Pilot Feasibility Study of Incorporating Whole Person Care Health Coaching Into an Employee Wellness Program

Abstract

Prior research supports positive health coaching outcomes, but there is limited literature on the integration of employer-sponsored health coaching into employee wellness strategy. The aim of our mixed methods study was to assess feasibility, acceptability, and preliminary efficacy of incorporating a whole-person care model of health coaching into an employee wellness program (i.e., weight loss, smoking cessation) that is made available by an employer-sponsored health plan. For the quantitative study, eligible employees and covered spouses (n = 39) from Loma Linda University Health were recruited into a novel, 12-week, whole person care intervention that combined health coaching and health education and examined outcomes from surveys detailing the participants' experience and biometric data from the intervention and maintenance periods. For the qualitative study, data were collected through key informant interviews from three health coaches and six intervention participants who were recruited via random sampling. Health coaching was well-received by the participants, and led to a slight albeit positive behavioral change for obesity. A significant decrease in body mass index occurred over 12 weeks of intervention (−0.36 kg/m2, p = 0.016), that did not continue during the maintenance phase (−0.17 kg/m2, p = 0.218). Qualitative findings indicated improved personal health awareness, accountability, motivation, and self-efficacy along with goal setting and barrier overcoming skills among the key themes. Our pilot study findings identify positive behavior change effects of an employee health intervention based on a whole person care model of health coaching with integrated health education, and also identify the need for methods to maintain behavior change (i.e., mHealth, peer-support) post-intervention. Further investigation in randomized controlled trials is the next step in this research.

Exploring facilitators and barriers to long‐term behavior change following health–wellness coaching for stroke prevention: A qualitative study conducted in Auckland, New Zealand

“…Using tools to support decision‐making and learning new skills in prioritizing self, establishing routines, goal‐setting, problem‐solving, and time‐management were found to be significant facilitators of long‐term behavior change. Similar findings were reported in an employer‐offered pilot study of HWC coaching where goal‐setting, improved personal awareness, and motivation were seen as key values of health coaching (Nelson et al., 2020 ). Some of the skills and tools discussed by participants were acquired via HWC, whereas others were learned more organically through life experiences.…”

“…This finding is supported by Nelson et al. ( 2020 ) who found that accountability and self‐efficacy are valuable components of HWC. Within our study, participants who made themselves accountable to others and took personal responsibility for their health had greater success in maintaining healthy behaviors.…”

Cohort profile for the Loma Linda University Health BREATHE programme: a model to study continuously incentivised employee smoking cessation

“…The LLUH BREATHE cohort profiled in this report is an open, dynamic cohort of current and former smokers who are continuously incentivised to maintain or attempt tobacco cessation through an ‘opt-in wellness discount’ on the out of pocket cost of their health plan. The initial findings from LLUH BREATHE indicated (1) high rates of participation and 4-month abstinence rates1 and (2) preliminary findings of acceptability of the incentivised health plan model to members and providers 14. Our profile of the cohort after more than 5 years of follow-up identifies a rich data set for inquiry into workplace and health plan-based incentives for achieving long -term abstinence from tobacco among employed adults.…”

“…1 The first year cessation rate of LLUH BREATHE participants was also notably high (48% achieved a 4-month point prevalence abstinence) 1. Pilot qualitative data provide preliminary clues that the WHP cohort members and their providers are receptive to the incentivised intervention model 14…”

“…These outcomes can be related to demographic, behavioural, health plan services used, nicotine screening methods (self-report, bio-specimen testing, retesting appeals) and costs incurred. We are beginning to publish exploratory qualitative analyses of WHP and LLUH BREATHE cohort member programme experiences to identify programmatic areas for improvement 14…”