(June 30, 2021) Health Coaching Without Barriers is honored to have been nominated for the Institute of Coaching’s “Coaching For Social Good Award” which looks for outstanding contributions to the research and/or practice of coaching which furthers social and climate justice, equity and peace, and whose work has contributed to social good globally and nationally.
Rationale for this Nomination
Rationale
Health Coaching Without Barriers (HCWB; formerly Health Coaches Without Borders) formed in March 2020 to provide pro bono health coaching to people disproportionately impacted by or at risk for COVID-19 due to chronic health conditions or social inequities. In doing so, the project focused on promoting health equity while striving to elevate and normalize the field of health coaching.
The founding statement declared the following as the rationale for this project:
In a world where chronic disease makes up 71% of deaths each year, health coaching for habit change and self-care fulfills a need, not a luxury (WHO, 2018).
HCWB believes that with structured support from trained health coaches, people can use their own self-knowledge to identify and overcome challenges by making habit changes that improve their health outcomes.
Knowing that:
Six out of every 10 people in the US alone suffer a chronic condition, and four in 10 have multiple chronic diseases (CDC). This both increases their need for ongoing health and lifestyle support and makes it more likely they will become high-risk patients during the COVID-19 pandemic.
Many people's wellbeing and self-care routines have been suddenly disrupted by broad, sweeping changes to socio-economic life, and this too increases stress. And,
Physical distancing is critical to prevent the spread of COVID-19 and also contributes to loneliness, another known cause of stress and poor health outcomes.
Background
HCWB piloted two coaching programs during the spring and summer of 2020. One was individually focused, and the other was a group coaching program. Both programs ran twice for four consecutive weeks. In total, they connected over 200 clients and included coaching in five different languages. Over 50 certified health coaches from eight countries across four continents provided direct services, while countless other worked in teams to create and promote the program.
HCWB created program models for providing pro bono health coaching during the COVID-19 crisis connecting coaching services to diverse populations across the globe while providing social connection, growth, and a sense of purpose for coaches and clients alike. This approach, focused on addressing rising social isolation alongside increased health risks, resulted in a rapid startup and piloting during the height of global lockdowns.
HCWB sought to blend the foundational principles of health coaching with community organizing. The program was grounded in taking the normative bottom-up approach of coaching and letting clients be guided by the coaching structure as they identified their own priorities and needs as related to personal, wellness-related difficulty caused by the pandemic crisis.
Health Coaching and HERO: Tipping the Equity Scale on Both Acute and Chronic Disease
Because COVID-19 is notable in its association with certain types of non-communicable epidemic diseases that have a higher prevalence in more socially vulnerable populations, such as diabetes and hypertension, the project as designed to address 21st century, acute health crises by focusing on habit change needs. HCWB believes that lasting individual change, if implemented across communities and populations, can help tip the scale toward better outcomes in the case of both acute and chronic disease.
Further, HCWB coaching focused on the core principles of Psychological Capital (PsyCap) by cultivating hope, and building efficacy, resilience, and realistic optimism (HERO). Additional client-centered support related to key areas of healthy habit change included stress management, sleep, movement, social connection, and nutrition was provided as needed. The project intended to help participants better respond to challenges and crises and thus improve well-being and the ability to thrive. The PsyCap focus was chosen because data showed it could help improve job and life satisfaction, which were significant factors during this time of great upheaval (Luthans, Youssef et al., 2007).
Scientific Contribution to Coaching Research in Coaching for Social Good
HCWB's Response to COVID-19 Created a Model for Pro Bono Health Coaching
Some COVID-19 coaching responses focused on crisis intervention through one-off sessions or by connecting pre-existing expertise to immediate needs for self-care, for example by providing coaching to professionals on the frontlines of COVID support. In contrast, HCWB created a new model of pro bono health coaching intended to support people who were disproportionately impacted by or at risk for COVID-19 due to chronic health conditions or social inequities.
