a part of their work.ResultsThe health care professionals all found establishing and maintaining an empathic relationship essential and that asynchronous eHealth lifestyle coaching challenged this compared to face-to-face coaching. The primary reason was that unlike typical in-person encounters in health care, they did not receive immediate feedback from the patients. We identified four central themes relevant to the health care professionals in their asynchronous eHealth coaching: (1) establishing an empathic relationship, (2) reflection in asynchronous eHealth coaching, (3) identifying realistic goals based on personal barriers, and (4) staying connected in asynchronous coaching.ConclusionsEstablishing and maintaining an empathic relationship is probably the most crucial factor for successful subsequent eHealth coaching. It was of paramount importance to get to know the patient first, and the asynchronous interaction aspect presented challenges because of the delay in response times (both ways). It also presented opportunities for reflection before answering. The health care professionals found t...

E-health – modern technologies in mental health care

“…Despite many advantages of electronic technologies implementation in healthcare, research findings show that their effectiveness depends on thorough assessment of the patients' state and functioning, as well as on establishing and maintaining an emphatic relationship with them [42]. It is of pivotal importance that realistic goals of electronic interventions, with patients' individual barriers accounted for, should be set in a direct contact with the health care professional [42].…”

“…Mimo licznych zalet korzystania z elektronicznych technologii w służbie zdrowiu, wyniki badań pokazują, że ich skuteczność uzależniona jest od dokładnego poznania stanu pacjenta, jego funkcjonowania, nawiązywania i utrzymywania empatycznej relacji z nim [42]. W bezpośrednim kontakcie ze specjalistą kluczowe jest ustalenie realistycznych celów elektronicznych interwencji przy uwzględnieniu indywidualnych barier pacjentów [42].…”

“…Numerous short-term research studies indicate that the e-health system is highly effective as regards interventions targeted at patient lifestyle changes including body weight reduction [47], withdrawal from nicotine and other habit-forming substances, or increasing physical activity [42]. The research findings reported by John Naslund and collaborators [47] from their study involving people with obesity show effectiveness of mobile applications in body weight reduction.…”

“…E-tools provided the study participants with motivation to change their lifestyle, helped them improve self-control and use social media. Effectiveness of e-health programs in promoting lifestyle changes and in rehabilitation depended on collaboration of professionals from various disciplines: dieticians, nurses, physiotherapists, occupational therapists, and psychologists who begin to fulfill the role of e-health coaches [42,48]. zaangażowania w oddziaływania w ramach e-zdrowia: typ aktywny (acivism), partnerski (partnership) i uległy (compliance).…”

“…W świetle licznych badań krótkoterminowych system e-zdrowia okazał się niezwykle efektywny, jeśli chodzi o oddziaływania mające na celu zmianę stylu życia pacjentów dotyczącą utraty masy ciała [47], odstawienia nikotyny i innych substancji uzależniających czy wzrostu poziomu aktywności fizycznej [42]. Wyniki badań Johna Naslunda i wsp.…”