Is Health Coaching Effective?

Abstract:
Because health coaching is so new, outcomes of its use and implementation are somewhat limited, especially its impact on cost. However, a brief review of the literature shared here reveals findings that we hope you’ll find useful in your work, as many of you have requested to know what types of results others are obtaining in health coaching and in what populations. If you are aware of other organizations or individuals who have achieved various outcomes in health coaching/motivational interviewing, please these send our way with your references, and we’ll send this information out to everyone on our email list! Thanks!

Evidence-based practice is highly encouraged in healthcare, and it’s no different in health coaching! It is the author’s opinion that motivational interviewing (MI), the primary evidence-based foundation for the NSHC’s health coaching education and certification program, has been the single most influential method to date of addressing the patient’s agenda and self- motivation for behavior change. Why?

Dr. William Miller began describing its use in the early1980s as a clinical intervention for those patients in whom problem drinking was particularly difficult to abate. He found that MI was as effective as other methods to assist these patients, but achieved results more quickly. Because of this success, MI began to be used in the early 1990s to help those with chronic conditions change their behavior, in which one finding the motivation to change is also problematic. Dr. Miller has conducted numerous studies on the subject of MI. While health coaching takes on many forms today, clearly the work of Dr. Miller and his colleagues was the catalyst for the fresh, new approach: evidence-based health coaching that the National Society of Health Coaches (www.nshcoa.com) promotes today.

Dr. S. Butterworth et al. of Oregon Health and Science University studied the response of 276 self-selected medical center employees in a 3-month study¹ using MI-based health coaching. The intervention included a minimum of one initial session and two follow-up contacts. The Short Form 12 Health Survey was used to describe health status. The treatment group showed significant improvement in health status versus the control group.

Mayo Clinic 2005² health coaching outcomes revealed the following:

• 64% increased exercise time
• 42% tobacco users quit at 6 mo and 37% at 12 mo
• 61% increased healthy eating choices

Dept of Cardiology, St. Vincent ’s Hosp, Melbourne, Australia³

• At 6 mo, serum Total-C and LDL-C levels significantly lower
• Being coached had an effect of equal magnitude to being prescribed lipid-lowering drug therapy.

HCIN 2010 Benchmarks Survey4

• 34.4% decreased claims cost
• 36% say ROI increased from 2 to >4:1; 64% said too early to tell about ROI

Ribak et al. performed a systematic review and meta-analysis that was published in the British Journal of Medical Practice in 2005 that found many positive outcomes in the use of motivational interviewing in the studies evaluated.

• 95% confidence level for combined effect estimates for BMI, total blood cholesterol, systolic BP
• Three of four studies revealed an equal effect on physiological and psychological diseases at 72 and 75% respectively.
• In 64% of the studies, the use of motivational interviewing showed an effect even in brief 15-minute encounters.

References:

1. Butterworth,S., Linden ,A., McClay,W., Leo, M.C., (2006). Effect of motivational interviewing-based health coaching on employees’ physical and mental health status. Journal of Occupational Health Psychology, 11(4), 358-365.
2. Healthcare Intelligence Network. (2007). Coaching in the healthcare continuum: Models, methods, measurements and motivation. Manasquan , NJ : author.
3. Vale, M.J., Jelinek,M.V., Best, J.D., & Santamaria, J.D. (2002, March). Coaching patient with coronary heart disease to achieve the target cholesterol: A method to bridge the gap between evidence-based medicine and the “real world”- randomized controlled trial. Journal of Clinical Epidemiology, 55(3), 245-52.
4. Healthcare Intelligence Network. (2010). 2010 Health coaching benchmarks. Manasquan, NJ: author
5. Rubak,S., Sandbæk,A., Torsten, L., & Christensen, B. (2005, April). Motivational interviewing: A systematic review and meta-analysis. British Journal of General Practice. Review Article, p305-312. Retrieved Sept 28, 2010, from http://www.motivationalinterview.org/library/RubakMIreview.pdf

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