The following evidenced based examples illustrate the roll health coaches can perform in general practice

 

Diabetes (Pre and Type 2)

Health coaches assist patients by:

• Educating clients about healthy eating habits, focusing on teaching how to eat a balanced diet that helps manage blood sugar levels[1].

• Providing strategies to improve nutrition, medication adherence, physical activity, and stress management[1].

• Setting realistic health goals and developing action plans to achieve them[1].

• Offering regular support through weekly phone calls or face-to-face sessions over several months[1].

• Using motivational interviewing techniques to encourage lifestyle changes[1].

• Consulting with registered dietitians and diabetes educators on individual cases[1].

• Discussing the role of sleep, movement, and stress reduction in patient context.

 

These interventions have led to improved hemoglobin A1c levels, enhanced patient self-efficacy, and better diabetes self-care[1]. Other outcomes include:

    •    Improved hemoglobin A1c levels

    •    Reduced BMI and waist circumference

    •    Enhanced patient self-efficacy and diabetes self-care

    •    Increased healthy eating habits (0.71 more days per week of healthy eating)

    •    Improved diabetes self-efficacy scores

    •    Greater satisfaction with health system support for family involvement

 

Hypertension (High Blood Pressure)

Health coaches help patients with hypertension by:

• Conducting small group or individual educational sessions on hypertension self-management[2].

• Providing education on the basics of hypertension control[2].

• Guiding patients in creating personal physical activity plans[2].

• Offering sessions on stress management and medication management[2].

• Using experiential learning strategies appropriate for those with health literacy challenges[2].

• Reinforcing main messages with motivational interviewing, or functional visual aids[2].

 

These interventions have resulted in reduced systolic blood pressure, increased consumption of fruits and vegetables, and improved stress coping[2]. Other outcomes include:

• Significantly improved blood pressure control (51.4% vs 11.3% in usual care)

• Enhanced hypertension self-care activities:

• Improved medication usage

• Better adherence to low-salt diet

• Improved weight management

• Reduced sodium consumption

 

Obesity

Health coaches support patients with obesity by:

• Setting realistic weight loss goals[3].

• Creating personalized nutrition plans[3].

• Encouraging regular physical activity[3].

• Providing emotional support and accountability[3].

• Using techniques like active listening and empathy[3].

• Identifying and addressing obstacles to weight loss[3].

• Offering ongoing education and resources[3].

• Discussing cravings habits, and meal timing.

 

These strategies have led to significant weight loss, improved dietary habits, and increased physical activity levels[3]. Other outcomes include:

• Statistically significant weight loss (approximately 3% of initial weight, (see study below)

• Over 25% of participants achieved at least 5% weight loss

• Improved readiness to adopt and maintain weight management behaviors

• Better engagement associated with more frequent coach contacts

 

Rheumatoid Arthritis

Health coaches assist patients with rheumatoid arthritis through:

• Weekly telephone contact over a 12-week period[9].

• Focusing on reducing disease-related stressors[9].

• Encouraging behavior changes such as healthy eating and exercise[9].

• Providing support for sleep improvement[9].

• Offering guidance on reducing alcohol and tobacco consumption[9].

 

These interventions have resulted in decreased body mass index, increased physical activity, improved sleep, and reduced rheumatoid arthritis flare frequency[9]. Other outcomes include: (see studies below)

• Decreased body mass index (0.54 kg/m²)

• 73% increase in weekly physical activity

• 0.4 hours increase in sleep per night

• 15% decrease in alcohol consumption

• 25% decrease in tobacco use

• 24% improvement in physical health domain (PROMIS Global Health-10 scores)

• 17% improvement in mental health domain

• 48% reduction in rheumatoid arthritis flare frequency

 

Cardiovascular disease

Health coaches assist patients with cardiovascular disease through:

• Structured disease management programs like The COACH Program

• Regular coaching sessions over extended periods (e.g., 6 months)

• Telephone and face-to-face contacts for personalized support

• Education on cardiovascular risk factors and self-management strategies

• Goal setting and action planning for lifestyle modifications

• Guidance on medication adherence and working with physicians

 

Specific Interventions:

• Educating patients about their cholesterol levels and targets

• Providing strategies to improve diet, physical activity, and stress management

• Encouraging patients to work with their physicians for appropriate medication adjustments

• Offering support for smoking cessation and alcohol reduction

• Using motivational interviewing techniques to promote behavior change

 

Outcomes (see study below):

• Significant reduction in total cholesterol levels (14 mg/dL greater reduction compared to usual care)

• Substantial decrease in hospital costs ($12,707 per person lower)

• 30% decrease in overall mortality

• Dose-response effect: 4 or more coaching sessions led to 42% decrease in mortality

• Improvements in other coronary risk factors and patient quality of life

• Better adherence to treatment prescribed by usual medical practitioners

• Enhanced patient engagement in self-care activities

 

Health coaching has demonstrated effectiveness in improving cardiovascular health outcomes, reducing mortality, and lowering healthcare costs for patients with coronary heart disease. By providing ongoing support, education, and motivation, health coaches play a crucial role in helping patients manage their cardiovascular disease and achieve better health outcomes.

