Does Health Coaching Improve Client Wellness? What The Research Says
Certified health and wellness coaches are expert health advisors that use evidence-based methodologies to improve their clients’ health and wellness. Health coaching is a relatively new profession, and it was born out of the public health system’s need to have a more consistent, personal, and long-term presence in people’s lives.
Whether you want to prepare a response for the naysayers, or you are interested in understanding your role in contributing to healthier communities, it is useful to understand how health coaches help to support client wellness.
In this article, we’ve compiled the most up-to-date research about how health coaches help to support client health.
The Need for Health Coaches in the Public Health System
Primary care health professionals, like doctors and nurses, only have a limited amount of time with patients. In the average four to twenty minutes with each patient, the length of which is shorter in the hospital and longer in the clinical setting, they have the task of diagnosing, treating, and offering advice to prevent health problems.
It goes without saying the primary care physicians and nurses are overworked and do not have the time or bandwidth to coach people through adopting changes that aim to improve their health.
Additionally, while public health systems are designed to have a focus on preventing disease, of the $3 trillion spent on healthcare annually, more than 80% goes to treating chronic conditions. The report titled Prevention for a Healthier America: Investments in Disease Prevention Yield Significant Savings, Stronger Communities by Trust for America’s Health (TFAH) found that an investment of $10 per person per year focused on prevention through lifestyle improvements could save the country more than $16 billion annually.
As a result, there is a gap in the public health system that health coaching professionals, including wellness coaches, fitness coaches, and nutrition coaches, aim to fill.
5 Roles of a Health Coach in the Public Health System:
- Provide self-management support: Work closely with clients to provide them with information and tools they need to manage their health.
- Bridge the gap between clinician and patient: Ask clients about their needs and help them understand the need for the medication and lifestyle changes and identify the obstacles that would prevent them from implementing medication properly and helping them follow through.
- Help clients navigate the healthcare system: Support clients in locating, negotiating, and engaging in services. The elderly, people with disabilities, LGBTQIA+, and BIPOC communities are most at risk.
- Offer emotional support. Meet emotional needs and help clients cope with challenges and illnesses.
- Serve as a community figure: Create familiarity and continuity between clinical visits.
The relevance of health coaches in healthcare is clear, and health coaches are beginning to become a regular part of healthcare across the US. In fact, the evidence to support the integration of health coaching is so strong that primary care is beginning to transform into a team sport with new players, including health coaches. Most of the research on the impact of health coaches focus on disease management, but there is also increased interest in measuring the impact of health coaches on disease prevention.
Keep reading to learn why health coaches are becoming so important for improving client health and wellness.
5 Ways Health Coaches Help Improve Client Wellness
Improved Doctor-Patient Relationships
There are many factors that influence a person’s trust in their primary care team, including historical and present racial bias, communication and listening abilities, the type of information that is provided, and perceived levels of compassion.
A randomized controlled trial with 441 patients examined the impact health coaches could have on physician trust after a year of health coaching. The study found that the level of trust in patients who received health coaching was over double that of patients who didn’t receive health coaching.
The study results have strong implications for medical practice, and the researchers conclude by recommending that health coaches be added to clinical teams to enhance doctor-patient relationships, as improved relationships have a positive impact on patient anxiety and adherence to the treatment plan.
Increased Engagement in Health Care
The standard healthcare model relies on individuals taking an active role to maintain or improve their health on their own. In other words, it relies on people doing the following:
- Understanding their insurance plans, including what they do and don’t cover and how to take advantage of their plans
- Navigating the health system without insurance or if their plans don’t cover their needs
- Being proactive about locating and approaching healthcare providers
- Understanding the information provided to them
- Applying the information in a way that makes sense for their lives
- Adhering to the treatment plan exactly
In reality, from your client’s perspective, there are numerous barriers that make it difficult to have complete control over all of these elements, including confusing insurance information, limited time with specialists, and unrealistic expectations or condescending attitudes from providers. These factors make it difficult for individuals to feel comfortable being their own advocates and being full participants in their own healthcare.
Even so, when patients manage to become actively involved in their healthcare experience—referred to as “patient activation”—they tend to have better health outcomes at lower costs.
