What do health coaches do? Direct observation of health coach activities during medical and patient-health coach visits at 3 federally qualified health centers. Issue 5 (May 2018)

• Record Type: Journal Article
• Authors: Johnson, Christopher; Saba, George; Wolf, Jessica; Gardner, Heather; Thom, David H.
• Is Part Of: Patient education and counseling. Volume 101:Issue 5(2018)
• Page Start: 900
• Page End: 907
• Publication Date: 2018-05
• Subjects: Patient education -- Periodicals; Health counseling -- Periodicals; Health education -- Periodicals; Counseling -- Periodicals; Patient Education -- Periodicals; Éducation des patients -- Périodiques; Counseling -- Périodiques; Éducation sanitaire -- Périodiques; 615.5071
• DOI: 10.1016/j.pec.2017.11.017
• Languages: English
• ISSNs: 0738-3991

Abstract

Highlights: There has been very little direct observation of health coaching activities. We identified 11 categories of coach activities and measured time spent by category. Content of health coaching differed between medical visits and patient-coach visits. Coaches spent proportionally more time on patient support during patient-coach visits. Results may inform choice between coaching during clinic visit and one-on-one visits. Abstract: Objective: To examine activities of health coaches during patient medical visits and when meeting one-on-one with patients at 3 urban federally qualified health centers. Methods: Encounters were videotaped and transcribed. Data was analyzed using a matrix analysis approach that allowed a priori identification of expected categories of activity, based on the health coach training model and previously developed conceptual framework, which were modified based on activities observed. Results: A total of 10 medical visits (patient, clinician and health coach), and 8 patient-coach visits were recorded. We identified 9 categories common to both medical and patient-coach visits and 2 categories unique to the medical visit. While observed activities were generally consistent with expected categories, some activities were observed infrequently or not at all. We also observed additional activity categories, including information gathering and personal conversation. The average amount of time spent on some categories of coaching activities differed substantially between medical visits and patient-coach visits. Conclusions: Health coaching activities observed differed in several respects to those expected, and differed between medical visits and coaching only visits. Practice implications: These results provide insights into health coaching behaviors that can be used to inform training and improve utilization of health coaches in practice.