 

In all these cases, health coaches use evidence-based techniques such as motivational interviewing, goal-setting, and personalized action planning to support patients in making sustainable lifestyle changes. By providing ongoing support, education, and accountability, health coaches play a crucial role in improving outcomes for patients with chronic conditions.

 

Sources

[1] [PDF] What Do Patients with Diabetes Think of Health Coaching? https://www.urban.org/sites/default/files/publication/96336/2001692_chw_client_interviews_brief_finalized_2.pdf

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[2] Evidence-Based Program: Health Coaches for Hypertension Control https://www.ncoa.org/article/evidence-based-program-health-coaches-for-hypertension-control/

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[3] Effective coaching strategies for overcoming obesity https://obesity-care-clinic.com/holistic-approach/coaching/effective-coaching-strategies-for-overcoming-obesity/

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[4] How can a health coach support someone with arthritis? https://www.arthritis.org.nz/2024/06/26/how-can-a-health-coach-support-someone-with-arthritis/

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[5] Health Coaching Improves Outcomes of Informal Caregivers ... - NCBI https://pmc.ncbi.nlm.nih.gov/articles/PMC11244754/

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[6] Diabetes Education, the Quadruple Aim and Health Coaching - ADE https://ade.adea.com.au/diabetes-education-the-quadruple-aim-and-health-coaching-a-perfect-match/

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[7] What's the evidence that health coaching works? https://www.smstoolkit.nz/health-coaching-evidence

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[8] Effect of health coaching on blood pressure control and behavioral ... https://pubmed.ncbi.nlm.nih.gov/36473304/

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[9] Digital Coaching Enhances Rheumatoid Arthritis Outcomes - HCPLive https://www.hcplive.com/view/digital-coaching-enhances-rheumatoid-arthritis-outcomes

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[10] The Role of Coaching in Obesity Management: An Overview https://obesity-care-clinic.com/holistic-approach/coaching/the-role-of-coaching-in-obesity-management-an-overview/

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[11] Health Coaching Improves Outcomes of Caregivers of Adults With HF https://www.acc.org/Latest-in-Cardiology/Journal-Scans/2024/08/13/13/22/health-coaching-improves

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Cardiovascular management:

Sources

[1] A Multicenter Randomized Trial in Patients With Coronary Heart ... https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/757469

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[2] Effects of health coaching on behavioral modification among adults ... https://pubmed.ncbi.nlm.nih.gov/32448627/

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[3] Effect of a Peer Health Coaching Intervention on Clinical Outcomes ... https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2805604

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[4] Health and Wellness Coaching for 5-Year Projected Cardiovascular ... https://pmc.ncbi.nlm.nih.gov/articles/PMC10775165/

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[5] What's the evidence that health coaching works? https://www.smstoolkit.nz/health-coaching-evidence

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[6] Abstract 254: The Benefits and Barriers to Remote Health Coaching ... https://www.ahajournals.org/doi/10.1161/circoutcomes.11.suppl_1.254

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[7] Health Coaching Improves Outcomes of Informal Caregivers of ... https://www.ahajournals.org/doi/10.1161/CIRCHEARTFAILURE.123.011475

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More references:

Feasibility and acceptability of a tailored health coaching ... https://bmjopen.bmj.com/content/14/5/e078631

 

Effectiveness of a Health Coaching Intervention for Patient-Family ... https://pubmed.ncbi.nlm.nih.gov/36374502/

 

Health coaching for hypertension control in primary care patients ... https://pmc.ncbi.nlm.nih.gov/articles/PMC10883430/

 

Coaching Patients Saves Lives and Money - PubMed https://pubmed.ncbi.nlm.nih.gov/29106978/

 

Health Coaching for Weight Loss Among Overweight and Obese ... https://pmc.ncbi.nlm.nih.gov/articles/PMC10411960/

 

Factors associated with attaining coaching goals during an ... https://pmc.ncbi.nlm.nih.gov/articles/PMC3408563/

 

Digital Coaching Enhances Rheumatoid Arthritis Outcomes - HCPLive https://www.hcplive.com/view/digital-coaching-enhances-rheumatoid-arthritis-outcomes

 

Health coaching for hypertension control in primary care patients ... https://journals.lww.com/jfcm/fulltext/2024/31010/health_coaching_for_hypertension_control_in.3.aspx

 

Health Coaching Improves Outcomes of Caregivers of Adults With HF https://www.acc.org/Latest-in-Cardiology/Journal-Scans/2024/08/13/13/22/health-coaching-improves

 

Obese individuals achieve their goals: with health coaches. https://obesity-care-clinic.com/holistic-approach/coaching/obese-individuals-achieve-their-goals-with-health-coaches/