Wellness solutions include health coaching
Wellness solutions include health coaching
Coaches are trained to motivate participants
Based on the positive outcomes of a health coaching pilot for its employees with diabetes, Advocate Health Care, an integrated healthcare system based in Oak Brook, IL, now offers health coaching to its patients, employees, spouses, and employer groups as part of its comprehensive wellness solution.
When the health coaching program was piloted with patients with diabetes in 2006, participants reduced their LDL cholesterol by an average of 10 points and their hemoglobin A1c by one point. The health coaching program now targets patients with diabetes, asthma, and/or cardiac disease but doesn't turn away anyone who wants to participate, says Jennifer Sponholtz, CHES, wellness coordinator. Sponholtz, who works in the Advocate Medical Group division supervises and trains Advocate Health Care's lifestyle coaches, all of whom work from their homes and counsel their clients by telephone.
In the first year that Advocate added a weight-loss component to the program, participants reduced their body mass index (BMI) by an average of 0.8 in the first year. "Studies show that for every one-point drop in the BMI, the company saves $202 per employee per year," Sponholtz says.
The lifestyle coaches work closely with the organization's case managers and disease managers to provide whatever assistance patients need. "Our goal in this program is to provide the best outcomes for our patients using any kind of support we can provide," Sponholtz says.
Advocate's lifestyle coaches include health educators, nurses, dieticians, and exercise physiologists. All have at least a bachelor's degree in a healthcare field. Some have master's degrees.
All lifestyle coaches go through intensive training on how to engage individuals who are resistant to change. They complete the Intrinsic Coaching Development Series, offered by Intrinsic Solutions Group. The course is a series of classes and mentoring sessions that teach the coach how to support people in improving their health by helping them come up with their own goals.1
"Instead of giving suggestions on how people can become healthier, the coaches guide them in deciding what they want to do. When people have that 'a-ha' moment about what is important to them, they are more likely to act on it," she says.
The coaches also are trained in motivational interviewing, which helps them identify the clients' readiness to change. "We find that a combination of intrinsic development training and motivational interviewing creates a balanced approach for coaches to be successful when working with individuals," Sponholtz says.
Physicians, care managers, and other clinical staff refer patients for the program, or patients can self-refer. Employer groups can risk stratify their population to identify which employees should be offered the opportunity to work with a coach.
Advocate employees and spouses undergo a comprehensive screening each year to assess their health status. If the screening identifies risk factors, the individual can work with a health coach to earn an insurance based incentive. This year, the company offered HMO members who completed the program a $200 incentive toward healthcare expenses for HMO members who participate. PPO members were offered $600 toward their deductible.
Once the patients are identified for the program, Advocate either sends them information on the program and invites them to participate or calls them to enroll them.
When participants enroll, they answer questions about their goals, their personality, and decision-making habits. The information is entered into a coaching system developed by Advocate, which matches the individual with a coach whose skills meet their need. Advocate developed the coach match process based on the Myers-Briggs Type Indicator, Sponholtz says.
"All our coaches have different skill sets. Our technology applies a filter so that only coaches that match the individual's criteria show up in the system," she says.
During the initial phone calls, the coaches work with the participants to determine goals. Common goals include smoking cessation, weight loss, diabetes management, and making behavioral changes such as increasing physical activity, improving nutrition, and managing stress.
"The important thing is to help the individual identify his or her goals, and not to impose the goals of the coach on them," Sponholtz says. For instance, the coach may say, 'Your doctor recommended you for this program because you have diabetes but that doesn't mean we need to talk about controlling your diabetes. You may have another goal in mind and we can start there.'
"If people aren't motivated to change their diet or lose weight, they won't want to talk about it and may just go through the motions. We look at what they want to do and help make lifestyle changes to meet that goal," she says.
Reference
- For more information on intrinsic coaching, see: http://intrinsicsolutionsgroup.com/
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