Description of Themes for Patient Decision Making With Health Coaches
| Theme | Description | Components | Relationship to Patient’s Decision Making | Participants (No.) Sharing Experiences Identified for Themea |
|---|---|---|---|---|
| Shared characteristics | Demographic characteristics and life experiences shared by patient and health coach | Shared language, culture, and sex Similar social status, experiences, and values | Shared characteristics may help the patient feel more comfortable with and understood by health coach and therefore more likely to work with coach to make health decisions | Patients (6) Family/friends (1) Health coaches (13) Clinicians (11) |
| Availability | Health coach being available to the patient | Frequency of contacts Duration of contacts Continuity over time Being accessible to patient Proactively contacting patient | Health coach’s ongoing contact with patient helps build the relationship and allows for reinforcement and support of patient’s decisions | Patients (32) Family/friends (5) Health coaches (16) Clinicians (14) |
| Trusting relationship | Positive, trusting relationship between health coach and patient | Patient trust in health coach Health coach trust in patient Factors that create or reinforce trust Consequences of trust | Trust makes patient more willing to confide in and accept support from health coach around health decisions | Patients (29) Family/friends (5) Health coaches (17) Clinicians (9) |
| Education | Health coach educates patient in person and through written materials | Providing patients with basic information about his/her condition and explaining how his/her behaviors affect it Describing options and possible consequences Explaining purpose of medication | Education provides a foundation to effective decision making; patients need to understand their options and how their choices affect their health | Patients (28) Family/friends (4) Health coaches (14) Clinicians (6) |
| Personal support | Health coach provides emotional support, engages with patient, makes personal commitment to help patient | Caring about and valuing patient Listening to and understanding patient Allaying patients’ fears Providing hope and confidence Encouraging and empowering patient Motivating patient using encouragement, reminders, connecting actions to outcomes | Providing a supportive relationship allows patient to disclose more, be more honest about goals, barriers, and decisions; active listening helps the patient process information, express needs and emotions; patient may be more likely to care for self when feels cared for by health coach; motivated patients more likely to make and carry out decisions | Patients (33) Family/friends (6) Health coaches (17) Clinicians (8) |
| Decision support | Pragmatic support for patient to make and carry out health decision | Helping patient identify goals Helping create action plans Checking back with patient Identifying barriers and problem solving Encouraging small steps Helping patient get prescription filled Helping patient make and keep appointments | Using specific methods and techniques from coach training to help patient identify their goals and choose an action plan to move toward those goals; makes it easier for patients to get what they need to carry out their decision, thereby increasing range of options | Patients (28) Family/friends (5) Health coaches (16) Clinicians (10) |
| Bridging as part of the theme | Health coach acts as a liaison or bridge between patient and primary care clinician | Helping patient communicate with clinician Providing clinician with information about patient Clarifying clinician’s communication to patient Checking with patient between visits about treatment plan Helping patient to disclose to clinician Reducing patient’s fear of physician | Health coach can help strengthen the patient-clinician relationship and improve patient-clinician communication leading to more informed and shared decision making between patient and clinician | Patients (18) Family/friends (4) Health coaches (15) Clinicians (16) |
↵a Counts are of the number of participants in each group who contributed at least 1 experience during their interview that was coded.