Methods and evaluation of a health coach training practicum experience for healthy lifestyle behavior change

The promotion of healthy lifestyle behaviors is a high public health priority due to the strong links to chronic disease and the associated impacts on health and quality of life. Motivational interviewing-based health coaching is a popular behavior change strategy to work toward encouraging healthy-decision making and provide accountability in making progress toward health goals and outcomes. A key priority in the field of health coaching is proper training to ensure proficient health coaches to engage with clients, participants, or patients for healthy lifestyle change. The purposes of this dissertation were to: 1) develop and implement an effective semester-based course to train upper level college students in the skills of motivational interviewing-based health coaching, 2) examine the effects of health coaching as a behavior change strategy among incoming college students, and 3) disseminate and evaluate a brief version of the motivational interviewing training for widespread skill obtainment. The first study provided insight into the proficiency levels achieved by upper level undergraduate students that completed a semester long training in motivational interviewing-based health coaching. All students were able to obtain proficiency levels for technical and relational Global scores following the 16 week-period of training and practice. However, it was more difficult to obtain proficiency in the use of reflections with 13% meeting proficiency in the percent of complex reflections used, and 0% meeting proficiency for the reflection-to-question ratio. The second study evaluated the effectiveness of these previously trained peer health coaches in their ability to communicate with incoming undergraduate students regarding healthy lifestyle behavior changes. Incoming Freshman and Sophomore students were offered the opportunity to meet one-on-one with a trained peer health coach for 8 weeks during a semester to work toward health goals of their choice (physical activity, dietary habits, stress management, etc.). Following four health coaching sessions in an 8-week period, results show that incoming college students appreciated the accountability that a peer health coach provided and the sessions elicited positive changes in all domains observed. Participants reported an average gain of 39.6% in physical activity levels, 9.9% increase in sticking to healthy dietary habits, and a 16.3% decline in stress levels. The third study demonstrates the ability to train county extension workers to effectively learn the spirit and relational components of motivational interviewing through an online version of the training model that was adapted from the 16-week training protocol tested in study one. This study answered a novel question since it demonstrated that individuals completing training were able to communicate more effectively than those that did not complete the brief training. This dissertation adds to the existing literature on methods for health coach training but also provides an example of a novel synergy between research, teaching and practice. The training methods were developed to provide a quality training experience for undergraduates to learn the skill of health coaching; however, the practicum component also provided a direct service to Iowa State University students that received the health coaching. The systematic evaluation of the programming advances the research and provides a strong foundation to ensure a sustainable future for the CydeKicks program. This dissertation also shows merit in the broad dissemination of brief motivational interviewing training for widespread health promotion efforts. Future research is needed to further evaluation the online platform and the impacts from health coaching