Health Coaching works. There is ample evidence demonstrating its efficacy. How can digital coaching be woven in so that the potential of coaching can be scaled to real world population sizes. Take a read and see what we’ve learned along the way.
I sometimes feel as though I walk in two different worlds. One, following and consuming research from the hallowed halls of academia – the rigour, the focus on proving or disproving a hypothesis, the ambition to discover something new that could change how we do things or what we thought was true. The second – industry, of developing, building and selling things that matter in the real world, that live or die by the value they deliver to the people who use them.
Where these two worlds intersect is where I find my purpose. What does the evidence say is possible in the controlled environment of the research lab, and how can we translate it to the real world and convey tangible value to customers and the community? I’m highly motivated to answer this question, and it’s at the heart of what my team is working on currently.
In this piece I’ll explore this concept of evidence to real-world outcomes for digital coaching tools. I’ll hone in on health coaching, but the principles can be extended to anywhere coaching can make a positive difference to wellbeing – financial, leadership, sport, relationships, lifestyle behaviours.
Can coaching improve wellbeing?
In short, yes. Coaching is a powerful tool for driving change. This systematic review found that health coaching was effective in improving health outcomes for a variety of chronic diseases, including diabetes, hypertension, and heart disease. The review also found that health coaching was effective in improving lifestyle behaviours such as physical activity, diet, and smoking cessation.
Can a hybrid digital + human coaching modality achieve more?
Again, yes. Leading researchers in this field have shown that adding technology solutions to assist coaching are better than standard coaching alone. As well as better outcomes, tech-supported solutions also benefited the coaches – they were able to manage nearly twice as many patients when assisted by the platform.
I was fortunate to be close to the work of John Moore and team at MIT, and the work they did to demonstrate that Coaching + Tech platform could significantly outperform coaching alone. A critical factor in the success of this work was that feedback loops were shortened because the tech bought the coach and participant so much closer. In their study, the MIT team showed patients receiving remote tech-supported coaching to manage hypertension, 75% achieved blood pressure control vs 32% in the control group (that received normal health coaching support); the tech-supported group also had systolic readings that were on average 13mmHg lower than the control group.
Technology-Supported Apprenticeship in the Management of Hypertension: A Randomized Controlled Trial
The results were echoed in a similar study in type 2 diabetes management – the tech-supported group achieved better glycaemic control (35-point drop in HbA1C mmol/mol), reported better satisfaction with care and their improvements were better than would be seen with medicine alone.
A similar pilot I was involved in in the New Zealand context provided us with evidence to support a hybrid coach + digital app intervention. Participants who were referred to the pilot received an initial hour-long session with the human coach, followed up by three months of digital support via a prototype app. Participants were surveyed to provide the following results:
- 77.8% reported an improvement in their health condition, with weight loss and improved exercise as the key outcomes. Others included glycaemic control, improved diet, wellbeing and general health goals
- 60.9% of patients who wanted to lose weight did so, with an average individual weight loss of 5.4kg
- 2 out of 3 patients said the health coaching helped their commitment to managing their condition, improved their knowledge and helped them make lifestyle changes
- The most positively rated aspects of coaching were: accountability, motivation and focus; and 1 out of 3 patients said the coaching helped their mental wellbeing
The pilot also elicited helpful feedback about the patient experience and areas for improvement, including further development of the app and preferences around goal setting, frequency of contact and the content.
Digitally enhanced coaching works, now how to make it scale.
In every client situation I have worked in, the trick is scaling. There are never enough coaches to service all participants. Thats the magic of digital coaching: creating experiences that have impact, and emulate the kind of response a coach would provide.
What are some experiences that a digital coach can deliver?
- It can monitor behaviour, and support or provide feedback on that behaviour
- Well done when the plan is on track
- Prompts to reflect when the plan is off track
- It can monitor behaviour, and sense when the behaviour is inconsistent with the plan (i.e. an action plan)
- It can then prompt an intervention, like, say, problem solving
With confidence that digitally-enabled coaching is effective, the next questions we are looking to tackle are around the factors that drive successful coaching outcomes, such as:
- Participant engagement: how to drive active participation in setting goals, developing action plans and acting on them
- Coach-participant relationship: how to create a trusted, strong and supportive relationship
- Goal setting: how to ensure specific, measurable, achievable, relevant, and time-bound goals can be set
- Action planning: how to develop action plans that are tailored to a participant’s individual needs and preferences
- Self-efficacy: how to build a participant’s belief in their ability to make positive change
- Social support: how to leverage social support from friends, family, and peers to enhance change
Digital-first solutions can improve many of these factors, streamline the flow of information, reduce workload, and assimilate siloed data points (such as activity data from wearables and wellbeing from passive listening tools) to enhance motivation and drive positive reinforcement. The big win with digital is scale – it can drive exponentially greater reach and amplify outcomes.
The evidence for positive change is there, the challenge we are tackling is how to weave together published evidence and technical prowess in digital to start achieving outcomes at scale. Digitally-enabled coaching means better experiences, better outcomes and greater productivity – everyone stands to benefit if we can get it right. Watch this space!
In the next blog we’ll explore the tech – and how to make coaching and behaviour change work in our customer’s environments
We’re working on something exciting that will change the way we support people’s wellbeing. If you’re interested, please follow me on LinkedIn or get in touch at Hamish@artilect.co.nz