The Use of Health Coaching to Improve Health Outcomes: Implications for Applied Behavior Analysis

Finn, Heather E.; Watson, R. A.

doi:10.1007/s40732-017-0241-4

Cited by 9 publications

(14 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The model enabled the evaluation of a regional-level intervention using data from routine practice, with scope for external validity and generalisability of the results to other regions in England. Our findings are plausible and are supported by the logic model, our parallel qualitative research [15], and previous literature on health coaching [49, 50].…”

Section: Discussionsupporting

confidence: 87%

“…However the evidence for this approach is mixed [47]. On one hand, researchers have highlighted self-care as key to the management of chronic conditions [48], with findings of positive behavioural changes associated with increased patient activation [49, 50]. On the other hand, they have found a range of barriers to self-management including low health literacy and the challenging burden associated with chronic conditions (especially for patients with multiple conditions) [51–53].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of non-medical health coaching on multimorbid patients in primary care: a difference-in-differences analysis

Shah

Stokes

Sutton

2019

BMC Health Serv Res

View full text Add to dashboard Cite

Background: Health systems, globally, are attempting to strengthen primary care to promote a population-health management approach to care provision, incentivising prevention and self-management. This paper evaluates the "Enhanced Primary Care" model implemented in a geographical region in England. Enhanced Primary Care introduces a new non-medical role, health coaches, to the traditional primary care team to provide additional support for patients with chronic conditions. We evaluate effects of health coaching on patient outcomes using a quasi-experiment. Methods: We estimate the programme's effects on health status (EQ-5D-5L, physical functioning, psychological wellbeing, and resilience), health behaviour (smoking habit), experience of care (person-centeredness and continuity of care), and health care (primary care) utilisation using data from 3.5 million respondents to the national GP Patient Surveys between 2013 and 2017. We use a weighted difference-indifferences design to compare changes in outcomes over time between intervention practices and comparable control practices in the rest of England. We conduct our main analysis on multimorbid patients and additional analysis on all patients to assess population-level effects. Results: For multimorbid patients, we find reductions in psychological wellbeing (short and medium term) of −0.0174 (95% confidence interval −0.0283 to −0.0065), relative difference −2% from the pre-intervention mean; and personcenteredness (short term) of −0.0356 (−0.0530 to −0.0183), −4%. We find no significant effects on other outcome measures. For population-level effects, in the short term we find reductions in primary care utilisation of −0.0331 (−0.0448 to −0.0214), −5%. All other outcomes are not consistently statistically significant. Conclusions: Our results show that there is very little effect of health coaching on patient experience and outcomes in the short-to-medium term (up to 14 months). Introduction of Enhanced Primary Care was associated with slightly lower psychological wellbeing and person-centeredness amongst multimorbid patients (it might be initially difficult for patients to adjust to the model). However, it was also associated with a decline in primary care visits at the population-level (potentially freeing up practitioner time for more complex patients). The results raise important questions regarding primary care workforce changes advocated in the NHS Long Term Plan, and the time horizon of any benefits of prevention strategies.

show abstract

Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Effects of non-medical health coaching on multimorbid patients in primary care: a difference-in-differences analysis

Shah

Stokes

Sutton

2019

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

“…In addition to the special series on public health in this journal, a 2019 special issue of Perspectives on Behavior Science focused on addictions, and showcased substantial basic, translational, applied, and public health contributions of behavior analysis (Washington & Galizio, 2019). Recent conceptual and empirical work has focused on diabetes prevention and management (Raiff et al, 2020), disease transmission in the workplace (Gravina et al, 2020) injury prevention in sports (Quintero et al, 2020;Harris et al, 2020), physical activity (Nieto & Wiskow, 2020;Stedman-Falls & Dallery, 2020), cigarette smoking (Dallery et al, 2021), and health and wellness coaching (Finn & Watson, 2017;Normand & Bober, 2020). The strengths of behavior analysis (e.g., rigorous experimental methods, conceptual account of the causes of health behavior) increase the chances, but do not guarantee, that behavioral technology may lead to public health impact (Hantula, 2019).…”

Section: Do More Of What We Are Doingmentioning

confidence: 99%

Leveraging applied behavior analysis research and practice in the service of public health

Normand

Dallery

Slanzi

2021

J of App Behav Analysis

View full text Add to dashboard Cite

Human behavior plays a central role in all domains of public health. Applied behavior analysis (ABA) research and practice can contribute to public health solutions that directly address human behavior. In this paper, we describe the field of public health, identify points of interaction between public health and ABA, summarize what ABA research has already contributed, and provide several recommendations for how ABA research and practice could continue to promote public health outcomes. A clearer focus on behavior and widespread adoption of research designs and interventions informed by the ABA literature could lead to better public health outcomes. Reciprocally, better integration of public health goals and strategies into ABA research, harnessing of technology, and more collaboration would help diversify and disseminate our applied science and could yield more effective and scalable interventions to prevent and treat public health problems.

show abstract

“…Behavioral health coaching has caught the attention of behavior analysts in recent years (i.e., Finn & Watson, 2017 ; Normand & Bober, 2020 ) and may be the ideal profession in which to incorporate ACT. Health coaches typically work in fitness centers, gyms, and clinics to help clients achieve goals related to their overall health (Normand & Bober, 2020 ).…”

Section: Behavioral Health Coachingmentioning

confidence: 99%

“…Health coaches typically work in fitness centers, gyms, and clinics to help clients achieve goals related to their overall health (Normand & Bober, 2020 ). Health coaches use several strategies that are consistent with applied behavior analysis, including tracking client progress, teaching self-management skills, and arranging for social reinforcement when goals are met (Finn & Watson, 2017 ; Rehfeldt, 2020 ). Its emphasis on measurement, skill generalization and maintenance, and data-based decision making further aligns health coaching within the professional scope of applied behavior analysis (see Normand & Bober, 2020 ).…”

Section: Behavioral Health Coachingmentioning

confidence: 99%

Why We Are Not Acting to Save Ourselves: ACT, Health, and Culture

Rehfeldt

Tyndall

2021

Behav Analysis Practice

View full text Add to dashboard Cite

Chronic health conditions are increasing at an alarming rate worldwide, and many could be prevented if people were to engage in specific lifestyle behaviors. Intervening on lifestyle behaviors is challenging due to the fact that the consequences associated with unhealthy behaviors are temporally distant and probabilistic, and the aversive functions of covert stimuli may interfere with people's engagement in healthy, preventative behaviors. This article explores the role of relational framing in the promotion of healthy lifestyle behaviors and summarizes research supporting the use of acceptance and commitment training (ACT) as a framework for prevention and intervention. We explore how ACT alters the context in which rigid patterns of rule following occur. ACT loosens the literal functions of stimuli so that experiential-avoidance behaviors are weakened, and healthy, valuesconsistent behaviors are strengthened. We propose culture-wide interventions inspired by contextual behavior science so that healthier societies can be cultivated.

show abstract

The Use of Health Coaching to Improve Health Outcomes: Implications for Applied Behavior Analysis

Cited by 9 publications

References 30 publications

Effects of non-medical health coaching on multimorbid patients in primary care: a difference-in-differences analysis

Effects of non-medical health coaching on multimorbid patients in primary care: a difference-in-differences analysis

Leveraging applied behavior analysis research and practice in the service of public health

Why We Are Not Acting to Save Ourselves: ACT, Health, and Culture

Contact Info

Product

Resources

About