June 21, 2016
By Dr. Joel Kreisberg, DC, ACC
Research on Health Coaching was well represented at the 2016 International Congress of Integrative Medicine and Health. Leading researchers including Karen Lawson and Ruth Wolever presented several posters of recent research. As well, I (Joel Kreisberg) presented Reggie Marra’s and my initial findings in the use of healing narratives in the teaching of health coaches. A brief review follows.
In How Effective is Health Coaching in Reducing Health Services Expenditures? researchers Karen Lawson and Mary Jo Kreitzer, both from University of Minnesota, and noted researcher David Eisenberg of Harvard School of Public Health, posed the question, “Would health coaching that encouraged high risk persons to take a more proactive role in improving health, improve their ability to navigate the health care system and ultimately reduce costs?” The assessment looked at the impact of health coaching on inpatient, emergency room, outpatient, and prescription drug expenditures.
Over a 2-year period from 2009-2010, 6,940 health coaching participants were coached, 1,161 of whom received at least 4 weeks of health coaching. In this latter group, 6 months of individual claims were examined both pre-participation and post- participation. While emergency room services were not affected, inpatient and outpatient total costs fell significantly relative to controls. The estimated outpatient and total cost savings were $286 and $412 per person per month respectively.
The study concluded that health coaching led to “significant reductions in outpatient and total expenditures for high-risk plan enrollees.” Further studies are called for to consider specific populations as well as to clearly articulate the health coaching intervention.
In the study presented by Mark Dreusicke of Duke University School of Medicine and Ruth Wolever of Vanderbilt University School of Medicine, entitledIntegrative Health Coaching: A Behavioral Skills Approach to Improve Diabetes Medication Adherence and Glycemic Control, the authors looked at the impact of health coaching on medication adherence of diabetes patients.
56 patients were provided with Integrative Health Coaching and claims data were analyzed for improved and sustained oral medication adherence. Patients received 14 coaching calls by telephone over 6 months. The results showed that medication adherence increased from 0.74 to 0.85 during the coaching and was sustained at 0.82 during the six months after the study. Better adherence correlated with a greater decrease in in Hemoglobin A1c (a diabetes measure) from 8.0 to 7.7 over the six month intervention. Psychosocial measures were also monitored and showed significant improvement.
The study concluded that targeting the underlying internal motivations and behavior skills through health coaching yields sustainable results for medications adherence. Further exploration of health-related behavior change through health coaching is warranted.
Research from Teleosis Institute, authored by Reggie Marra and myself (Joel Kreisberg), entitled Healing Narratives and The Nature of Healing in Developing Health Coaches was presented. Based on the innovative work we developed while teaching Integrative Health Coaching at Maryland University of Integrative Health, our initial findings were presented on seven core themes that our Applied Healing Strategies students identified through inquiry into their own healing narratives.
The themes included: acceptance—acceptance is healing; connection—reaching out and sharing with others is healing; awareness—healing involves increasing awareness; release—letting go is healing;gratitude—feeling and expressing gratitude is healing; wholeness—healing involves becoming increasingly whole; presence—an increasing ability to be present is healing.
Our conclusion points to the need to investigate salutogenic approaches that balance the illness/wellness continuum. This narrative inquiry allows students to further understand a broad range of health generating perspectives that serve both client and coach.
Overall, the literature on health coaching is growing—a necessary and vital element in the growth and validity of the profession.