Health coaching is becoming more popular for the management of chronic diseases, preventive health, treatment adherence (O’Hara, McGill & Phongsavan 2016) and weight loss (Munoz Obino, Pereira & Caron-Leinert 2017).
Munoz Obino et a.l’s (2017) integrative review concluded that coaching is a cost-efficient way to provide clients with education and treat health during weight-loss. Interestingly, Leahey and Wing (2013) found in a randomised, controlled pilot study, that obese clients with professional health coaches were (statistically significantly) more likely than those with mentor health coaches to lose ten percent of their initial body weight. Thus, promoting the importance of clients gaining access to accredited and/or professionally qualified and trained health coaches.
At present in Australia, the Get Healthy Information and Coaching Service have shown some success with preventive healthcare (O’Hara et al. 2016). This service utilises health coaching approaches such as goal-setting, health education, relationship-building, behaviour modification and management of emotions. O’Hara et al. (2016) recommend that health coaching incorporate more client accountability with their goals and encouragement for clients to take action. Furthermore, they highlight that health coaching should ideally involve increased referencing of evidence/literature and better information delivery.
Venditti et al. (2014) demonstrated that health coaches need to be trained in behavioural problem-solving. Evidently, it would be ideal for professional health coaches to be trained to combat behaviours that act as barriers to weight loss and activity, such as self-monitoring, thoughts, mood, time management, social cues and motivation.
There are some different types of health coaching or health management programs on offer, such as the Quitline (to stop smoking), COACH program (phone coaching for health management and to prevent avoidable hospital admissions), and Get Healthy Service (phone coaching for achieving a healthier lifestyle) (Queensland Government 2015).
Whilst these options suggestively offer increased accessibility for Australians’ healthcare, it can be questioned as to whether health coaches should more routinely form part of face-to-face interdisciplinary teams. It could be argued that access to health coaches with nil out-of-pocket costs for Australians could be of great value.
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Could this preventive healthcare approach be one way to reduce unnecessary hospital presentations and GP visits?
Interestingly, at present Medicare Provider Number Application Forms do not have a listing for ‘health coaches’ nor ‘registered nurses’ (Department of Human Services 2017). Thereby, could the health system be missing a valuable resource for preventive healthcare? Should there be more roles in medical clinics, community health centres, residential aged care facilities, and hospital settings for professional health coaches? Could other services and facilities (e.g. schools, gyms, and worksites) also utilise professional health coaches to promote health and wellness?
With the current epidemic of obesity, it can be argued that there is indeed a role for professional health coaches in Australia.
The Australian Institute of Health and Welfare (AIHW) (2017) puts forward that two out of every three Australian adults are overweight or obese! One-quarter of Australian children aged 2-17 in 2014-2015 were overweight or obese (AIHW 2017). Moreover, 5% of the burden of disease in 2011 was linked to overweight and obesity (AIHW 2017). 52% of Australians aged 18-64yrs were not physically active enough in 2014-2015 (AIHW 2017). There were over 22000 weight loss surgeries in 2014-2015 (AIHW 2017). People that are overweight or obese have increased chances of developing heart disease, type 2 diabetes, certain cancers, and some musculoskeletal conditions (AIHW 2017).
With the literature indicating that health coaching is a cost-efficient and effective way to prevent disease and manage weight, it is clear that there is a strong need to implement more professional health coach roles within communities and health services.
