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Bezner J.R.1, Lloyd L.2, Crixell S.3, Franklin K.1
1Texas State University, Department of Physical Therapy, San Marcos, United States, 2Texas State University, Department of Health and Human Performance, San Marcos, United States, 3Texas State University, School of Family and Consumer Sciences, San Marcos, United States
Background: Lifestyle behaviors have been estimated to be a factor in at least 80% of chronic disease, making them a prime target for employee wellness programs (EWPs) and requiring innovative approaches to create sustainable behavior change. Health coaching is an effective strategy for changing health behaviors, but one-on-one coaching can be expensive and inefficient. Group health coaching formats have shown promise in impacting more people without compromising positive outcomes; however, little research exists documenting the effects of group coaching.
Purpose: The purpose of this study was to determine if group health coaching impacts physical fitness and psychological constructs in an understudied population of university employees.
Methods: A quasi-experimental longitudinal study design was employed. University employees newly enrolled in an EWP (n=100) were randomly selected from a pool of volunteers who were overweight or obese and at risk for cardiovascular disease. Subjects participated in 3, face-to-face, monthly, one-hour group coaching sessions tailored to stage of change for physical activity, facilitated by a physical therapist. Grounded in health behavior change theories, these sessions focused on improving physical activity behavior, both in adopting new physical activity habits and managing lifestyle changes long-term. Physical fitness and psychological constructs from the Transtheoretical Model and self-determination theory were measured before and after the coaching sessions using published and validated tests and questionnaires. Data were analyzed using paired t-tests and a multivariate regression analysis with post-coaching self-efficacy as the dependent variable.
Results: 84 employees completed the intervention. Participants stage of change improved from pre-test to post-test (2.77±1.26 to 3.91±1.22), as did self-efficacy (2.76±0.44 to 2.97±0.72), perceived competence (5.32±1.88 to 5.62±1.73), and perceived support (3.86±2.11 to 4.80±3.04). Attendance across all university wellness program events, fitness classes, and coaching sessions was significantly predictive of post-test self-efficacy (p 0.01). Overall, participants lost fat mass, gained fat free mass, improved cardiorespiratory endurance, core strength, and low back and leg flexibility as measured after the coaching sessions.
Conclusion(s): In this study the positive effect of a group health coaching intervention on university employees at risk for cardiovascular disease was demonstrated. Several groups of authors suggest that researchers studying health coaching define health coaching in terms of the intervention applied, specify the theoretical foundation of the intervention and relate the theories to the intervention delivered, and measure process variables (such as self-efficacy). In the current study, these recommendations were addressed and improvements in cognitive or process and health outcomes occurred in the study population. The intervention was delivered in a group coaching format, thereby increasing the availability, access, and cost effectiveness of health coaching. Research is needed to determine which aspects of the coaching curriculum and what behavior change theory or theories influenced change in the variables measured.
Implications: Physical therapists treat patients daily who can benefit from the adoption of healthy lifestyle behaviors. Group health coaching has been shown to promote behavior change and can be delivered effectively by physical therapists and was shown in the current study to improve cognitive and physical parameters associated with improved health outcomes.
Funding acknowledgements: Project funded by Texas State University
Topic: Health promotion & wellbeing/healthy ageing
Ethics approval: Project approved by the Texas State University Institutional Review Board (IRB # CON2015T920)
All authors, affiliations and abstracts have been published as submitted.
