Posts from — May 2010

Thinking about an obesity-related disease management program for your organization? Here’s what you need to know.

In order to be effective, the program must meet participants’ individual medical and psychological needs, not to mention your own organization’s need to control long-term health costs.

How wide-reaching should the program be? After all, it doesn’t make sense to pay for services your employees don’t want or can’t use.

Mary Beth Chalk of Resources for Living suggests that obesity programs could be broken down into four tiers of worker need, from which your organization’s return on investment (ROI) can also be measured.

Tier 1 -  Education

Tier I workers struggle with weight management problems but don’t need a health coach.  Instead, they may benefit from a self-directed program that provides weight-management related materials online, targeted mailing, and/or access to nurse call line.

How to measure ROI -  utilization. Do staff members click on the Web site? Do they return to the site regularly? Do individuals  use the nurse line? Your program provider ought to provide you detailed use stats.

Tier 2 -  Clinical supervision

If the staff member has been diagnosed as obese - a Body Mass Index (BMI)  score over 30 is obese, over 35 is clinically obese - he or she’d do better working with a health coach in a clinically supervised program.

Three keys to getting maximum results -

1. Periodically have participants rate their relationship with their health coaches. Not everyone clicks, so a change might  be in order.

2. Coordinate your disease management care with your worker assistance program (EAP)services. Reason -  Inability to control weight is often closely tied with mental health issues - and one can adversely affect the other. the more closely your employee assistance program (EAP) and obesity program managers work together, the higher the chance for success.

3. Beware of the fade-out effect. A lot of employees in weight-loss programs get off to a excellent start and then fall back into old habits. Individuals  should re-commit to the program after three sessions, four months and nine months.

To measure ROI, look at utlization, goal achievement and reduced presenteeism. of course, presenteeism is notoriously difficult to measure with reliable dollar figures. So how can you overcome that problem?

• Begin with employees’ salaries. Let’s suppose one participant earns $40,000 per year.

• Ask staff members to self-report how energetic and productive they feel on the job, on a percentage scale. Then have supervisors estimate the employee’s productivity and split the difference. for this example, let’s assume it averaged to 50%.

• Collect scores again six months and one year into the program and then multiply the difference by salary. the result is your estimated productivity ROI.

In the example above, when the employee earning $40,000 improves from 50 percent to 75 percent after one year, the productivity related ROI is $10,000.  

Tier 3 -  Medical management

At this level, the obese worker needs a higher level of care than a health coach can offer. the worker has chronic health conditions related to obesity - like diabetes, high blood pressure, and/or sleep apnea - and needs a physician case manager. Namely, the worker needs to set up regular visits with the physician and create a treatment plan.

To measure ROI, begin with the lower-tier criteria, then track quarterly and year differences in FMLA or compensated absences, and prescription drug costs. Then compare it to the per-participant cost of the obesity program.

Tier 4 -  Morbid obesity

At this level, the staff member has been diagnosed as morbidly obese - BMI over 40 - and is considered a potential candidate for gastric bypass surgery.

ROI is measured through ongoing health claims as well as the previous criteria.

Given the gigantic growth of wellness programs over the last two years, it was inevitable resistance would creep up among watchdog groups.

In Washington, lobbyists have spearheaded a push for Congress, the DOL and IRS to crack down on “punitive” wellness programs.

Namely, the groups seek to limit programs in which employees’ share of their healthcare costs are directly tied to their willingness to participate in a wellness program.

HIPAA’s non-discrimination rules prohibit corporations from creating negative financial incentives for staff members with health risks.

For example, you can’t raise someone’s premium share because he or she smokes. What you can do is offer a discount if someone completes a use of tobacco cessation program.

Reason -  the law does allow for financial incentives to employees who willingly participate in wellness programs.

The watchdog groups seek greater regulation to be certain incentives and discounts are used only as rewards for healthful behavior, not as a thinly veiled form of discrimination against high-risk employees.

A recent survey finds almost 42 percent of employers with 200 or fewer staff members have some sort of disease management program.

That’s a immense increase from four years ago, when just 28% of smaller companys offered such programs.

There’s more to come, too. Fifteen% of respondents that didn’t currently have a disease management component to their medical plan hope to add one by 2011.

The highest-demand disease management programs are for diabetes, asthma and heart illness.

