Most people understand that eating sensibly, not smoking, exercising and managing their stress will improve their health. So why are Americans having difficulty practicing these healthy lifestyle habits?
A national poll commissioned by the American Academy of Family Physicians surveyed 1,000 adults in the United States, asking why they knowingly continue a habit that puts their health at risk. The results were not surprising. The majority reported that they continue risky health behaviors because they lack the willpower to change or because of the pressures of a stressful, time-crunched life.
What is so difficult about changing health behaviors? Volumes of articles, books and research have been written on this topic. Yet it continues to be a challenge for individuals as well as their physicians, health educators and health promotion practitioners. Experience tells us that the older model of health education, which involves the expert talking and the patient listening, is not working. If anything, we’ve learned that telling someone what to do just doesn’t get us the results we want.
The discouragement and frustration health and wellness professionals experience from their lack of success in helping people change lifestyle behaviors has led to a new concept in health promotion programming. Although there is still much to be learned about impact and outcome, wellness coaching has now become an integral part of many corporate-sponsored wellness programs.
The concept of coaching is not new to corporations. Executive coaching is common in organizations looking for ways to provide leadership development, enhance communication skills and increase employee retention. The return on investment is well documented among corporations, large and small.
However, investing in coaching to help employees change health behaviors is a somewhat new phenomenon. A growing number of employers are offering wellness coaching as a way to help employees make lifestyle choices that will minimize their risk for illness and disease.
How does coaching differ from the traditional approach to health education and what makes it more effective? The difference lies in the nature of the relationship between the educator and the participant. Coaches work with individuals one-on-one, using an asset approach rather than a deficit approach.
The focus is on strengths, rather than weaknesses. People are not seen as passive recipients needing to be directed but are asked to lead with their own responses and choices. This means wellness practitioners primarily elicit and listen, rather than tell people what to do.
The participant becomes the expert on himself and identifies his own needs, challenges and goals. The coach asks the participant to identify his greatest health concern and which issues he wants to tackle.
In the world of wellness, where we tend to see individuals as walking risk factors with one-size-fits-all solutions, this personalized approach is having positive results.
The process generally begins when an individual’s health risks are identified through a health risk assessment, including completion of a health questionnaire, and a screening for specific blood and body measurements. The results are discussed with the employee in a follow-up counseling session with a health professional.
Employees who are struggling with health issues related to unhealthy behaviors are encouraged to participate in an ongoing coaching program, through which the employee works with a coach to set specific health behavior related goals. Health coaches range from physicians and nurses to nutrition and fitness experts.
Generally, companies contract with wellness vendors, who in addition to providing the health risk appraisal, do the follow-up delivery and counseling. Employees who fall into higher risk categories are offered ongoing coaching that ranges from simple goal setting to disease management. An advantage of health coaching is that it can occur anywhere, even by telephone, so its benefits are not limited by location or distance.
Not everyone has access to a health coach, but there is hope for anyone who wants to change health behaviors, even if you’ve experienced failure in the past. In his book, "Why and How People Change Health Behaviors," Joseph Leutzinger from Health Improvement Solutions compiled stories told by individuals who had made successful lifestyle changes and have been able to sustain them for some time.
The following are ideas the participants shared:
- Do what works for you – Everyone changes differently.
- Be ready – Don’t go into the effort unprepared or lacking confidence.
- Set goals – Measurable goals provide a "yardstick" against which to chart progress.
- Take it one day at a time – Seeing change as a series of day-by-day steps makes it easier to accept.
- Plan ahead for situations that you find threatening – This will help avoid pitfalls.
- Control your environment – Making the house or office a non-smoking area, or keeping healthy food in the pantry helps.
- Take small steps – You did not get to your current situation overnight, thus returning to a more healthy state will take time.
- Seek support from others – Family members, co-workers, support groups, workplace health promotion programs.
- Don’t let a short-term relapse impact your potential for long-term success – Very few people make change without some amount of relapse.
- Know that one successful change leads to another – Success drives success.
