Health Coaching (HC) is a provider-based lifestyle education program (LSP) that applies a collaborative, participant-focused approach to enable participants to take responsibility for their health and well-being. The goal of HC is to help participants increase readiness and gain confidence to make lasting changes for improved health. Health Coaching can be conducted by any trained medical professional (e.g. nurse, dietitian, pharmacist, counselor, community health worker, etc.) involved in implementing Team-Based Care as a WISEWOMAN provider. Utilizing a range of medical professionals is encouraged by the WISEWOMAN program to best serve the participant’s needs and meet their defined goals.

Women will work collaboratively with their health coach to determine a priority area(s) of focus for the brief coaching interventions. Motivational interviewing techniques will be effectively utilized to elicit and strengthen motivation for changing behaviors related to the priority area. Drawing on core components of this counseling approach, health coaches will employ open ended questions, affirmative statements, reflective listening skills and summarizations to effectively capture and resonate change talk and self-motivational statements communicated by the participant.

Principal Tenets of Health Coaching

• Participant-Centered—interaction is collaborative and non-directive
• Participant-Tailored—participants choose the goals that they want to address, quantity and duration of sessions can vary based on participant’s needs and desires, coaching can be done in person or by phone to eliminate barriers to participation
• Whole-Person Approach—all health risks and conditions of an individual are taken into consideration and women are linked to additional community-based resources, as necessary

Health Coaching Priority Areas

WISEWOMAN Health Coaching priority areas include, but are not limited, to the following topics:

• Healthy eating
• Physical activity
• Blood pressure management
• Smoking cessation
• Medication education
• Mental health

Referral to Health Coaching

Health Coaching should be offered and encouraged for all WISEWOMAN participants. However, it is most appropriate for WISEWOMAN participants who:

• Indicate a readiness for change
• Agree that HC is an appropriate HBSS for them
• Prefer to individualize their HBSS
• Desire a condensed program delivery timeline

Health Coaching Guidelines

Risk Reduction Counseling precedes Health Coaching and lays the groundwork for a woman’s priority areas. For participants that show readiness for engagement and motivation to change, an initial Health Coaching session may be conducted in conjunction with a WISEWOMAN Screening/Risk Reduction Counseling. Because Health Coaching differs from RRC, Health Coaching content must be distinct and separate from RRC. Health Coaching should be submitted as a WISEWOMAN Education claim in MOHSAIC or included in the WISEWOMAN Screening (RRC, Initial or Annual) claim submission.

Initiation of Health Coaching

WISEWOMAN participants should be encouraged to schedule an initial Health Coaching session within two weeks of referral, if unable to complete the first Health Coaching in conjunction with RRC, but ultimately may propose a schedule informed by personal goals, learning style and schedule availability. Health Coaching sessions should be staggered in intervals to ensure that participants have sufficient time to institute behavior change, maximize opportunity for application and support self-efficacy.

Delivery of Health Coaching

To minimize known barriers to participant access and maximize participant choice, Health Coaching must be offered both face-to-face and via phone. Health Coaching sessions can range from 15-45 minutes, completed individually or in a group setting.

Requirements for Health Coaching Delivery Methods Include:

• Individual, face-to-face Health Coaching—provided, at a minimum, in a private exam, counseling or conference room located at a WISEWOMAN clinic
• Individual, telephonic Health Coaching—health coach must be, at a minimum, conducting counseling from a private or semi-private room or office in a clinic
• Group, face-to-face Health Coaching—provided, at a minimum, in a private conference room at a clinic with multiple WISEWOMAN participants

Tracking Health Coaching Sessions

Health Coaching sessions conducted by WISEWOMAN providers will be documented using the Health Coaching Reporting Form (peach). Each form is used through the completion of Health Coaching. The form will be incorporated into the WISEWOMAN MOHSAIC database to further support documentation and program evaluation processes. Health Coaching sessions should be completed 2-4 weeks apart, if possible. The WISEWOMAN health coach will document the date, session length, delivery method, topic(s) and comments on the form for Health Coaching sessions 1-3. On the 4th Health Coaching, it is required to complete a face-to-face WISEWOMAN Follow-Up Rescreen (hot pink).

Follow-Up Rescreen Requirements

WISEWOMAN health coaches must follow-up with participants within four weeks of completion of their third Health Coaching session to complete the WISEWOMAN Follow-Up Rescreen (hot pink). This should be submitted as a WISEWOMAN Follow-Up Rescreen claim in MOHSAIC. A Follow-Up Rescreen should be conducted face-to-face and must include the following components:

• Completion of health history assessment questions (also found on the WISEWOMAN Assessment Form) regarding a woman’s risk for CVD including:
  • Previous CVD and risk levels
  • Use of medications for HTN, cholesterol and/or diabetes
  • Nutritional habits
  • Physical activity
  • Alcohol use
  • Overall wellness/mental health
  • Smoking status/tobacco use
• Height, weight and BMI
• Two complete blood pressure (BP) readings with an average reading
• *Laboratory tests (if ordered and deemed necessary by a qualified practitioner)

Completion and Continuation of Health Coaching

Completion of Health Coaching consists of three Health Coaching sessions, in addition to, a face-to-face Follow-up Rescreen (hot pink) during the 4th session. Health Coaching should ideally be completed in less than six months. Once a participant has completed one cycle of Health Coaching, further HBSS should be offered to the woman. After a Follow-Up Rescreen, a WISEWOMAN participant can continue Health Coaching sessions for up to 16 sessions/year. A new Health Coaching Reporting Form (peach) will be used to track each cycle of Health Coaching sessions.