Source -  Small Corporation Benefits Survey, PDR Consulting Group, 9/1/2008.

Thinking about an obesity-related disease management (DM) program for your organization? Here’s what you need to know.

In order to be effective, the program must meet participants’ individual medical and psychological needs, not to mention your own organization’s need to control long-term health care costs.

How wide-reaching should the program be? After all, it doesn’t make sense to pay for services your workers don’t want or can’t use.

Mary Beth Chalk of Resources for Living suggests that obesity programs may be broken down into four tiers of staff member need, from which your organization’s return on investment (ROI) can also be measured.

Tier 1 -  Education

Tier I employees struggle with weight management problems but don’t need a health coach.  Instead, they might benefit from a self-directed program that provides weight-management related materials online, targeted mailing, and/or access to nurse call line.

How to measure ROI -  utilization. Do staff members click on the Web site? Do they return to the site regularly? Do individuals  use the nurse line? Your program vendor ought to provide you detailed use stats.

Tier 2 -  Clinical supervision

When the staff member has been diagnosed as obese - a Body Mass Index  score over 30 is obese, over 35 is clinically obese - he or she would do better working with a health coach in a clinically supervised program.

Three keys to getting maximum results -

1. Periodically have participants rate their relationship with their health coaches. Not everyone clicks, so a change may  be in order.

2. Coordinate your disease management (DM) care with your employee assistance program (EAP)services. Reason -  Inability to control weight is often closely tied with mental health issues - and one can adversely affect the other.

The more closely your employee assistance program and obesity program managers work together, the higher the chance for success.

3. Beware of the fade-out effect. A lot of staff members in weight-loss programs get off to a excellent start and then fall back into old habits. People  should re-commit to the program after three sessions, four months and nine months.

To measure ROI, look at utlization, goal achievement and decreased presenteeism. of course, presenteeism is notoriously challenging to measure with reliable dollar figures. So how can you overcome that problem?

• Begin with employees’ salaries. Let’s suppose one participant earns $40,000 per year.

• Ask employees to self-report how energetic and productive they feel on the job, on a percentage scale. Then have supervisors estimate the employee’s productivity and split the difference. for this example, let’s assume it averaged to 50 percent.

• Collect scores again six months and one year into the program and then multiply the difference by salary. the result is your estimated productivity ROI.

In the example above, when the employee earning $40,000 improves from 50% to 75% after one year, the productivity related ROI is $10,000.  

Tier 3 -  Medical management

At this level, the obese employee needs a higher level of care than a health coach can offer. the employee has chronic medical conditions related to obesity - such as diabetes, high blood pressure, and/or sleep apnea - and needs a doctor case manager.

Namely, the worker needs to set up regular visits with the doctor and create a treatment plan.

To measure ROI, begin with the lower-tier criteria, then track quarterly and year differences in FMLA or paid absences, and prescription drug costs. Then compare it to the per-participant cost of the obesity program.

Tier 4 -  Morbid obesity

At this level, the staff member has been diagnosed as morbidly obese - Body Mass Index over 40 - and is considered a potential candidate for gastric bypass surgery.

ROI is measured through ongoing health claims as well as the previous criteria.

Develop a culture of wellness within your organization

Develop Exemplary Management Support

In the most successful Wellness Programs, upper managers lead their organizations by example. and they work to ensure that the management structure not only allows, but actively encourages their workers to participate.

Organize a Wellness Advisory Team

Wellness committees serve as the eyes, ears, arms and legs of the program, representing colleagues ideas and concerns, and assisting reshape the organizational culture toward health.

Conduct an Assessment of Financial and Human Assets and Liabilities

Successful Wellness Programs are built upon a foundation of information, including claims review, demographic analysis of the workforce, management and employee surveys, health risk data, history of organizational wellness, and health benefit plan design.

Create Obviously Announced Vision, Mission and Outcomes

Establish a clear vision of program direction, expectations and measures to answer the questions, “Where are we going and how’ll we know when we get there?”

Develop a Extensive and Strategic Wellness Program

A multi-component plan should consist of strategically created and implemented awareness, lifestyle change, and supportive environment programs, in addition to policies and activities that target appropriate health risk behaviors and needs of the staff members.