Health coaches use interpersonal processes and communication strategies to help patients step into an active learning role for their health. One study found that health coaches help to engage patients with goal orientation, self-direction, and intrinsic motivation to take on more active roles in their healthcare.
Improvements in Health Outcomes of People with Chronic Diseases
Chronic disease management is a complicated topic, and there are multiple economic, environmental, social, and psychological factors that influence if and how a person manages their diagnosis on physical, social, cultural, and psychological levels.
Research shows that health coaches have an essential role in helping to support patients to have improved disease management and health outcomes. Here are some of the interventions with health coach components and a summary of the study findings:
- Hypertension: The use of home monitoring technology together with regular virtual support from a health coach and clinical pharmacist resulted in a significant decrease in sodium consumption and blood pressure and a significant increase in patient activation compared to patients who received standard care.
- Diabetes: Patients with issues with glycemic control (measured by HBA1C) who received support from a peer health coach showed significant improvements in HB1AC levels over individuals who received usual care after six months. Additionally, another study showed that elderly patients with diabetes who received support from a coach saw improved physical activity levels.
- Asthma: Community health workers trained as asthma coaches contributed to a reduction in asthma rehospitalization in Black children compared to a control group.
- Chronic pain: Peer health coaching for patients with chronic conditions contributed to reductions in pain, disability, and depression, compared to a control group.
- Depression: A study with 626 patients who attended 74 small primary care practices in Germany examined whether case management through health coaching had an impact on depression symptoms and treatment adherence. The intervention group saw significant improvements in both compared to the group that received usual care.
Since health coaching models adapt to different health needs, there will likely be more research on the health outcomes of people with several other conditions not yet on this list.
Improvements in the Health Outcomes of Minorities and Low-Income Individuals
Research shows that health coaching can help to bridge the gap between these populations and their primary care clinics.
Peer health coaching, for example, can help to significantly improve diabetes control in low-income individuals who had difficulties managing their diabetes.
A Detroit-based program called the Racial and Ethnic Approach to Community Health (REACH) utilized a health coaching model to extend services and adapt them to community needs with the goal of improving dietary, physical activity, and diabetes self-care behaviors.
The study found that in Black and Latinx individuals who were part of the REACH program, there were significant improvements in knowledge about diet and exercise and behaviors. There were also significant improvements in A1C levels, the main indicator for long-term blood sugar management, in program participants compared to a group of patients with diabetes in the same system who were not enrolled.
Another study with 237 patients examined whether health coaching could support minority, low-income individuals with poorly controlled blood pressure, which is a widespread problem in the United States. The study determined whether health coaching focused on blood pressure management could improve outcomes. The two groups in the randomized controlled trial included one group that received health coaching and at-home support with medication or health coaching alone.
Both groups saw a significant improvement in blood pressure without a significant difference between them. Additionally, the study revealed that the more coaching encounters patients had, the greater reductions they had in blood pressure.
The study demonstrated that when patients received personalized, regular support from health coaches, they had improved management of their high blood pressure.
Clients Follow Prescribed Medication Plan
One of the main interests for primary care systems in including health coaches as part of the healthcare team is to support their clients in adhering to their prescribed medication and treatment plan.
An intervention study with patients diagnosed with type 2 diabetes, hypertension, and/or hyperlipidemia examined the effects of health coaching on medication adherence as measured by the number of days individuals took all prescribed medications.
The participants were divided into two groups—one that received health coaching in addition to usual care, and another that only received usual care.
Results revealed that health coaching resulted in a significant improvement in medication adherence, with fewer days of skipped or forgotten medications, compared to the group that received usual care.
The research supports that a well-implemented health coaching program in the primary care system can significantly improve client health and wellness. Health coaches help to fill several gaps in healthcare that extend services to individuals to meet their needs. In addition to showing promise for improvements in individual health, it also supports health systems where physicians and nurses are overworked and have limited time with patients.
Research shows that health coaches help to improve client health and wellness by:
- Improving relationships with doctors
- Increasing engagement and activation to take control of their own health
- Improving health outcomes of people with chronic diseases
- Improving health outcomes of minorities and low-income people
- Improving adherence to treatment and medication plans
These all have important implications for how healthcare systems are structured as well as for the urgent need for widespread access to health coaches for lifestyle improvements and disease prevention and management.