title: A Qualitative Study of How Health Coaches Support Patients in Making Health-Related Decisions and Behavioral Changes.
abstract: Although health coaches are a growing resource for supporting patients in making health decisions, we know very little about the experience of health. We undertook a qualitative study of how health coaches support patients in making decisions and implementing changes to improve their health.
  
  
  
  We conducted 6 focus groups (3 in Spanish and 3 in English) with 25 patients and 5 friends or family members, followed by individual interviews with 42 patients, 17 family members, 17 health coaches, and 20 clinicians. Audio recordings were transcribed and analyzed by at least 2 members of the study team in ATLAS.ti using principles of grounded theory to identify themes and the relationship between them.
  
  
  
  We identified 7 major themes that were related to each other in the final conceptual model. Similarities between health coaches and patients and the time health coaches spent with patients helped establish the health coach-patient relationship. The coach-patient relationship allowed for, and was further strengthened by, 4 themes of key coaching activities: education, personal support, practical support, and acting as a bridge between patients and clinicians.
  
  
  
  We identified a conceptual model that supports the development of a strong relationship, which in turn provides the basis for effective coaching. These results can be used to design health coach training curricula and to support health coaches in practice.
authors.affiliation: Center for Excellence in Primary Care, Department of Family and Community Medicine, University of California, San Francisco School of Medicine, San Francisco, California David.Thom@UCSF.edu.
authors.forename: David H
authors.initials: DH
authors.lastname: Thom
authors.affiliation: Center for Excellence in Primary Care, Department of Family and Community Medicine, University of California, San Francisco School of Medicine, San Francisco, California.
authors.forename: Jessica
authors.initials: J
authors.lastname: Wolf
authors.affiliation: Center for Excellence in Primary Care, Department of Family and Community Medicine, University of California, San Francisco School of Medicine, San Francisco, California.
authors.forename: Heather
authors.initials: H
authors.lastname: Gardner
authors.affiliation: Center for Excellence in Primary Care, Department of Family and Community Medicine, University of California, San Francisco School of Medicine, San Francisco, California.
authors.forename: Denise
authors.initials: D
authors.lastname: DeVore
authors.affiliation: Center for Excellence in Primary Care, Department of Family and Community Medicine, University of California, San Francisco School of Medicine, San Francisco, California.
authors.forename: Michael
authors.initials: M
authors.lastname: Lin
authors.affiliation: Center for Excellence in Primary Care, Department of Family and Community Medicine, University of California, San Francisco School of Medicine, San Francisco, California.
authors.forename: Andy
authors.initials: A
authors.lastname: Ma
authors.affiliation: Center for Excellence in Primary Care, Department of Family and Community Medicine, University of California, San Francisco School of Medicine, San Francisco, California.
authors.forename: Ana
authors.initials: A
authors.lastname: Ibarra-Castro
authors.affiliation: Center for Excellence in Primary Care, Department of Family and Community Medicine, University of California, San Francisco School of Medicine, San Francisco, California.
authors.forename: George
authors.initials: G
authors.lastname: Saba
mesh_terms: D000328:Adult; D003376:Counseling; D003657:Decision Making; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D000071252:Mentoring / Q000379:methods*; D008875:Middle Aged; D010353:Patient Education as Topic; D036301:Qualitative Research; D012648:Self Care
keywords: allied health personnel; health coaching; patient decision making; patient-centered care; practice-based research; primary care; qualitative research; self-management support