Identify an Incentive and Reward Strategy

Incentives show the organizational commitment to the program and motivate person to participate. Incentives vary commonly from program to program, but can include such things as time off, reduction in health insurance premiums or co-pays, cash incentives, discounts to fitness clubs, free pedometers, etc.

Communicate to Employees

Your program ought to be simple and concise, use an identifiable brand, and rely on a variety of media to communicate with workers and managers.

Evaluate Outcomes

Evaluate program participation, satisfaction levels and behavioral change. You could want to track the number of workers’ compensation claims, productivity, turnover morale and absenteeism.

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Wellness Program - Management Support.

Develop Exemplary Management Support

Goal -  A Wellness Program established into the organization’s culture.

Focus -  Develop support and excitement for the program from all levels of the corporation -   senior management, mid-level management, and grass-roots workers.

Obtaining  upper management’s buy-in is essential to launching an effective program. the staff members must understand that management is supportive of the wellness program.

Actions -

Develop an Senior Management Executive Team to determine high-level decisions - positions that must be included are the Chief Executive Officer, Chief Operating Officer, Chief Financial Officer, Communications Officer, and other appropriate division-level managers and program experts, as necessary.

The Upper Management Executive Team will -

• Communicate to all levels of management about the program and drive the integration of the Wellness Program as a part of the company culture.

• Ensure that organizational resources are available for program planning and implementation.

• Be sure to encourage staff members to participate and to assist in “recruiting” other staff members, get the momentum going, and keep it growing.

• Share success stories within the business, and continue to raise the perceived value of participation.

Organize a Wellness Advisory Team

Goal -  Develop a working committee that consists of workers and essential functional parts of the organization.

Focus -  to assist in reshaping the organizational culture to support employee-wellness activities by serving as messengers and supporters for the program.

Wellness Advisory Committees serve as an essential part of the infrastructure of your Wellness Program. the team members are the eyes, ears, arms, and legs of the program.

They represent their coworkers by sharing ideas and concerns about the wellness program.

Actions -

The Wellness Advisory Committee will -

• Make certain to work with  senior level management and the Wellness Program coordinator in the design, implementation, and evaluation of the program.

• Create methods to enhance the acceptance and success of the activities of your Wellness Program by encouraging employee ownership of the program.

• Hold periodic meetings to keep the committee informed of upcoming plans and events and to provide feedback to the program coordinator about their thoughts, ideas, and suggestions, and those of their coworkers.

• Recommend policy and environmental changes that are aimed at improving the health and safety of employees.

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Wellness Program - Vision and Mission.

Goal -  Create a baseline of information and identify human and organizational needs.

Focus -  Review a variety of information to better understand past and current conditions regarding health-care utilization, organizational culture, demographic overview, and health-promotion initiatives.

Data collection plays an important role in planning, monitoring, and analyzing  a wellness program. It will also set the baseline for continued and future analysiss of program efficiency, effectiveness, and feasibility.

Actions -

• Claims review (health care, pharmaceutical) -

• What have been the 10 most costly major illness categories in each of the past five years? What are the number of claims and dollars compensated for each?

• What have been the 10 most costly therapeutic classes of drugs in each of the past five years? What are the number of claims and dollars paid for each?

• What have been the 10 most frequently prescribed and filled therapeutic classes of drugs in each of the past five years? What are the number of claims and dollars compensated for each?

• Demographic analysis of staff member population (may include dependents) -

• List your number of staff members, by gender, for each of the past five years and the percentages of males and females by age groups.

• Think about any other factors that might have affected the health of your staff members and their use of the health-care system.

This may include mergers, acquisitions, workplace trauma, worker strikes, layoffs, early retirement offers, etc.

Management survey -

• Conduct surveys of mid-level management to understand their concerns and measure their level of interest and buy-in.

• Employee-interest survey -  Gather information to find out what the employees want and to measure the level of participation, satisfaction, and “success” of any previous activities.

Risk data (health-risk assessments) -

• is there any data from health-risk appraisals over the past five years?

Participation in similar activities -

• List and describe all wellness programs that have been implemented over the past five years, including participation rates.

Design of the health plan, and anticipated changes -

• Have there been any meaningful changes in the health plan’s design in each of the past five years, like a change from an Health Maintenance Organization to a PPO, increased co-payments or deductibles, or increased staff member contributions?

Develop Clearly Stated Vision, Mission and Outcomes

Goal -  Establish a clear vision of program direction, expectations, and measures.

