Wellness Coaching Initiative
Public health, clinical practice and employee wellness models are evolving to help individuals change their health behaviors to prevent and better manage disease. One rapidly emerging strategy to help individuals successfully change their health behaviors is health and wellness coaching1.
Scientific evidence continues to show that diet, lifestyle and environment are critical factors in creating optimal health. The causal factor of chronic diseases, including cardiovascular disease, obesity and cancer, can be influenced by nutrition and daily lifestyle choices. EPIC, a landmark long-term study of 23,000 people in 2016, studied the health impact of four simple behavioral choices—not smoking, exercising 3.5 hours weekly, eating a plant-forward diet, and maintaining a healthy weight. Researchers found that people who adhered to the lifestyle choices had a 78% lower overall risk of developing chronic disease2. These data demonstrate that a healthy diet, consistent exercise, and daily choices based on the best science available can improve overall health.
COVID-19 has created obstacles for living and for making healthy choices. With the challenges of self-quarantining taking over family life, consumers are frequently ordering in meals during the pandemic, barely going out for groceries, not eating healthy, and feeling stressed3. In addition to needing help maintaining the core pillars of health and wellness (nutrition, exercise and stress management), people also need help with social contact, connection with nature, and financial wellbeing, which can be addressed by health and wellness coaches4.
During the pandemic, where underlying conditions increase the risk of death, the value of health and wellness coaching in preventive health takes on an additional dimension. For 2021, global health and wellness coaching trends are systemically integrating health and wellness coaching into new delivery models, including personalized care, global corporate wellness, schools/universities and community centers, through a hybrid coaching model supported by technology that complements the face-to-face human connection.
TREND 1: Personalized care, a new era of health care, is integrating health and wellness coaches.
The center of the personalized health care system is support for the individual who is engaged in their own wellbeing in a way that is cost-effective and sustainable. Through the support of a multidisciplinary team with a health and wellness coach, individuals are empowered to make choices and control based on what matters most to them and their needs. Dr. Jeffrey Bland, functional medicine pioneer in the United States, states that there is a shift in the approach to medicine to personalized care, offering a reliable guide to optimal health. These personalized approaches with disease-prevention strategies will ultimately be proven to be more effective than the current episodic treatment of disease5.
The National Health Service (NHS) in the United Kingdom is focusing on patient empowerment in the context of personalized care requiring a long-term partnership with patients. The need for novel interventions and approaches to service delivery suggests a health and wellness coach with a whole person approach at the heart of their care6. There is recognition in the United Kingdom that health and wellness coaching offers a significant contribution both as a stand-alone intervention and as an adjunctive service to health care interventions7.
TREND 2: Governments in preventive health-focused countries are expanding community-based programs and providing free access to health and wellness coaches.
Preventive health and wellness, which was considered nonessential pre-COVID, is now the focus of many governments and institutions and should ideally be considered the first line of defense8. The focus on poor lifestyle prevention is as important as ever, and health and wellness coaching is seen as a way to support individuals for lasting behavior change.
In Singapore, the government is supporting Singaporeans to care for their own health and wellbeing. The push for a healthy lifestyle is undertaken by the Ministry of Health, which regularly rolls out health campaigns. Online portals and apps provide customized information and incentives to promote healthy lifestyle changes and help the population minimize the risk of disease. The government recently expanded the community-based program to let patients get free advice from health and wellness coaches in personalized one-on-one coaching and group coaching sessions9.
The Australian government has also become more focused on preventative health with the growing realization that lifestyle-related illnesses are a major risk for disease and COVID-19. With initiatives such as the National Preventive Health Strategy and the Australian Commission on Safety and Quality of Healthcare, the government is moving toward supporting key concepts that health and wellness coaching embraces—person-centered care and shared decision-making. Free programs such as “Get Healthy” telephonic health and wellness coaching are being promoted, and the COACH program in Queensland is increasing awareness of the need and availability for support even if, at this stage, the information being provided is of a more prescriptive nature than what health and wellness coaching embraces10.
TREND 3: Private corporate sector wellness programs have shifted to virtual coaching.
Dr. Kenneth R. Pelletier, clinical professor of medicine, University of California San Francisco School of Medicine at the Sanford Stanford Center for Research in Disease Prevention and director of the Corporate Health Improvement Program (CHIP) in the United States, advised that this sector is more receptive and unequivocally the best place for health and wellness coaches. COVID-19 has accelerated this trend because companies have had to disperse their workforce. Companies have had to find ways to offer wellness programs off-site and in the employees’ homes. The solution was inter-digitizing health and wellness coaches into a corporate program at home, and that’s not going to change. Health and wellness coaches are supporting employees to have a daily routine, concentrate on healthy lifestyle behaviors they can control, and supporting them to make positive change, improve their health, and build resilience.
Dr. Pelletier believes health and wellness coaching is intersectional in the corporate setting. He envisions health and wellness coaching programs located anywhere in the world, providing services to any country in which a company has offices. Health and wellness coaches help the employee set their own goals, examine their motivation, and support their decision-making. If the focus is on dietary management, the foods would very clearly be different from country to country, but the basic coaching strategies of working with a person for sustainable behavior change, over dietary changes, weight management, smoking cessation or stress management, really are quite universal11.
