Does coaching improve health?
This is an important question for 160+ million people in the US, and multiples of that number globally, who have a health risk or chronic condition that can be improved by health-giving habits of mind and body.
It’s also an important question for doctors and healthcare providers, leaders, employers, healthcare systems, health plans, governments, and of course coaches, who are dedicated to improving individual and population health.
It’s an even more important question today because health is declining in the US and globally, mostly caused by unhealthy habits. More than 95% of adults don’t engage IN ALL OF THE TOP SEVEN HEALTH HABITS, 60% OF ADULTS HAVE AT LEAST ONE CHRONIC DISEASE, ONE THIRD OF ADULTS AND 19% OF CHILDREN ARE OBESE, and 50% OF ADULTS HAVE DIABETES OR PRE-DIABETES, which can be described as a food-borne disease.
From the Aspen Health Strategy Group earlier this year: THE COST OF UNHEALTHY LIFESTYLES IN THE US WILL ADD UP TO $42 TRILLION BETWEEN 2016 AND 2030 IN HEALTHCARE COSTS AND LOST PRODUCTIVITY TO EMPLOYERS.
Wellcoaches research advisor Gary Sforzo is leading a team that just published an UPDATE TO THE 2017 COMPENDIUM ON THE HEALTH & WELLNESS COACHING LITERATURE in May 2019. Two new meta-analyses of coaching outcomes were published in 2018 and the number of randomized clinical trials increased from 72 to 108 in two years since the 2017 compendium.
The author team ambitiously delivered a complete review of HWC research, first from 2000-2016, and now an update from 2016-2018. Selected papers met criteria that define coaching which emerged from a 2013 SYSTEMATIC REVIEW:
1. coaches trained in behavior change, motivational techniques
2. patient-centered (guided by patient values)
3. patient determined goals
4. self-discovery
5. accountability
6. ongoing relationship
Key Characteristics
You can see in Exhibit A that obesity, diabetes, and wellness are the main areas of research focus. In Exhibit B, we learn that approximately half of selected studies are randomized controlled studies, 108 in total (well exceeding the 15 RANDOMIZED CONTROLLED STUDIES IN THE EXECUTIVE COACHING LITERATURE as of 2016). There is also one welcomed meta-analysis on the positive HWC effects on A1C IN DIABETES PUBLISHED IN 2018, and another meta-analysis on SEVERAL APPROACHES TO HYPERTENSION INCLUDING COACHING.
Limitations of HWC outcomes research The main limitation is that many studies combine HWC with other education or wellness interventions (in fact, mirroring real world practice), thereby obscuring the pure effect of a coaching intervention on a particular outcome. In recent years, there are more studies isolating the effects of coaching.
Yes, coaching improves health
While not unanimous, the bulk of the research reports a favorable impact of HWC on obesity, diabetes, hypertension, cholesterol, heart disease, and general wellness. The study of cancer patients, more limited, shows positive findings. The consistent and beneficial impacts of HWC on weight loss, A1C, blood pressure, cholesterol, stress, anxiety, self-efficacy, exercise participation, and nutritional habits nicely support the use of HWC to prevent or treat chronic conditions.
More to come The HWC literature is on pace to double every four years or so. This will include better-designed studies and studies using coaches who meet newly established standards, passing the NATIONAL BOARD CERTIFICATION FOR HEALTH AND WELLNESS COACHES backed by the NATIONAL BOARD OF MEDICAL EXAMINERS. Studies will likely explore the optimal coaching dose, how to improve sustainability and cost effectiveness as well as emerging coaching trends, such as combining coaching with digital tools and group coaching models.
Takeaways for Coaches
1. If you are a coach and your health needs an upgrade, walk the walk and engage a health and wellness coach.
2. Recommend to your doctor that s/he refers patients to NBC-HWC – national board certified health and wellness coaches.
3. If you coach leaders and their employees’ health needs an upgrade, suggest they hire health and wellness coaches to help them improve employee health, engagement and productivity.
Let’s toast our most precious asset, health, and the hundreds of researchers showing that coaching improves health!
Sforzo, Kaye, Harenberg, Costello, Cobus-Kuo, Rauff, Edman, Frates, Moore. (2019). COMPENDIUM OF HEALTH AND WELLNESS COACHING: 2019 ADDENDUM. American Journal of Lifestyle Medicine.