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A New Resource for Health & Fitness Professionals

Sforzo, Gary, A., Ph.D., FACSM; Moore, Margaret, M.B.A.

doi: 10.1249/FIT.0000000000000368
Columns: ACSM Certification
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Gary A. Sforzo, Ph.D., FACSM, is a professor and coordinator of the Applied Exercise Science program in the Department of Exercise & Sport Sciences at Ithaca College. He has published extensively in health and wellness coaching and exercise and fitness research. He is a Certified Clinical Exercise Physiologist and active member of ACSM for more than 30 years.

Margaret Moore, M.B.A., is founder and CEO of Wellcoaches Corporation, a strategic partner of ACSM; a faculty member at Harvard University Extension School, and codirects the Institute of Coaching at McLean Hospital, an affiliate of Harvard Medical School. She is a featured contributor to ACSM’s Certified News and has authored numerous articles and books on health and wellness coaching.

Disclosure: The authors declare no conflict of interest and do not have any financial disclosures.

In this issue, the ACSM Certification column provides insight into a valuable resource for the health and fitness professional. Dr. Gary Sforzo (Ithaca College) and Ms. Margaret Moore (Wellcoaches Corp.) briefly discuss the creation and utility of the Health and Wellness Coaching compendium, “a comprehensive collection of the health and wellness coaching scientific literature,” which is a resource for all health and fitness professionals interested in engaging clients in behavior change. We thank the authors for their contribution to this valuable resource and for bringing this to our attention.

In an ACSM’s Health & Fitness Journal ® article in 2015, we proposed exercise professionals develop health and wellness coaching (HWC) competencies to help their clients engage in sustainable behavior changes (1). Since then, the field of HWC has continued to expand, and recently, in an effort spearheaded by the International Consortium for Health and Wellness Coaching (ICHWC) in partnership with the National Board of Medical Examiners, a new national board certification was launched (2). The Wellcoaches School of Coaching, in partnership with ACSM, has now trained more than 10,000 health and wellness coaches in 50 countries and, recently, a comprehensive compendium of HWC literature that encompasses research and writings in the field since 2000 was published (3). The HWC Compendium provides a valuable resource to all HWC practitioners and researchers (3). The purpose of this column is to alert ACSM exercise professionals to this resource and to keep exercise professionals at the cutting edge of HWC and knowledgeable about behavior change strategies.

A compendium is a systematically gathered collection of concise yet detailed information on a particular subject. The HWC Compendium, which was recently published in the American Journal of Lifestyle Medicine (3) allows anyone to easily find information on HWC studies to serve their needs. Whether developing a coaching program or working with a client managing any one of many disorders, the HWC Compendium can be a valuable resource. The HWC Compendium article and its supplemental materials are available open access and can be downloaded from: http://journals.sagepub.com/doi/suppl/10.1177/1559827617708562).

The HWC Compendium is organized into two large spreadsheets. One (Part A) has 150 rows citing 150 data-based HWC articles and 50 columns examining details of each article. Column details address specifics such as the population studied, design of the experiment, number of subjects, scientific quality of information, number of coaching sessions, and results. A second spreadsheet (Part B) has 69 rows citing HWC reviews, program descriptions, and commentary/opinion papers. Compendium Part B only has 22 columns because there is no need to review experimental details or findings in these non–data-containing, expert-based publications. Both Parts A and B also are organized into patient/client categories (Cancer, Cholesterol, Diabetes, Heart Disease, Hypertension, Obesity, and Wellness). When examined chronologically, there is a near exponential increase in HWC research in the last 16 years, with nearly half of the 150 cited articles published in the last 5 years. This growth in scholarly attention parallels and supports the growth in the coaching profession in a similar period.

The results section of the accompanying HWC Compendium article (3) provides summary statements for each compendium patient/client presentation category. Diabetes (32 articles) and obesity (31 articles) are the conditions most often studied with an HWC intervention, whereas cancer is represented with nine articles in the Compendium. In short, one can deduce HWC studies are largely reporting intervention effectiveness for a wide variety of patient diagnosis and coaching clients. Although encouraging, HWC research is in early development, and many studies in the Compendium contain confounders limiting the strength of conclusions. A common study design that confounds the interpretation of results integrates HWC into an exercise or wellness program, making it difficult to partition out the effects of coaching versus the accompanying program. On the other hand, grouping these treatments is common practice, and successful results from coaching studies during real-world implementation should not be minimized — this conveys a good sense of external validity for HWC interventions (Box 1). A summary conclusion of positive HWC intervention effects in the Compendium agrees with findings from a recent systematic review of randomized and controlled trials (RCTs) (4). Kivela et al. (4) selectively reviewed 13 studies of high scientific quality and concluded coaching often is an effective treatment that takes advantage of a patient’s willingness to change his or her lifestyle. However, one limitation to consider is the potential for negative publication bias resulting in a higher publication rate for studies with positive findings. In summary, whether examining studies with high internal validity such as RCTs (4) or using the Compendium (3) for a more comprehensive analysis of the literature, HWC seems to yield positive results as an effective behavior change intervention.

In conclusion, HWC seems to be an excellent strategy to promote healthy behavior change in clients or patient populations. Despite limitations, the HWC Compendium provides a practical resource for exercise professionals, practicing coaches, and clinicians, serving as a valuable tool to explore the nature and scope of coaching interventions. In addition, researchers of HWC can use the Compendium to identify gaps in the literature or simply review the existing evidence on a specific topic or patient category. HWC presents an exciting new field that offers exercise professionals an opportunity to potentially augment their coaching/training effectiveness with their clients and patients.

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Box 1

Internal validity – refers to the design of the study and how investigators control for factors that may impact the results. For example, if studying body composition, dietary intake should be taken into consideration.

External validity – refers to the ability of the study findings to be generalized to the larger population. For example, was the study randomized or was a homogenous convenience sample chosen as participants.

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References

1. Sforzo GA, Moore M, Scholtz M. Delivering change that lasts: health and wellness coaching competencies for exercise professionals. ACSMs Health Fit J. 2015;19( 2):20–6. doi: 10.1249/FIT.0000000000000109.
2. International Consortium of Health and Wellness Coaching Web site [Internet]. San Diego, (CA): International Consortium of Health and Wellness Coaching; [cited 2017 July 2]. Available from: www.ichwc.org.
3. Sforzo GA, Kaye MP, Todorva I, et al. Compendium of health and wellness coaching literature. Am J. Lifestyle Med. 2017. Available from: http://journals.sagepub.com/doi/full/10.1177/1559827617708562.
4. Kivelä K, Elo S, Kyngäs H, Kääriäinen M. The effects of health coaching on adult patients with chronic diseases: a systematic review. Patient Educ Couns. 2014;97( 2):147–57. doi: 10.1016/j.pec.2014.07.026.
© 2018 American College of Sports Medicine.