HCWB found that statistically significant improvements in increasing PsyCap and well-being could be made, during a time of heightened stress, in a four-week health coaching program. The framework was grounded in core coaching principles including motivational interviewing, the transtheoretical model of change, and appreciative inquiry.
With scope of practice and potential red flags in mind, HCWB focused on increasing accessibility to personal development and creating a self-care space for those who either may not have been ready for, or needing of, more intensive support. It was considered to be both an immediate form of support while also serving as a potential gateway to deeper care, either by leading to longer-term health coaching or as an avenue to facilitate seeking deeper support through additional forms of healthcare.
The programs provided client-driven solutions for individuals that specifically honor self-expertise, autonomy, competence, and need for connection. During the program, clients worked with coaches to build self-confidence, instill a positive outlook/mindset, cultivate resilience, and create connection. By exploring their self-knowledge, clients were supported in identifying and overcoming challenges, as well as making habit changes to improve their health outcomes.
Analysis of Reported Outcomes
Program participants for both individual and group coaching programs on average showed increases in all areas of PsyCap on a 5-point scale, which was measured a the program's start and then again at the end: Hope: 3.4 to 4.3; Efficacy/Self-confidence: 3.9 to 4.6; Resilience: 3.8 to 4.3; Optimism: 3.4 to 4.1. Additionally, 97% of respondents reported a shift in mindset or knowledge, and 99% reported being more motivated to take action on their learning. Further analysis of the 4-week HERO Group Coaching Program showed statistically significant increases in the all areas of PsyCap and participants who reported the lowest scores at the program's outset were the ones who then experienced the greatest change (see below section "Program Demographics and Outcomes").
Professional Contribution to the Practice of Coaching for Social Good
HCWB Helped Coaches and Clients Alike
HCWB volunteer coaches have served over 200 people worldwide while developing a new model for coaching for social good. This has deepened their skills while advancing the conversation about how the field of coaching fosters health equity during times of global uncertainty and change.
Volunteers came together seeking to serve while recognizing that they too were going through the stress and turmoil of the global pandemic. Through HCWB, they developed a well-organized platform to give back, grow, and collaborate.
As a program developed by coaches in the spirit of collaborative support, HCWB allowed volunteers to step into leadership roles, work together to develop strengths, engage in thoughtful discussion around coaching and health equity, and apply coaching principles toward a shared vision. HCWB cultivated a strong sense of community and purpose among their volunteer corps.
Participation enabled coaches to hone their skills and work within a new context. Volunteer coaches reported multiple benefits, including:
Being of service to those whose lives have been altered by COVID-19
Working for social good as part of the broader HCWB community
Working with clients they would not have otherwise reached individually
Feeling connected to coaches and clients across continents during a challenging and alienating time
Engaging with the HERO principles of hope, self-efficacy, resilience, and optimism
Being inspired by the strength and resilience of their clients
Gaining group coaching experience
Advancing the concept of health coaching
Coach Capacity Building
HCWB created a group coaching structure for volunteer coaches and equipped them with related training and client materials. To prepare for potentially challenging client situations in either individual or group settings, HCWB provided ongoing mentor coach and peer supervision. With additional resources around applying the scope of practice and potential red flags in place, HCWB ensured that as challenging client situations arose, coaches were supported with the experience of colleagues and mentors to draw upon.
HCWB also sought continuous input from volunteer coaches for how they could be best supported in their development and surveyed coaches at the end of each pilot program. Through this process, HCWB learned that volunteer coaches who had not offered group coaching wanted to learn more about the process and have access to additional forms of peer support.
In response, HCWB then ran a smaller, third pilot program, focused solely on group coaching for volunteer coach participants as a form of internal training and support. Coaches were able to test out their group coaching skills and receive feedback, while participant coaches received support and observed group coaching as a client. Additionally, HCWB provided an environment for coach-led innovation. Volunteer coaches were supported by HCWB to develop a co-coaching format in which two coaches facilitated a group together, thus providing support in real-time throughout the running of their groups.
