The Evidence Base for the Wellcoaches Protocol

Updated: May 17



Today, more than 14,000 coaches in 50 countries have been trained in the Wellcoaches protocol, which was first designed and tested in 2000-2002 for the launch of the first Wellcoaches coach training program in September 2002.


The protocol continued to expand, deepen, and evolve through the teamwork of ten Wellcoaches faculty, leading to its publication in the Wellcoaches Coaching Psychology Manual by Wolters Kluwer in 2009 (2nd edition in 2016).


Research Since 2009, research teams in the US and Europe have designed, implemented, and published 22 outcomes-oriented studies of the Wellcoaches protocol, delivered by Wellcoaches trained and certified coaches, in peer-reviewed scientific journals. The evidence base consisting of 22 data-based studies of the Wellcoaches protocol, from 2009 to 2020, involved 623 coaches serving 34,0646 clients and delivering 129,225 coaching sessions. All 22 studies produced beneficial results with statistically significant outcomes.


These 22 studies (summarized in the Table) are diverse in patient/client application, settings, demographics, and locations:

  • Applications - patients or clients with obesity, pre-diabetes and diabetes, cancer, fibromyalgia, cardiovascular risk factors, smoking cessation, in need of lifestyle medicine or enhanced wellness behaviors.

  • Settings - implemented in primary care practices, hospitals, community clinics, medical fitness programs, and employee wellness centers.

  • Demographics – young, middle-age, and older adults, military, health-care workers, minority and low income, rural and urban settings

  • Locations – throughout the US (15 states) and abroad.


Weight Management There are five published studies of the Wellcoaches protocol addressing weight management. Weight loss was achieved in all four studies where it was a goal. The fifth study focused on disordered eating syndromes and showed diminished incidence of binge-eating in the 225 patients studied.


Diabetes There are four research papers describing the impact of Wellcoaches protocol in patients with diabetes and/or pre-diabetes. Three of these studies tested A1C and all found a beneficial reduction in this primary diabetes outcome measure. The fourth study did not evaluate A1C; it found improved autonomy and self-efficacy, implying better diabetic self-care, after experiencing the coaching intervention.


Risk Factors & Wellness There are nine research papers studying the Wellcoaches protocol for improvements in wellness, lifestyle medicine, and cardiovascular disease risk factors. These studies are unanimous in finding health benefits such as reduced blood pressure, lower BMI, improved fitness, lower anxiety, smoking cessation, and improved physical functioning. There are also reports of enhanced exercise habits and improved nutritional behaviors.


Fibromyalgia and Cancer The beneficial results in studies of cancer and fibromyalgia include reduced anxiety and pain, reduced use of health care services, and improved quality of life.


Physician Burnout Wellcoaches coaches adapted the Wellcoaches protocol to mitigate the effects of burnout for primary care physicans. After six coaching sessions, reduced burnout, improved job satisfaction and psychological capital were reported.


Conclusions

1. The Wellcoaches protocol is the most thoroughly tested coaching protocol.


2. The evidence base for the Wellcoaches protocol includes 22 studies published in scientific journals between 2009 and 2020.


3. All 22 studies showed beneficial and statistically significant outcomes.


4. These studies involved 623 Wellcoaches-trained coaches serving 34,064 clients and delivering 139,225 coaching sessions.


5. The 22 studies addressed diverse:

a. challenges including obesity, diabetes, cardiovascular risk factors, smoking cessation, lifestyle medicine/wellness behaviors, cancer, fibromyalgia, and physician burnout.

b. demographics: age, low income, minority, military, healthcare workers, rural and urban populations, US and Europe.

c. settings including primary care, community clinics, medical fitness facilities, hospitals, and employee wellness.


Overview of published Wellcoaches Protocol studies


Citations


1. Ahn S, Lee J, Bartlett-Prescott J, Carson L, Post L, Ward KD. Evaluation of a Behavioral Intervention with Multiple Components Among Low-Income and Uninsured Adults With Obesity and Diabetes. Am J Health Promotion 2018;32(2):409-422. doi:10.1177/0890117117696250

2. Berman MA, Guthrie NL, Edwards KL, Appelbaum KJ, Njike VY, Eisenberg DM, Katz DL. Change in Glycemic Control With Use of a Digital Therapeutic in Adults With Type 2 Diabetes: Cohort Study. JMIR Diabetes 2018; 3(1):e4. doi: 10.2196/diabetes.9591. PMID: 30291074; PMCID: PMC6238888

3. Djuric Z, Segar M, Orizondo C, Mann J, Faison M, Peddireddy N, Paletta M, Locke A. Delivery of Health Coaching by Medical Assistants in Primary Care. J Am Board Fam Med. 2017 May-Jun;30(3):362-370. doi: 10.3122/jabfm.2017.03.160321. PMID: 28484068; PMCID: PMC5634140

4. Edman JS, Galantino ML, Hutchinson J, Greeson JM. Health coaching for healthcare employees with chronic disease: A pilot study. Work 2019;63(1):49-56. doi: 10.3233/WOR-192907. PMID: 31127744.

5. Eisenberg DM, Righter AC, Matthews B, Zhang W, Willett WC, Massa J. Feasibility Pilot Study of a Teaching Kitchen and Self-Care Curriculum in a Workplace Setting. Am J Lifestyle Med. 2017;13(3):319-330. doi: 10.1177/1559827617709757.