Focus -  Establishing a vision, mission, goals and goals to keep your Wellness Program focused toward its desired outcomes. It’ll answer the questions, “Where are we going?” and “How’ll we know when we get there?”

Actions -

• Identify two to five clearly announced objectives. Be certain that your program is capable of having an impact in the area desired, and be certain that you’re capable of measuring that impact.

Example Goal -  Employees having access to healthier food options

• Establish two to five measurable goals that especially state what your program is going to accomplish, by when, how, and how it’ll be measured.

Example Objective -  Modify all vending machines to include 50 percent healthful food options.

• Identify several activities that’ll help you reachyour objective. Activities are very specific.

Example Activity -  Make sure to work with vending machine owners to identify healthful food choices and restock with 50 percent of items that are healthier food choices.

• Identify who is going to do what, by when, and what resources are needed.

Example Detail -  the Program coordinator will contact XXX Vending Business by September 30.

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Wellness Program Incentives.

Create a Extensive and Strategic Wellness Program

Goal -  A extensive Wellness Program plan.

Focus -  Development of a plan that consists of a variety of awareness, lifestyle change, and supportive environment program, policies, and activities that will target risk behaviors, needs, and interests of workers.

Your Wellness Program should provide an integrated, strategic approach specific to the needs, objectives, and culture of your organization, designed throughout an annual cycle.

It’ll be important to review and revise existing policies governing such areas as tobacco use, vending machines, and the staff cafeteria. Additionally, it is useful to examine what corporate wellness or health-promotion activities are offered under your existing health-benefit plan.

Actions -

• Create activities based on your program goals and the specific needs of your staff members. Focus on those topics that are of greatest interest to your staff members and the greatest needs of your corporation, in that order. Prevent topics with narrow appeal.

• Keep it simple. Design the program so it’s easy for the participants to understand and track. Let employees focus their learning efforts on their own behavior, not on the rules and regulations of the program.

Additionally, simplify the program administration. Let people  record their own activities when possible; develop a mixture of self-reported activities along with verified activities.

• Integrate a combination of activities to include awareness, educational, and behavior elements. Link the activities throughout the year to allow for desired behavior repetition.

• Select activities that every employee can participate in.

Examples -

• Challenges -  Activities that focus on practicing a desired behavior and continue for 4-8 weeks and focus on specific topics (like exercise, nutrition, or stress management).

• Learning experiences (seminars, videos, classes) -  One-time activities that last for a relatively short time and focus on a specific topic; these can precede “challenge activities” to prepare participants for behavior change.

• Behavior changes (such as use of tobacco cessation) -  Interventions may or may not be offered at the workplace; person must be encouraged to make lifestyle changes that they wanted to make even without the incentive.

• Disease management (support and education groups for diabetes and hypertension) -  These may  be provided or supported by the business through disease-management vendors, or by community, health, or religious organizations.

• New skills (first aid, cardiopulmonary resuscitation) -  These could  be provided or supported by the business, or by community, health, or religious organizations.

• Screenings, wellness assessments, physical exams -  A wellness assessment provides the company with aggregate data that may be used in program planning and analysis; preventive screenings and physical exams may be encouraged by awarding credits to employees.

• Program support (membership or leadership in wellness committee or challenge team) -  Reward those who work with you to help make your Wellness Program a success.

• Community events -  Reward participation in events like the Heart Walk or March of Dimes Walk; limit the number of these events that may be counted toward the annual total, and be selective about which events you allow to be counted.

Create an Incentive Strategy

Goal -  to motivate and reward worker participation and completion.

Focus -  Create a sense of interest in participation and completion of wellness activities.

Providing incentives and rewards will send an important message to the workers that the organization is committed to improving their health and will share the rewards that these changes will bring. It also plays a significant role in exciting person to participate.

Actions -

• Identify through employees what incentives they value most.

• Identify what incentives the organization can provide.

• Integrate your incentives into your benefits strategy.

• Ensure that every participant who achieves a goal receives some recognition.

• Offer participation incentives.

• Prevent offering incentives for the “best” or the “most.”

• Prevent rewards for biometric changes.

• Use incentives to promote your Wellness Program, through logos and branding.

Examples -

Compensated time off, reduction in health insurance premiums or co-pays, cash incentives, discounts to gyms, free pedometers, etc.