Volunteer coaches with HCWB have since gone on to take what they've learned and execute it in their private practices with new group coaching programs and formats, as well as continuing to see some of the clients they originally coached through HCWB—both in individual and group settings.
Elevating the Field of Health Coaching
HCWB sought to elevate and normalize the field of health coaching by creating a new model for pro bono health coaching, thus making it more visible as a service that meets critical needs. Providing health coaching freely to those most in need is one of the many ways along the path to comprehensive health equity. To this end, HCWB also sought to bring value to the field of health coaching through voluntarism.
As the field grows and normalizes within the changing standards of healthcare, coaches have a responsibility to incorporate equity and access as an ethical call within our scope. Without this, health coaching will forever remain faddish, as something that only a certain kind of person wants to or can afford to do.
At the same time, pro bono services rely on the ability of qualified professionals to sustain voluntarism. For a pro bono ethos to become normative and for such services to be broadly available, the field itself must be mature enough so that its professionals can afford to volunteer.
For this reason, HCWB hopes that its efforts will be part of the greater shift within the broader health and wellness movements as well as within the broader field of coaching for improved healthcare and access to health. HCWB envisions a world that equally values health coaching and health equity, so that access to career stabilization and to pro bono service are supported and available.
Program Demographics and Outcomes
Program Dates
First meeting: March 17, 2020
Pilot program 1.0: April 19, 2020 - May 23, 2020
Pilot program 1.5: July 12, 2020 - August 8, 2020
HERO Group Coaching Program pilot for volunteer coaches: November 29, 2020 - December 21, 2020
Demographics
Coach Demographics:
Total number of volunteers: 66
Number of volunteer coaches (coaching clients): 58*
Number of volunteer coaches (supporting operations): 21*
Number of mentor coaches (supporting ovlunteer coaches): 3
Countries represented: 9 (Canada, El Salvador, France, Mexico, Singapore, South Africa, South Korea, United Kingdom, United States)
Available languages: 6 (Brazilian Portuguese, English, French, Italian, Korean, Spanish)
*some volunteer coaches were involved in both coaching clients and supporting operations
Client Demographics:
Number of clients: 219
Countries represented: 13 (Canada, Finland, France, Germany, Hong Kong, Israel, Lithuania, Mexico, New Zealand, South Africa, Thailand, United Kingdom, United States)
Age range of clients: 15-72 years of age
HERO Group Coaching Program Outcomes
Further analysis of the 4-week HERO Group Coaching Program showed statistically significant increases in the following areas of PsyCap:
Hope: Feelings of present-day hopefulness rose from pre-coaching values (T=-3.75 (72.90), p<0.0003; mean of 3.40±SD0.82 vs post of 4.05±SD0.90)
Self-efficacy: Feeling confidence to make a positive change in one's life rose from pre-coaching values (T=-3.80 (96.68), p<0.0003; mean of 3.99±SD0.76 vs post of 4.48±SD0.60)
Resilience: Feeling confident that one can bounce back from the challenges imposed by the COVID-19 pandemic (resilience) rose from pre-coaching values (T=-3.88 (110.67), p<0.0002; mean of 3.91±SD0.88 vs post of 4.43 ±SD0.55)
Optimism: Feeling optimistic about the future rose from pre-coaching values (T=-2.12 (80.67), p<0.0375; mean of 3.42±SD0.92 vs post of 3.80±SD0.91)
Additionally, participants who reported the lowest scores at the program's outset were the ones who then experienced the greatest change.
Volunteer Coach Feedback
98% are very likely or likely to offer volunteer services again in the future
As a result of running the HERO Group Coaching Program during Pilot 1.5, 84% feel more confident in group coaching skills, and 50% intend to offer group coaching in private practice.