6. Galantino ML, Schmid P, Milos A, Leonard S, Botis S, Dagan C, Albert W, Teixeira J, Mao J. Longitudinal Benefits of Wellness Coaching Interventions for Cancer Survivors. The International Journal of Interdisciplinary Social Sciences: Annual Review 2009: 4 (10): 41-58. doi:10.18848/1833-1882/CGP/v04i10/53020

7. Guthrie NL, Berman MA, Edwards KL, Appelbaum KJ, Dey S, Carpenter J, Eisenberg DM, Katz DL. Achieving Rapid Blood Pressure Control With Digital Therapeutics: Retrospective Cohort and Machine Learning Study. JMIR Cardio. 2019; 12;3(1):e13030. doi: 10.2196/13030. PMID: 31758792; PMCID: PMC6834235.

8. Hackshaw KV, Plans-Pujolras M, Rodriguez-Saona LE, Moore MA, Jackson EK, Sforzo GA, Buffington CA. A pilot study of health and wellness coaching for fibromyalgia. BMC Musculoskelet Disord. 2016 Nov 8;17(1):457. doi: 10.1186/s12891-016-1316-0. PMID: 27821160; PMCID: PMC5100173.

9. Hildebrandt T, Michaeledes A, Mayhew M, Greif R, Sysko R, Toro-Ramos T, DeBar L. Randomized Controlled Trial Comparing Health Coach-Delivered Smartphone-Guided Self-Help With Standard Care for Adults With Binge Eating. Am J Psychiatry 2020 Feb 1;177(2):134-142. doi:10.1176/appi.ajp.2019.19020184.

10. Long DA, Reed RW, Duncan I. Outcomes Across the Value Chain for a Comprehensive Employee Health and Wellness Intervention: A Cohort Study by Degrees of Health Engagement. J Occup Environ Med. 2016 Jul;58(7):696-706. doi: 10.1097/JOM.0000000000000765. PMID: 27294443.

11. McGloin H. Exploring the potential of telephone health and wellness coaching intervention for supporting behaviour change in adults with diabetes. Journal of Diabetes Nursing 2015:19:394-400.

12. McGonagle AK, Schwab L, Yahanda N, Duskey H, Gertz N, Prior L, Roy M, Kriegel G.. Coaching for primary care physician well-being: A randomized trial and follow-up analysis. Journal of Occupational Health Psychology 2020: 25(5), 297–314. https://doi.org/10.1037/ocp0000180

13. Mielenz TJ, Tracy M, Jia H, et al. Creation of the Person-Centered Wellness Home in Older Adults. Innov Aging. 2020;4(1): 1-13. igaa005. doi:10.1093/geroni/igaa005

14. Mettler EA, Preston HR, Jenkins SM, Lackore KA, Werneburg BL, Larson BG, Bradley KL, Warren BA, Olsen KD, Hagen PT, Vickers KS, Clark MM. Motivational improvements for health behavior change from wellness coaching. Am J Health Behav. 2014 Jan;38(1):83-91. doi: 10.5993/AJHB.38.1.9. PMID: 24034683.

15. Rivera LO, Ford JD, Hartzell MM, Hoover TA. An Evaluation of Army Wellness Center Clients' Health-Related Outcomes. Am J Health Promot. 2018 Sep;32(7):1526-1536. doi: 10.1177/0890117117753184. Epub 2018 Feb 5. PMID: 29402124.

16. Roy BA, Roberts PA, Lisowski C, Kaye MP, Sforzo GA. Integrating Health Coaching With a Medical Fitness Program to Treat Chronic Health Conditions. Am J Lifestyle Med. 2017;14(3):326-334 doi:10.1177/1559827617728025

17. Schwartz J. Wellness Coaching for Obesity: A Case Report . Global Adv Health Med. 2013;2(4)68-70. DOI: 10.7453/gahmj.2013.029

18. Sforzo GA, Kaye MP, Simunovich S, Micale FG. The effects of health coaching when added to a wellness program. Journal of Workplace Behavioral Health, 31:4, 242-257, doi: 10.1080/15555240.2016.1228463

19. Sforzo GA, Kaye M, Ayers GD, Talbert B, Hill M. Effective Tobacco Cessation via Health Coaching: An Institutional Case Report. Glob Adv Health Med. 2014 Sep;3(5):37-44. doi: 10.7453/gahmj.2014.029. PMID: 25568823; PMCID: PMC4268607.

20. Sherman RP, Petersen R, Guarino AJ, Crocker JB. Primary Care–Based Health Coaching Intervention for Weight Loss in Overweight/Obese Adults: A 2-Year Experience. Am J Lifestyle Med. 2019;13(4):405-413. doi.org/10.1177/1559827617715218

21. Sherman RP, Ganguli I. Primary Care-Based Health Coaching for the Management of Prediabetes. Am J Lifestyle Med. 2017; Apr 11;12(2):175-178. doi: 10.1177/1559827617702074. PMID: 30202390; PMCID: PMC6124994.

22. Tucker LA, Cook AJ, Nokes NR, Adams TB. Telephone-based diet and exercise coaching and a weight-loss supplement result in weight and fat loss in 120 men and women. Am J Health Promot. 2008;23(2):121-9. doi: 10.4278/ajhp.07051646.

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