Integrating a Health Coach into Primary Care: Reflections From the Penn State Ambulatory Research Network

Alan M. Adelman; Marie Graybill

doi:10.1370/afm.317

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Patients' Stories Reveal A Need for In depth Intervention for the BMI > Caseload
Judith Doherty

Published on: 04 August 2005
Put Me In, Coach
Emily M Graybill

Published on: 02 August 2005

Published on: (4 August 2005)
Page navigation anchor for Patients' Stories Reveal A Need for In depth Intervention for the BMI > Caseload
Patients' Stories Reveal A Need for In depth Intervention for the BMI > Caseload
Judith Doherty, West Boylston, MA, USA
Working with over 100 patients in primary care settings who were intent on enacting behavior change but who often got off course and lapsed into unhealthy habits was both discouraging and bewildering to this health coach.
Embedded in the stories that many patients were quick to share was a sense of longing, a lack of ful-"fill"ment. As I listened to the recurring theme of loss in the lives of patients, I refle...
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Working with over 100 patients in primary care settings who were intent on enacting behavior change but who often got off course and lapsed into unhealthy habits was both discouraging and bewildering to this health coach.
Embedded in the stories that many patients were quick to share was a sense of longing, a lack of ful-"fill"ment. As I listened to the recurring theme of loss in the lives of patients, I reflected on the interventions that often come out of health professionals and even gurus of diet planning programs. Emphasis on counting fruits and vegetables, or carbs misses the broader psychological issues.
Self-love and its link to self-efficacy may well be underlying attitudes that lead some patients to take action to alter their habits in favor of life and longetivity. Having something to move towards and live for may unconsciously impact eating and exercising choices.
Or not. The remarks submitted by Emily Graybill point to a societial phenomenon that was well addressed in the recent film "Supersize Me". From childhood play at MacDonalds to candy for a boo boo, perhaps this culture's abundance and extreme consumptive habits cause an African friend of mine to laugh out loud at my job description as a health coach. He says, "Only in America!"
Solutions? In my estimation motivational interviewing does not go far enough for the BMI over 30 crowd. Therapy, combined with supportive interactions with a health coach can make a difference.
My best to all...Judith Doherty 5 Evans Rd. West Boylston, MA 01583
Competing interests: None declared
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Competing Interests: None declared.
Published on: (2 August 2005)
Page navigation anchor for Put Me In, Coach
Put Me In, Coach
Emily M Graybill, Denver, CO
When it comes to establishing healthy behavior, I say the more help, the better. After all, if eating less and exercising more were as simple as they sound, we wouldn't be part of a society where up to 70% of people are overweight or obese and confident that gratuitous bacon consumption will facilitate their weight loss. I welcome with fanfare any kind of influence that will help us negotiate choices for a healthier li...
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When it comes to establishing healthy behavior, I say the more help, the better. After all, if eating less and exercising more were as simple as they sound, we wouldn't be part of a society where up to 70% of people are overweight or obese and confident that gratuitous bacon consumption will facilitate their weight loss. I welcome with fanfare any kind of influence that will help us negotiate choices for a healthier lifestyle. And until I find someone who will physically wrestle ice cream away from me, a health coach might be the next best thing.
And as no such gastronomic guardian yet exists at my doctor's office, I am taking my support where I can get it.
In the past month, as much as it pains me to admit it, I have spent a not insignificant amount of time in the booths of several fast-food restaurants. However, what I noticed nestled among the grease and mayo surprised me. Mandarin oranges, fruit cups, or yogurt were prominently offered at three of the four establishments I patronized this past July. Consequently, three out of four times, I chose the healthier alternative.
This article supports the hypothesis in my own little case study: those who are willing to make a change for the better are likely to take advantage of - and benefit from – the resources and options that are made available to them. And who knows? Maybe with a little motivation, I'll skip the fast food entirely and head home to that broccoli in the fridge.
Competing interests: None declared
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Competing Interests: None declared.