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Wellness Program Communication.

Goal -  Increase awareness of and participation in the Wellness Program.

Focus -  Promote the Wellness Program to staff members to encourage participation in activities and benefits.

A well-designed communications strategy is paramount to successful program awareness and participation. Even a “world class” program design will not succeed when nobody knows that it’s available or how to get involved.

Employees who do not get involved in the program ought to be doing so because they select not to participate, not because they didn’t know about how, when, or where to participate.

Actions -

• Conduct a Resources and Communications Audit to identify internal and external resources available to support your Wellness Program, in addition to knowing how information will be disseminated.

• Keep the program simple and concise -  easy to peruse about, understand, and act upon.

• Build the brand; be sure it’s something that employees can identify with. Add the brand to T-shirts, water bottles, mouse pads, stress balls, etc.

Use a selection of media -

• Print -  pamphlets, fliers, posters, banners, paycheck inserts, newsletter articles, bulletin boards, literature racks, post cards.

• Electronic - Web, intranet, e-mail, closed-circuit TVs, sign lines, audiovideo productions.

• Staff meetings and organization events; word of mouth.

• Use existing channels of communication - what works best in your company - and make certain to know about all points of contact and systems of distribution.

Timing for communications -

• Prior to activity to develop awareness and to educate.

• During activity to stimulate participation.

• After an activity to report results.

• Between activities to maintain momentum and interest.

Consistency of communications -

• Use branding; maintain a consistent look, feel, and tone of messages.

• Maintain this consistency throughout the program.

Surveys and forms -

• Collect information.

• Disseminate information.

Research shows that untargeted health-promotion campaigns have little long-term impact.                  

Chronic conditions, which rob person and families of their health and happiness, represent major costs to corporations in the form of health-care and disability costs, lost productivity, and absenteeism.                  

Wellness Programs should address risky behaviors that can help your workers eat healthier, increase their level of exercise, help reduce stress, lower blood pressure and cholesterol, and quit smoking. Wellness programs should focus on assisting workers achieve and maintain their optimal health status.

Robust worksite-health programs focused on changing lifestyle behavior have been shown to yield a $3 to $6 return on investment for each dollar invested. It takes about three to five years after the initial program investment to realize these savings.

Ninety-three% of U.S.  businesses offer some kind of health-promotion program for their employees, but is it the right type?

Primary Types of Wellness Programs

Programs focusing on disease management. These programs monitor and treat specific diseases. Disease management follows the 80/20 rule -  80% of health-care costs are spent on 20% of workers.

Illness management is reported to have a $7 to $10 return on investment within a year. the 20 percent of workers requiring the greatest medical expenditures today are ordinarily different 20 percent who’ll cause the greatest health care expenses a year or two down the road.

Programs focusing on health enhancement and risk management. These programs focus on lifestyle behavior change, and offer a $3 to $6 return on investment within two to five years, as reported by a 2004 report issued by the National Corporation Group on Health.

It is important to note that a $3 to $6 return on an entire staff member population produces a higher total savings than does disease management.

Good Data Drives Good Business Decisions

• Based on more than 120 research studies, the National Business Group on Health stated that, within five years of program implementation, overall benefit-to-cost ratios (return on investment) of -

• $3.48 in decreased health-care costs per dollar invested.

• $5.82 in decrease absenteeism per dollar invested.

The Facts Speak for Themselves - Wellness Helps Reduce Costs

• A 2003 analysis of one big U.S.  employer found that simply helping employees control their blood pressure alone can save $547 per person per year.

• Johnson and Johnson claims to have saved $38 million in health-care costs for its employees between 1995 and 1999 by promoting healthful lifestyles.

Medical expenses reduced $224 per worker per year (averaged over four years), and this rate improved over time. the business found most benefits in the third and fourth years after program initiation.

• A 2004 Univ. of Michigan study of 23,500 General Motors staff members showed that nonexercising staff members claimed at least $100 more per year in health-care costs than exercisers.

The published study  also reported that obese, sedentary staff members who started exercising at least twice a week reduced their costs by an typical of $500 a year.

• the Washoe County School District in Nevada estimated that, in a single year, it spent $300,000 on direct costs associated with obesity and $1 million for gastric-bypass surgeries. It instituted a weight-loss program that compensated staff members $10 per pound lost, up to 25 pounds.

