Article Figures & Data
Figures
- Figure 1.
Self-care weekly planning worksheet developed for use in health coaching. This form was used by patients to formulate their own plans for better diet, physical activity, and/or sleep.
Tables
- Table 1.
Accrual, Retention, and Number of Coaching Contacts in the My Health Coach Study*
Study Data No. Referred patients 167 Subjects enrolled 82 Coaching goals selected Physical activity only 9 Diet only 12 Physical activity and diet 61 Sleep, physical activity, and/or diet† 24 Subjects who completed 8 weeks 59 Subjects who completed 12 weeks 40 Attempted calls 719 Completed calls 500 Contacts in person‡ 39 ↵* Study enrollment occurred September 3, 2014, through April 15, 2016, in a large, multiprovider family medicine practice.
↵† Sleep alone was not selected by any study participant.
↵‡ Study contacts were mainly by telephone appointment, but if a subject was in the office while in the study, the coaching contact was completed in person.
- Table 2.
Characteristics of Subjects Who Did or Did Not Complete 12 Weeks of Health Coaching
Baseline Characteristics Subjects Who Completed the Study (n = 39) Subjects Who Withdrew (n = 41) P Value* Age, years 53 (11) 51 (10) .484 Female sex† 30 39 .027 Body mass index (kg/m2) 34.5 (7.0) 35.1 (7.6) .705 Caucasian race† 28 27 .091 Married/in a committed relationship 33 22 .003 College graduate 32 33 .543 Physical activity (min/wk)‡ 324 (291) 303 (388) .787 Moderate or strenuous physical activity (min/wk)‡ 107 (123) 158 (345) .391 Fruit, vegetable, and bean intake (servings/day)§ 4.7 (4.0) 3.7 (2.4) .129 Pop and sugary beverage intake (servings/day)§ 0.30 (0.48) 0.39 (1.00) .568 Sleep score‖ 16.8 (3.6) 16.9 (4.2) .902 Data shown are mean (standard deviation) or number of subjects.
↵* Two-sample t tests were used to compare the characteristics of subjects who did or did not complete the study. The Pearson χ2 test was used to calculate the exact 2-sided p-value for categorical variables.
↵† Two subjects—one who completed the study and one who did not—did not fill out an Health Status Questionnaire (HSQ) at baseline, and demographic data are not available for these individuals, except for sex and race, which were collected outside of questionnaires, as required for institutional review board reporting. For sex and race, the data shown are therefore for 40 subjects who completed the study and 42 subjects who withdrew. Only 4 smokers were in the study, and none of them completed it.
↵‡ Physical activity was from the previously validated, modified version of the Godin Leisure Time Questionnaire, which was used to assess minutes of each type of physical activity.24,25
↵§ Diet was assessed using questions from the 2013 Behavioral Risk Factor Surveillance System Questionnaire.23 Intakes of juice, fruit, beans, dark green vegetables, orange vegetables, and other vegetables (½-cup serving sizes) were asked about. Regular and diet soda, and sugar-sweetened beverages (12-oz serving sizes) were asked about.
↵‖ Sleep was assessed using 5 items from the PROMIS Sleep Disturbance Item Bank version 1.0, and 1 additional item as described in the Methods. This resulted in 6 items total scored on a scale of 1 to 526.
Assessment Baseline 12 Weeks P Value* Body mass index (kg/m2) 34.1 (7.0) 33.4 (7.0) .014 Waist circumference (cm) 104 (16) 100 (16) <.001 Systolic blood pressure (mm) 116 (10) 115 (9) .385 Diastolic blood pressure (mm) 70 (8) 66 (8) .031 Fruits, vegetables, and beans (½-cup servings/day) 5.1 (3.8) 5.8 (3.9) .291 Sugary beverages (12-oz servings/day) 0.35 (0.51) 0.17 (0.31) .039 Total physical activity (min/week) 340 (292) 476 (388) .007 Moderate or strenuous physical activity (min/week) 123 (124) 207 (263) .061 Sleep score 17.2 (3.5) 15.9 (3.9) .016 Stress score† 18.3 (7.6) 16.8 (8.3) .229 Fatigue score‡ 22.7 (7.8) 20.9 (7.8) .096 Confidence to carry out physical activity§ 6.8 (1.6) 7.7 (1.7) .002 Confidence for improving diet§ 7.3 (1.4) 7.2 (2.0) .756 Data are mean (standard deviation) for 33 subjects who completed measures at both baseline and 12 weeks. The data include all subjects, regardless of coaching goal. Of the 33 subjects with completed 12-week data, 32 subjects received coaching that included a physical activity goal, 26 subjects with a diet goal, and 7 subjects with a better sleep goal.
↵* P values for differences over time are from paired t tests for subjects who completed 12 weeks of health coaching. A total of 33 subjects had paired anthropometric measures, and 32 subjects had paired questionnaire data. Physical activity, diet, and sleep were assessed using the methods described in Table 2.
↵† Stress was assessed using the 10-item Perceived Stress Scale developed by Cohen et al.28
↵‡ Fatigue was assessed using the Neuor-QOL Item Bank 1.0 Fatigue Short Form (8 items) from the Patient-Reported Outcomes Measurement Information System (PROMIS) health organization.26
↵§ Confidence for carrying out the indicated health behaviors was assessed using a study-specific questionnaire of 2 items that were answered on a 5-point scale (see the Methods).
- Table 4.
Study Evaluation by Health Care Providers at the Practice (n = 11) after the My Health Coach Study Was Completed
Question Providers Who Agree or Mostly Agree (n)* Recruiting for the study was easy. 9 The study impeded patient flow. 1 It took too much time to explain the study to patients.† 0 It was hard to remember to mention the study to patients. 5 Patients thought it was helpful to have the study available. 8 I would feel comfortable supervising an MA health coach. 7 Health coaching should be done by other staff, not MAs. 2 I liked having health coaching available for our patients who need it.‡ 10 ↵* The survey questions were answered on a 5-point Likert-type scale, with responses of do not agree, mostly disagree, neutral, mostly agree, or agree.
↵† One provider left this item blank; the rest were either neutral (n = 4) or disagreed/mostly disagreed.
↵‡ One provider was neutral about this item; the rest agreed or mostly agreed.
MA, medical assistant.
- Table 5.
Study Evaluation by Medical Assistants Other Than Those Acting as Health Coaches (n = 9) after the My Health Coach Study Was Completed
Question MAs Who Agree or Mostly Agree (n)* I would enjoy being a health coach. 3 MAs should be health coaches. 2 Recruiting for health coaching interfered with patient flow in our practice. 0 Patients thought it was helpful to have health coaching. 5 Patients gave good comments about the study. 5 Health coaching should be done by staff other than MAs. 6 It was a good thing to have health coaching available. 6 ↵* The survey questions were answered using a 5-point Likert-type scale, with responses of do not agree, mostly disagree, neutral, mostly agree, or agree. MA, medical assistant.
Question Subjects Who Agree or Mostly Agree (n)* I like the changes in my life from having a health coach. 31 I made more changes with the health coach versus what I could have done on my own. 29 Health coaching was a bother. 1 Health coaching took too much time. 0 I wanted more time with the health coach. 12 I liked the regular contacts with the health coach. 32 I used self-monitoring of diet. 27 I used self-monitoring of physical activity. 29 I intend to keep doing what the coach helped me change. 32 I would recommend health coaching to my friends and family. 31 I think health coaching should be part of every family medicine doctor's office. 31 I intend to continue with health coaching. 21 ↵* The survey questions were answered using a 5-point Likert-type scale, with responses of do not agree, mostly disagree, neutral, mostly agree, or agree.
