Should we be Making Room on the Interdisciplinary Team for Professional Health Coaches?
Published: 19 October 2017
Published: 19 October 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.
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.
Madeline Gilkes, CNS, RN, is a <a href="https://www.lifestylemedicine.org.au/fellows" target="_blank">Fellow of the Australasian Society of Lifestyle Medicine</a>. She focussed her master of healthcare leadership research project on health coaching for long-term weight loss in obese adults. In recent years, Madeline has found a passion for preventative nursing, transitioning from leadership roles (CNS Gerontology & Education, Clinical Facilitator) in hospital settings to primary healthcare nursing. Madeline’s vision is to implement lifestyle medicine to prevent and treat chronic conditions. Her brief research proposal for her PhD application involves Lifestyle Medicine for Type 2 Diabetes Mellitus. Madeline is working towards Credentialled Diabetes Educator (CDE) status and primarily works in the role of Head of Nursing. Madeline’s philosophy focuses on using humanistic management, adult learning theories/evidence and self-efficacy theories and interventions to promote positive learning environments. In addition to her Master of Healthcare Leadership, Madeline has a Graduate Certificate in Diabetes Education & Management, Graduate Certificate in Adult & Vocational Education, Graduate Certificate of Aged Care Nursing, and a Bachelor of Nursing. See Educator Profile