Program participants missed three fewer workdays per year, producing a cost savings of $15.60 per program dollar spent.

Staff Time                  

Building a successful Wellness Program requires staff time as well as money. Some larger organizations may spend 20 hours per week for three to six months preparing all the steps before launching a Wellness Program.                  

Corporation Costs                  

Monetary costs can fluctuate widely, depending on whether the employer compensates all costs, the staff members pay all costs, or the costs are shared.                  

A 1992 study indicated that 28% of companies spent $5 or less per employee, and 19% spent between $6-10 per employee.                  

The Wellness Council of America estimates the cost per employee to be between $100 and $150 per year for an effective wellness program that produces a return on investment of $300 to $450. A sample expenditure for various levels of programs include -                   

Program Type                  

A minimal (largely paper) program          $1 - $7         

A moderate program                   

A medium program with a few activities       $16 - $35            

A fairly robust program             $36 - $75      

A very extensive, effective program       $76 - $112            

• the news isn’t encouraging. As reported by Corporation Week, family health-care premiums increased 49 percent from 2000 to 2004.

Another increase of 12-15% is expected in 2005. General Motors expects to spend $5.6 billion on health costs in 2005, or 40% more than it earned in profits in 2004.

• More and more research shows that poor diet andlack of exercise are major drivers of increases in health care costs for companys. the number of obese adults has doubled since the 1970s.

• the rise in obesity has a meaningful impact on health-care costs. on average, 2002 health-care costs for an obese individuals were $1,244 higher than for a individuals with a healthy weight.

• Obesity is causing rapid increases in type 2 diabetes and contributes directly to a 65% increase in diabetes treatment from 1987 to 2002. Nearly $1 of every $5 spent on healthcare in the USA is for a individuals with diabetes.

Treating employee healthcare as an investment, rather than a cost, can yield long-term dividends

• at least 50 percent of your organization’s health-care costs are driven by the lifestyle related behaviors of your employees, such as use of tobacco, poor diet, and lack of exercise.

• In the past 10 years, the annual return on investment for Wellness Programs has been as much as $6 saved for every $1 spent, doubling the return on investment of earlier programs.

• the typical reduction in health-plan costs, sick leave, disability costs, and workers’ compensation is more than 25 percent for well-designed Wellness Programs.

• Fit staff members are more productive staff members, with fewer sick days, fewer accidents, higher morale, and lower job turnover.

The concern for employee wellness is an increasing trend for American business. Why? the link between employee wellness and the bottom line is clear and consistent.

Corporations who integrate wellness in their overall objectives find they experience decreased absences, better morale, decreased health risks, and decreased health-care costs.

The purpose of this guide to is to encourage and help you launch your own Wellness Program. If you already have a program, but aren’t receiving the results you expected, perhaps some ideas and best practices in this toolkit will help you and your workers reap the advantages of a healthier workforce.

At least 50% of health-care expenditures are lifestyle-related, and consequently, potentially preventable. Yet despite the $5,000 an typical employer spends on healthcare per employee each year, most employers are spending less than 5% of that on biometric testings and prevention.

The most extensive meta-evaluation of Wellness Program studies shows something very exciting! It shows that Wellness Programs are not only effective at assisting to reverse the rising spiral of health-care costs, but these programs are also becoming more effective. the average cost-benefit ratio has increased from 1 - 3 for earlier programs to 1 - 6 today.

Simply put, the typical reduction in health-care costs, sick time, disability costs, and workers’ compensation is more than 25% for well designed programs.

Corporate wellness provides a long-term approach for helping keep employees well. the single most vital thing you can do for your employees is to start a Wellness Program now.

Health coaching to facilitate the promotion of healthy behavior and achievement of health-related goals

Coaching has become acceptable to both corporation and person to help improve performance, manage stress and achieve work and personal goals. Yet very few papers have been published with a specific focus on health and coaching.

This article highlights the possible role of coaching to facilitate the promotion of healthful behaviors and to help person achieve their health-related objectives.

Introduction to Health Coaching

The practice of personal, family, health, life, company, sports, performance and executive coaching has grown substantially since the early 1990s (Cockerill 2002, Fournies 2000, Neenan and Palmer 2001, Parsloe and Wray 2000, Peltier 2001).

