St. Louis, MO (February 20, 2018) – Recent research conducted by the Envolve Center for Health Behavior Change™ examined expectations for health coaching relationships and preferences for titles of health coaches among adults with commercial insurance and those with Medicaid. While several studies have explored the effectiveness of health coaching, few studies have sought to understand how health coaching should be delivered, and even fewer studies have consulted recipients of health coaching on their preferences.
While “health coach” is most frequently used to describe someone who uses experience and one-on-one communication to help others change behaviors to improve their health, several other titles have also been used to define the same professionals as well as others who fill similar roles. Other notable titles include “navigator,” “peer educator,” and “guide.”
In-person interviews were conducted with 140 participants, including 61 adults with commercial insurance and 43 Medicaid beneficiaries from Missouri and 36 from Louisiana. During the interviews, some participants were shown common titles for health coaches and asked questions on their preferences and expectations associated with the functions of health coaches. After analyzing the information collected in the interviews for emergent themes, some differences related to preferences in the title used for health coaches emerged.
Although most people liked the term “coach,” participants with Medicaid insurance were less likely to prefer it, possibly due to greater associations with sports and a view that the term seemed less professional than “specialist” or “advisor,” which they preferred. These terms were also well liked by commercially insured participants.
While preferences for different terms may not generalize back to the entire population of Medicaid and commercially insured adults, they suggest that both groups may respond well to a health “specialist” or “advisor,” and that Medicaid beneficiaries may not respond as positively to invitations to meet with a health “coach.” Medicaid participants talked about coaches having medical knowledge and the ability to provide clinical advice and education on health topics. Similarly, some participants sought direction from coaches in the form of education, plan development, and continuous support.
In contrast, more commercially insured participants felt they knew the steps they needed to take for health behavior change and wanted coaches to help with their own ongoing, self-directed efforts at health behavior change by providing ideas, motivation, and accountability.
An important limitation to these findings is that more commercially insured participants had either participated in health coaching or knew someone who had than those participants with Medicaid insurance. Previous exposure to health coaching may have influenced the insights shared by commercially insured participants compared with Medicaid beneficiaries.
Ultimately, these findings point to the need for continued research to understand the differences in preferences and expectations of adults with commercial insurance and Medicaid beneficiaries, and testing approaches to tailoring coaching programs to serve different audiences.
Molly Loughran – Masters Research Fellow
Molly Loughran works with the Health Communication Research Laboratory (HCRL) at the George Warren Brown School of Social Work at Washington University in St. Louis. She is pursuing her Master of Social Work and Master of Public Health at the Brown School. She has worked with HCRL on Envolve Center projects related to health coaching and life values.
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