Table 2

Description of Themes for Patient Decision Making With Health Coaches

ThemeDescriptionComponentsRelationship to Patient’s Decision MakingParticipants (No.) Sharing Experiences Identified for Themea
Shared characteristicsDemographic characteristics and life experiences shared by patient and health coachShared 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 decisionsPatients (6)
Family/friends (1)
Health coaches (13)
Clinicians (11)
AvailabilityHealth coach being available to the patientFrequency 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 decisionsPatients (32)
Family/friends (5)
Health coaches (16)
Clinicians (14)
Trusting relationshipPositive, trusting relationship between health coach and patientPatient 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 decisionsPatients (29)
Family/friends (5)
Health coaches (17)
Clinicians (9)
EducationHealth coach educates patient in person and through written materialsProviding 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 healthPatients (28)
Family/friends (4)
Health coaches (14)
Clinicians (6)
Personal supportHealth coach provides emotional support, engages with patient, makes personal commitment to help patientCaring 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 decisionsPatients (33)
Family/friends (6)
Health coaches (17)
Clinicians (8)
Decision supportPragmatic support for patient to make and carry out health decisionHelping 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 optionsPatients (28)
Family/friends (5)
Health coaches (16)
Clinicians (10)
Bridging as part of the themeHealth coach acts as a liaison or bridge between patient and primary care clinicianHelping 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 clinicianPatients (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.