Value-Congruent Coaching, Engagement, and Behavior Change
Summary
Background. Value-congruent tailored coaching has proven more effective at persuasion and behavior change than non-tailored coaching. Research identifying subgroups of individuals defined by different patterns of health-related behavior have suggested tailored coaching to these patterns could be more effective at promoting positive health outcomes among large numbers of adults without a focus on individual differences. Objectives. This study used a pre-test post-test experimental design with a control group to evaluate the effectiveness of nurse-practitioner telephonic value congruent coaching delivered over a year tailored to clients based on client conformity to different patterns of health-related behavior. Outcomes examined were differences between pre-test and post-test measures of connectivity, engagement, and behavior change. Methods. Eight thousand disease management clients were recruited from an existing client population who had already been receiving disease management interventions for an unspecified length of time. Clients were assessed by telephone using the Adaptive Health Behavior Inventory (AHBI) through interactive voice response after a live transfer from a nurse. Analysis of AHBI responses was used to assign clients to one of ten patterns of health-related behavior identified by the Health Patterns Report (Patterns of Adapting to Health [PATH] model) based on best fit. The sample of 8,000 patients was randomly assigned to the experimental treatment group or the control group. Ten nurse practitioners received 16 hours of training in pattern-based value-congruent coaching tailored to each of the health behavior patterns. Following the training, clinicians received a guidebook containing a summary of each health behavior pattern, a break down of dispositions across five dimensions, and value-congruent coaching tactics. Treatment effects were assessed against three measures: number of successful telephone calls (connectivity), call time in minutes (engagement), and number of goals set and achieved (behavior change). Results. During the treatment period, 66% of the original sample was lost due to lapse of disease management contracts, leaving 1,399 in the experimental group and 1,303 in the Control group. Clinicians delivered pattern-based value congruent coaching in a blunt manner, only following tailoring guidelines 70% of the time. Post treatment analysis identified a statistically significant 9% improvement in client connectivity, 17% improvement in engagement, and a 13% improvement in behavior change in the treatment group relative to the control group. Conclusions. Outcomes support the conformity of adults to different readily identifiable patterns of health behavior (The Heath Patterns) with known characteristics. Even though delivered in a blunt manner, outcomes support the use of value-congruent coaching tailored to those patterns to improve connectivity, engagement, and health behavior change.
Background. Value-congruent tailored coaching has proven more effective at persuasion and behavior change than non-tailored coaching. Research identifying subgroups of individuals defined by different patterns of health-related behavior have suggested tailored coaching to these patterns could be more effective at promoting positive health outcomes among large numbers of adults without a focus on individual differences. Objectives. This study used a pre-test post-test experimental design with a control group to evaluate the effectiveness of nurse-practitioner telephonic value congruent coaching delivered over a year tailored to clients based on client conformity to different patterns of health-related behavior. Outcomes examined were differences between pre-test and post-test measures of connectivity, engagement, and behavior change. Methods. Eight thousand disease management clients were recruited from an existing client population who had already been receiving disease management interventions for an unspecified length of time. Clients were assessed by telephone using the Adaptive Health Behavior Inventory (AHBI) through interactive voice response after a live transfer from a nurse. Analysis of AHBI responses was used to assign clients to one of ten patterns of health-related behavior identified by the Health Patterns Report (Patterns of Adapting to Health [PATH] model) based on best fit. The sample of 8,000 patients was randomly assigned to the experimental treatment group or the control group. Ten nurse practitioners received 16 hours of training in pattern-based value-congruent coaching tailored to each of the health behavior patterns. Following the training, clinicians received a guidebook containing a summary of each health behavior pattern, a break down of dispositions across five dimensions, and value-congruent coaching tactics. Treatment effects were assessed against three measures: number of successful telephone calls (connectivity), call time in minutes (engagement), and number of goals set and achieved (behavior change). Results. During the treatment period, 66% of the original sample was lost due to lapse of disease management contracts, leaving 1,399 in the experimental group and 1,303 in the Control group. Clinicians delivered pattern-based value congruent coaching in a blunt manner, only following tailoring guidelines 70% of the time. Post treatment analysis identified a statistically significant 9% improvement in client connectivity, 17% improvement in engagement, and a 13% improvement in behavior change in the treatment group relative to the control group. Conclusions. Outcomes support the conformity of adults to different readily identifiable patterns of health behavior (The Heath Patterns) with known characteristics. Even though delivered in a blunt manner, outcomes support the use of value-congruent coaching tailored to those patterns to improve connectivity, engagement, and health behavior change.