title: The "Health Coaching" programme: a new patient-centred and visually supported approach for health behaviour change in primary care.
abstract: BACKGROUND
  Health related behaviour is an important determinant of chronic disease, with a high impact on public health. Motivating and assisting people to change their unfavourable health behaviour is thus a major challenge for health professionals. The objective of the study was to develop a structured programme of counselling in primary care practice, and to test its feasibility and acceptance among general practitioners (GPs) and their patients.
  
  
  METHODS
  Our new concept integrates change of roles, shared responsibility, patient-centredness, and modern communication techniques-such as motivational interviewing. A new colour-coded visual communication tool is used for the purpose of leading through the 4-step counselling process. As doctors' communication skills are crucial, communication training is a mandatory part of the programme. We tested the feasibility and acceptance of the "Health Coaching" programme with 20 GPs and 1045 patients, using questionnaires and semistructured interviewing techniques. The main outcomes were participation rates; the duration of counselling; patients' self-rated behavioural change in their areas of choice; and ratings of motivational, conceptual, acceptance, and feasibility issues.
  
  
  RESULTS
  In total, 37% (n=350) of the patients enrolled in step 1 completed the entire 4-Step counselling process, with each step taking 8-22 minutes. 50% of ratings (n=303) improved by one or two categories in the three-colour circle, and the proportion of favourable health behaviour ratings increased from 9% to 39%. The ratings for motivation, concept, acceptance, and feasibility of the "Health Coaching" programme were consistently high.
  
  
  CONCLUSIONS
  Our innovative, patient-centred counselling programme for health behaviour change was well accepted and feasible among patients and physicians in a primary care setting. Randomised controlled studies will have to establish cost-effectiveness and promote dissemination.
authors.affiliation: Institute of General Practice and Health Services Research, University of Zürich, Pestalozzistrasse 24, Zürich 8091, Switzerland. sneuner@bluewin.ch
authors.forename: Stefan
authors.initials: S
authors.lastname: Neuner-Jehle
authors.forename: Margareta
authors.initials: M
authors.lastname: Schmid
authors.forename: Ueli
authors.initials: U
authors.lastname: Grüninger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000517:prevention & control; D003376:Counseling / Q000193:education / Q000379:methods*; D004059:Diffusion of Innovation; D005240:Feasibility Studies; D005260:Female; D015438:Health Behavior; D058015:Health Communication / Q000379:methods; D006293:Health Promotion / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D062405:Motivational Interviewing; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D018802:Patient-Centered Care; D010817:Physician-Patient Relations; D011320:Primary Health Care / Q000379:methods*; D016730:Program Development; D011795:Surveys and Questionnaires; D013557:Switzerland; D055815:Young Adult