Although the term “coach” has been borrowed as a metaphor from sport, it is now applied to the personal and work domains. Hence the term “coaching” has entered into the public psyche beyond the sports pages of the national newspapers and is becoming generally accepted as beneficial to its recipients.

It can even be seen as trendy having your own personal life coach. Whereas, in the United Kingdom, there’s still a stigma attached to seeing a counsellor or psychotherapist.

What’s health coaching?

There are many definitions of coaching. Four are summarized below -

1. Health coaching is unlocking a person’s potential to maximize their own performance. It is assisting them to learn rather than teaching them - a facilitation approach (Whitmore 1992, based on Gallwey, a tennis specialist).

2. Health coaching - Directly concerned with the immediate betterment of performance and development of skills by a form of tutoring or instruction - an instructional approach (Parsloe 1995).

3. Health coaching - the art of facilitating the performance, learning and development of another - a facilitation approach (Downey 1999).

Psychologists have developed another variation -  

4. Health coaching psychology is for enhancing wellness and performance in personal life and work domains with normal, non-clinical populations, underpinned by models of coaching grounded in established adult learning or psychological approaches (adapted Grant and Palmer 2002).

It can probably be assumed that these definitions ought to reflect the nature of coaching as practised by many practitioners.

Thus the key aspects of coaching, depending upon the model of coaching being applied, appear to include enhancing well-being, learning, facilitation, tutoring, instruction, development of skills and bettering performance. In addition, coaching is generally goal and solution focused (Grant 2001).

Health Coaching

Similar to health education experts, ordinarily the coach takes an active and directive role. Usually, the coach helps the coachee to achieve their goals by facilitating the learning process.

If “health coaching” or “coaching for health” is the focus, the coach might help to educate the coachee on specific health-related topics and subsequently support them in achieving

Health Coaching -  Practice Briefing

Health coaching to facilitate the promotion of healthful behavior and achievement of their health-related objectives. as the term coaching is becoming acceptable to the public, the concept of health coaching could be more favourably received by a client group contrarily to attending a health education lecture.

An established health-related expert body, the Institute of Wellness and Education, provides a definition of wellness and health education in their constitution -

The practice of wellness and health education might  be described as the organisation and execution of the influences affecting the environment, in addition to individual knowledge, attitudes and behavior, in matters concerning health for empowering communities and individuals to maintain and promote personal and community health and wellness, together with a proper acceptance and use of the health and medical services available. (IHPE 2002)

This definition doesn’t conflict with the general principles of the coaching approach, although its focus is on health and it can also be at the community level. This would be similar to stress or stress management coaching that is now available.

The International Stress Management Association (UK) has recognized the practice of this form of coaching for a number of years. It may be argued that stress management training and stress management coaching comes below the umbrella of the health education field.

Another professional body, the Association for Coaching (2003), includes both stress management coaching and health coaching on its website as “Speciality Coaching’.

Consequently the term “health coaching” is entering into citizens awareness, although not necessarily among mainstream health education or promotion professionals.

Within the field of health, papers have been published on behavioral counselling which has been used to educate customers with coronary heart illness (Steptoe et al 1999). Intriguingly, the counselling is active and directive in nature and takes an educational approach which can be more accurately described as instructional coaching.

A tentative definition of health coaching is given below -

Health coaching is the practice of health education and wellness within a coaching context, to enhance the well-being of person and to facilitate the achievement of their health-related goals.

This definition attempts to link health education and promotion to the key elements of coaching.

Psychological Blocks to Change

Due to the personal nature of coaching it could include tackling the health-related psychological blocks to change which could be challenged in the individual or group coaching session.

These cognitive or attitudinal blocks to change may be divided into Health Inhibiting Thinking (HITs) and Health Enhancing Thinking (HETs).* Cognitive techniques like Socratic questioning may be used to help a client to modify their thinking.

Health Coaching -  Final Thoughts

With the increasing interest in coaching, the introduction of “health coaching” or “coaching for health” may have an appeal across different generations.

Notwithstanding, there is a lack of published research that underpins the effectiveness of health coaching. Although many models of coaching exist (Bluckert 2003), the application of models to health coaching which take an educational approach, like cognitive-behavioral or multimodal, might provide promising results (Neenan and Palmer 2001, Palmer et al 2003).