Is Health Coaching by Telephone Effective?

Health Coaching Via Telephone: Is it Effective?

By: Melinda Huffman, BSN,MSN,CCNS,CHC

According to Dr. John Piette, “Individuals often remember little of what they are told during outpatient encounters.” Many people are not well prepared to manage their conditions without intermittent help and guidance along the way. Managed care organizations have had plenty of experience in using the telephone as a primary means of communication with members, but other healthcare providers have been slow to adopt telephony as a means to guide care. With health coaching and motivational interviewing emerging as a unique and different way of improving outcomes and communicating with individuals, it only seems reasonable that we pay proper respects to phone communication as a means to implement this fresh, new approach.

There are several reasons to consider the telephone as an effective means by which a healthcare provider can communicate with individuals seeking support, guidance, and information about their health risk, condition(s), or illness:

• Ninety-eight percent of American households have phone communication
• Enhanced timeliness of appointments
• Affords more frequent contact
• Cellular communication affords mobility for the users; no specific locale needed for a meeting place
• Improved adherence to treatment plans
• Healthcare costs continue to soar

A study conducted by Thomson Reuters and American Specialty Health concluded that a program of telephone-based health coaching for weight management can change employees’ behavior and reduce their health risk factors. At the end of one year, the study of 890 employees demonstrated significant decreases in risk prevalence for poor eating habits (21.3% reduction) and poor physical activity (15.1% reduction). All of the biometric measures related to overweight and obesity also decreased, including percent overweight or obese (5.8% reduction), weight (4.5 pounds reduction), and body mass index (0.9% reduction).

Pinnock et al. found that assessments conducted via phone increased the proportion of those with asthma who received appropriate monitoring versus those receiving face-to-face encounters in the clinic setting. While there was no difference in “quality of life” in both groups, patients’ access was increased and outcomes were comparable with telephone communication.

Simon, et al found that using the telephone to engage the depressed patient in cognitive behavioral therapy was substantially effective. After six months, those who received counseling over the phone were more likely to have improved depressive symptoms and were more satisfied with treatment.

As you evaluate your current telephone program or as you consider implementing interventions via phone, Piette listed several factors that should be considered:

1. Content should be clearly structured
2. Don’t try and accomplish too much in one setting
3. Target those individuals who are likely to benefit most in your population
4. Most effective programs are linked to outpatient clinical follow-up
5. Incorporate outcome measures to validate program’s impact

Telephone outcomes that can be considered for measurement include, but aren’t limited to:

1. Confidence level of the individual to reach goal(s)
2. Number of phone appointments kept
3. Satisfaction with phone encounters
4. Improvement in symptoms, weight, exercise, diet, stress

To improve health outcomes in the population you serve, consider a wider use of the telephone as an adjunct to the individual’s treatment plan or if you already use the telephone to provide interventions, make sure that your active listening skills are sharp, that distractions are minimal to none, that you have an appointment for the call, and that you have an agreed upon agenda for the call!

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