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Telephonic Health Coaching Initiative

| Connecticut

Jun 18, 2018

This story was originally published June 18, 2018. It was updated on October 4, 2021.

Overview

The University of Saint Joseph’s (USJ) SNAP-Ed Telephone Health Coaching (THC) Intervention, supports Connecticut residents in making healthier choices and significant changes to their lifestyles. Health coaches at USJ provide the guidance needed to educate and motivate SNAP-Ed clients to meet their health and wellness goals.


"Since working with you, I have lost over 10 pounds and I am eating healthy. I eat lots of fruits and vegetables, yogurt and make healthy choices now. I read labels now before I buy a product to make sure it is nutritious and a healthy choice. Thanks to you and your program I am on my way to eating healthy and losing weight."

  • The THC intervention targets SNAP-Ed participants at all direct education sites, as well as solicits participants within the community partner network. 
  • A 30-45 minute coaching session is scheduled each week over period of 6 weeks.
  • Clients set 1-2 SMART goals per session.
  • Clients complete a pre and post survey on eating and physical activity behaviors.
  • The survey is based on the current USDA Dietary Guidelines for Americans.
  • The USJ SNAP-Ed THC Intervention is published on the SNAP-Ed Toolkit. 
a health coach is on the phone with a client

Challenges

  • The SNAP-Ed target population has a limited budget.
  • Even though there is ample evidence that low-income communities derive benefits from health coaching programs like THC, economically disadvantaged populations remain with limited access. 
  • These populations face barriers to health care, including long work hours, transportation issues, and lack of access to adequate health care providers.
  • Limited health coaching training tools in obesity prevention programs, such as nationwide SNAP-Ed programs.

Solutions

The THC Initiative:

  • Is at no cost to SNAP-Ed participants. 
  • Assists the SNAP-Ed target population to establish healthy eating habits despite a limited budget and to promote physically active lifestyles that prevent or postpone the onset of disease. 
  • Helps to address barriers to health care by offering THC at any time of day, 7 days a week for participant’s needs. Additionally, since the THC program is telephonic, transportation issues are eliminated. 
  • Offers a convenient and accessible modality that aims to ameliorate some of these social disparities. 
  • Has trained nutrition educators and health coaches (many who are also dietitians) which helps increase access to qualified health care providers. 
  • Health coaches guide the participants through client-centered conversations that promote the implementation of the current USDA Dietary Guidelines for Americans. The coaches use behavior change techniques to craft individual goals related to healthy eating and physical activity.
  • Is published on the SNAP-Ed Toolkit for other implementing agencies to use as a THC intervention start up and training tool for health coaches.

Program Success

Number of participants enrolled and retention in THC has significantly increased from 2015 to 2021. Please see image below for number of participants and sessions completed.

  years # participants # sessions
Health Coaching 2015-2021 508 2,130

 

Session 2015 2016 2017 2018 2019 2020 2021
First 56 59 83 74 92 62 82
Second 39 47 60 61 73 54 76
Third 34 40 54 54 63 49 67
Fourth 28 34 46 42 54 45 62
Fifth 19 30 41 39 47 44 56
Sixth 19 28 40 39 45 40 53
Total 195 238 324 309 374 294 396

Pre and post surveys were used to measure clients' success. The surveys showed changes in 14 of 18 behaviors derived from the USDA Dietary Guidelines for Americans.

Based on what clients have reported there was a statistically significant change in the following behaviors:

  • Increase in consumption of low-fat (1%) or fat free milk (p-value = 0.026)
  • Increase in consumption of low-fat or non-fat yogurt (p-value = 0.008)
  • Decrease in consumption of whole or 2%: Milk (p-value = 0.044)
  • Increase in consumption of brown rice (p-value = 0.001)
  • Increase in consumption of whole grain pasta (p-value = 0.002)
  • Increase in consumption of whole grain bread (p-value = 0.002)
  • Increase in consumption of whole grain cereal (p-value = 0.008)
  • Decrease in consumption of white rice (p-value < 001)
  • Decrease in consumption of regular pasta (p-value = 0.003)
  • Decrease in consumption of white bread (p-value < 001)
  • Decrease in consumption of refined grain cereal (p-value = 0.019)
  • Increase in cups of fruit consumed per day (p-value < 0.001).
  • Increase in cups of vegetables consumed per day (p-value < 0.001)
  • Statistically significant increase in daily physical (p-value < 0.001)

"It was on honor to work with you. Please remember that you made me believe in myself again and I could not have done it by myself. I believe I made a friend for life."

Sustaining Success

USJ SNAP-Ed agency plans to continue to expand our THC intervention by enrolling five additional participants per year, for a total increase of 30 completed sessions each year. Identical pre and post surveys will continue to be used to measure change in eating and exercise behaviors, an indicator of program success. This intervention addresses SNAP-Ed Evaluation Framework Indicators MT1 and MT3. Furthermore, we hope to receive more feedback about the THC intervention toolkit as additional implementing agencies across the nation begin to use it. To date, 9 other obesity prevention programs (such as SNAP-Ed) have indicated they intend to use the THC Intervention Toolkit.

Type of Program

Direct Nutrition Education

Target Audience

Adults eligible for SNAP


For more information contact Debbie Brinckman, MS, RDN, CD-N.

Evaluation Framework Indicators
Resource Type