A recent health and wellness coaching study by WebMD of corporate wellness programs customer outcomes concluded that “with proven risk reduction and cost savings, health and wellness coaching has emerged as one of the leading wellness solutions available today. Health and wellness coaching offers a true population management solution that engages a broad number of employees, motivates them to make long-term behavioral changes, and contributes to a stronger employer-employee partnership.” Telephonic health and wellness coaching to employees, which takes a holistic approach rather than focusing on specific disease or illness, has consistently shown a strong impact on population health. After the coaching program was in effect for one year, employers found impressive results in the key areas of repeatable outcomes and claims-backed cost savings. Health plans claims analysis resulted in a medical claim cost savings of US$148 per person per year across all risk groups, which translated into US$575,000 in total annual savings from avoided medical and pharmaceutical claims expenditures12.
TREND 4: Schools and universities are an emerging setting for health and wellness coaching.
Gerry Bodeker, PhD, whose doctoral studies were at Harvard with decades of research at Oxford and Columbia University, shared that the notion of health and wellness coaching in schools is growing. Health and wellness coaches support students in knowing what their potential is and knowing what the risks are in not managing a life well. Stand-alone coaches and/or teachers being trained in the principles of wellness coaching around behavior change are emerging4.
Research shows that college students are experiencing increased levels of stress and mental health concerns such as anxiety and depression, as well as overwhelming feelings when trying to balance their studies and life. The American College Health Association adds that health and wellness coaching is fairly new, gaining momentum, and has potential as an effective approach for improving student wellbeing and academic achievement in the higher education setting. Grounded in holistic wellness, health and wellness coaching is an intentional effort to reconnect all parts of the student and guide them in setting goals that acknowledge the complexity of the behaviors in which they choose to engage and the varying barriers that exist in the collegiate environment. A multidimensional model of wellbeing allows the coaching session to affirm that wellbeing is dynamic and often exists at the intersection of their identity, the environment in which they live, and the behaviors they choose. Health and wellness coaching is part of a range of multidisciplinary services and resources offered to support student mental health and wellbeing. Coaching is an effective methodology for energizing behavior changes because it concentrates on helping students become more autonomous experts in their own wellbeing and personal journeys13.
TREND 5: Health and wellness coaching is shifting to a hybrid model that scales the profession through technology and group coaching.
Human face-to-face interaction will remain the core of the coaching engagement to build a trust-based relationship driving sustainable change. However, supportive technology has become critical to scale the profession and address increasing societal demand. Coaches have integrated video sessions, phone calls and emails for goal setting, motivation and tracking 4,10. With coachee consent, data from fit bits and tracking devices are also becoming part of health records for ongoing assessment and goal evaluation4,10. Additionally, apps like Preventia Group and YourCoach are virtually connecting motivated individuals with health and wellness coaches to advance toward their goals.
Community-based group coaching is on the rise to help address the “catch-up” demand for health services during COVID-19 and overcome the impact on economies and personal income. In the United Kingdom, where health and wellness coaching is either funded by the National Health Service (NHS) with an over-stretched public budget or individuals’ out-of-pocket, group coaching models are becoming an increasingly important approach7.
Dr. Elizabeth Markel of Open Source Wellness in the Evolution of Medicine: Functional Forum highlights the benefits of facilitating behavior change in a group. Dr. Markel found that group coaching helps democratize health and wellness coaching while providing shared experiences for individuals to build healthy lifestyle behaviors and overcome health issues. Her work discovered that group visits reward the individual with improved health and community14.
1 Wolever R, PhD et al (2013). A Systematic Review of the Literature on Health and Wellness Coaching: Defining a Key Behavioral Intervention in Healthcare. Glob Adv Health Med. 2013 Jul; 2(4): 38–57. Published online 2013 July. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3833550/
2 Ford, Earl S et al. Healthy Living Is the Best Revenge – Findings from the European Prospective Investigation into Cancer and Nutrition-Potsdam Study, Archives of Internal Medicine 169, no 15 (2009): 1355-1362. Doi:10.1001/archintermed.2009.23.
LD Opler. Health and Wellness Coaches Are Fairly New. Here’s What You Need to Know About Them. The Washington Post. December 2020.
4 Interview with Professor Gerry Bodeker, PhD. December 10, 2020.
5 Bland. J. The Disease Delusion: Conquering the Causes of Illness for a Healthier, Longer and Happier Life. Harper Wave. 2014.
6 National Health Service (NHS), PCI (2020): Personalised Care Institute: https://www.personalisedcareinstitute.org.uk
7 Natrins I (2020). Towards defining Health and Wellness Coaching in the UK and Ireland. UKHCA unpublished paper. Unpublished Report. Available [email protected]
10 Queensland Health, https://www.health.qld.gov.au/clinical-practice/referrals/coach
Australian Institute of Health and Welfare 2020. Australia’s health 2020: in brief. Cat. no. AUS 232.
Canberra: AIHW Australian Commission on Safety and Quality in Health Care (2011), Patient-centred care: Improving quality and safety through partnerships with patients and consumers, ACSQHC, Sydney.
Australia’s Long-Term National Health Plan, 2019
11 Interview with Dr. Kenneth R. Pelletier. November 17, 2020.
12 KL Andalman. Wellness Coaching Positively Impacts Corporate Culture. Corporate Wellness Magazine. https://www.corporatewellnessmagazine.com/article/wellness-coaching-positively-impacts-corporate-culture
13 American College Health Association White Paper: Wellness Coaching (February 2020). www.acha.org
14 Dr. Elizabeth Market. The Evolution of Medicine: Functional Forum: https://functionalforum.com/podcasts/gvt9-open-source-wellness