The World Health Organisation (WHO) (n. d.) states that out-of-pocket costs are a barrier to accessing healthcare. WHO acknowledges that in order to abolish fees or provide fee exemptions for healthcare, it is essential to gain political support and adequately prepare for the demand of the services. Therefore, should the government politically and financially support the implementation of fee abolishment or fee exemption/reduction for Australians (or at least at-risk populations) to access professional health coaches, there will need to be preparation in place. This may include having funding to employ professionals to the specific role of a health coach throughout the nation. Additionally, preparation may involve creating public awareness of what health coaches are, and the importance of accessing health coaching to prevent lifestyle diseases now and in the future. Public awareness of the costs and benefits of accessing professional health coaches would be necessary, in order to facilitate informed decision-making or self-determination. Education for other health professionals would be another foreseeable area of preparation. This could involve explaining how professional health coaches fit into the interdisciplinary team and again, what the costs and benefits of their inclusion are for all stakeholders and the health system itself (e.g. potential for reduced burden of disease,
Public awareness of the costs and benefits of accessing professional health coaches would be necessary, in order to facilitate informed decision-making or self-determination. Education for other health professionals would be another foreseeable area of preparation. This could involve explaining how professional health coaches fit into the interdisciplinary team and again, what the costs and benefits of their inclusion are for all stakeholders and the health system itself (e.g. potential for reduced burden of disease, fewer hospital admissions or more time for other health professionals due to being able to refer clients to the health coach for health education and goal-setting).
As the health system continues to evolve, it can be wondered if professional health coaching is the way of the future for the Australian health system.
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- Australian Institute of Health and Welfare 2017, Overweight and obesity, AIHW, Australian Government, viewed 20 September 2017, https://www.aihw.gov.au/reports-statistics/behaviours-risk-factors/overweight-obesity/overview
- Department of Human Services 2017, Medicare provider number for health professionals, Australian Government, viewed 20 September 2017, https://www.humanservices.gov.au/organisations/health-professionals/forms/hw063
- Leahey, TM & Wing, RR 2013, ‘A randomized controlled pilot study testing three types of health coaches for obesity treatment: professional, peer, and mentor’, Obesity (silver spring, md.), vol. 21, iss. 5, pp. 928-34, viewed 20 September 2017, from http://onlinelibrary.wiley.com/o/cochrane/clcentral/articles/398/CN-00963398/frame.html
- Munoz Obino, KF, Pereira, CA & Caron-Lienert, RS 2017, ‘Coaching and barriers to weight loss: an integrative review’, Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, vol. 10, pp. 1-11, viewed 20 September 2017, http://onlinelibrary.wiley.com/o/cochrane/clcentral/articles/406/CN-01332406/frame.html
- O’Hara, BJ, McGill, B & Phongsavan, P 2016, ‘Preventive health coaching: is there room to be more prescriptive?’, International Journal of Health Promotion and Education, vol. 54, iss. 2, pp. 82-94, viewed 20 September 2017, http://onlinelibrary.wiley.com/o/cochrane/clcentral/articles/022/CN-01266022/frame.html
- Queensland Government 2015, Health management programs, viewed 20 September 2017, https://www.qld.gov.au/health/staying-healthy/community/programs
- Venditti, EM, Wylie-Rosett, J, Delahanty, LM, Mele, L, Hoskin, MA, Edelstein, SL & Diabetes Prevention Program Research Group 2014, ‘Short and long-term lifestyle coaching approaches used to address diverse participant barriers to weight loss and physical activity adherence’, The International Journal of Behavioural Nutrition and Physical Activity, vol. 11, p. 16, viewed 20 September 2017, http://onlinelibrary.wiley.com/o/cochrane/clcentral/articles/753/CN-01081753/frame.html
- World Health Organisation (n. d.), Out-of-pocket payments, user fees and catastrophic expenditure, WHO, viewed 20 September 2017, http://www.who.int/health_financing/topics/financial-protection/out-of-pocket-payments/en/
Madeline Gilkes focused her research project for her Master's of Healthcare Leadership on Health Coaching for Long-Term Weight Loss in Obese Adults. She also has a Graduate Certificate in Adult & Vocational Education, Graduate Certificate in Aged Care, Bachelor of Nursing, Certificate IV Weight Management and Certificate IV Frontline Management. Madeline is an academic and registered nurse. Her vision is to prevent lifestyle diseases, obesogenic environments, dementia and metabolic syndrome. She has spent the past years in the role of Clinical Facilitator and Clinical Nurse Specialist (Gerontology and Education).