Page Contents
Overview
- Increase frequency of eating all five food groups
- Increase frequency of eating a variety of fruits and vegetables
- Increase whole fruit consumption by at least half a cup per day
- Increase vegetable consumption by at least half a cup per day
- Increase frequency of intake of fat-free or low-fat dairy including (dairy/nondairy) and yogurt, and decrease frequency of intake of full fat dairy (milk/yogurt)
- Increase frequency of whole grains and decrease consumption of refined grains
- Increase frequency of lean proteins and decrease frequency of high fat proteins
- Decrease sugar-sweetened beverage intake
- Increase frequency of low sodium foods
- Increase minutes of daily physical activity
In order to achieve these goals, the THC intervention provides material to train SNAP-Ed educators to be health coaches that engage with clients by telephone and use behavior change techniques to craft individual goals related to healthy eating and physical activity. The increased intensity, duration and personalization of the THC intervention improve the likelihood that persons eligible for SNAP will make healthy food choices and choose physically active lifestyles consistent with the current USDA Dietary Guidelines for Americans.
Target Behavior: Healthy Eating, Physical Activity and Reducing Screen Time
Intervention Type: Direct Education
Intervention Reach and Adoption
Setting: Community (Live), Other: Telephonic administered intervention
Target Audience: Parents/Mothers/Fathers, Adults, Older Adults
Race/Ethnicity: No special focus
Intervention Components
Trained health coaches engage with clients by telephone for approximately thirty minutes every week, for a six-week period, and use behavior change techniques to work on individual goals related to healthy eating and physical activity. To document behavior changes, the health coach gathers information about the client’s overall health behavior during the first and last health coaching sessions. For each client, the coach also completes a program evaluation tool that contains:
- Pre/post behavior questions
- Overall goal/vision and topic code
- Goal set and topic code
- Confidence level (self-efficacy score) for goal(s) set
- Percent goal attainment.
Overall, the basic coaching procedure outlined in the Toolkit should be followed to maintain program integrity, such as conducting 30-minute telephonic coaching sessions for six weeks and completing the behavior questions, as well as tracking goal topics, goal attainment, and self-efficacy scores.
Intervention Materials
- Telephonic Health Coaching Intervention Toolkit
- Health Coaching Sign-up Form/Information Sheet*
- Health Coaching Receipt of Information*
- Health Coaching Program Welcome Brochure*
- Health Coaching Session Evaluation Tool*
- Health Coaching Certificate of Completion*
*Also available in Spanish
For access to intervention materials, please contact Elizabeth Boucher.
Intervention Costs
Evidence Summary
The preliminary results of THC were disseminated in two poster presentations:
- Telephonic Health Coaching: An Innovative Method to Promote Health Behavior Change among Participants in Supplemental Nutrition Assistance Program-Education (SNAP-Ed)
- Telephonic Health Coaching (THC) Promotes Health Behavior Changes among SNAP-Ed Participants
The unintended benefits of the intervention include:
- Participants showed significant changes in health behaviors that were not specifically chosen as goal topics
- The program was highly regarded by the clients, and some asked to continue coaching beyond the six sessions
- Participants referred friends and families to the THC program
The challenges include:
- Client recruitment and retention
- Maintaining well-trained staff including a bilingual health coach
Strategies to address the above include:
- Building greater interest during direct education for recruitment and retention of clients
- Sending clients a welcome packet and reminder of sessions
- Training all the nutrition educators to provide health coaching so that rapport building can start with the direct education process
Evidence-based Approach: Practice-tested
Evaluation Indicators
Readiness and Capacity – Short Term (ST) | Changes – Medium Term (MT) | Effectiveness and Maintenance – Long Term (LT) | Population Results (R) | |
---|---|---|---|---|
Individual | MT1, MT3 | |||
Environmental Settings | ||||
Sectors of Influence |
MT1: Healthy Eating
- 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)
- There was a statistically significant change in the following behaviors:
- 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)
- Statistically significant increase in cups of fruit consumed per day (p-value < 0.001).
- Statistically significant increase in cups of vegetables consumed per day (p-value < 0.001)
MT3: Physical Activity and Reduced Sedentary Behavior
- Statistically significant increase in daily physical (p-value < 0.001)
Evaluation Materials
Success Story
Telephonic Health Coaching Initiative:
https://snaped.fns.usda.gov/success-stories/telephonic-health-coaching-initiative
Additional Information
Contact Person(s):
Elizabeth Boucher
Program Coordinator, Department of Public Health/University of Saint Joseph SNAP-Ed Program
Phone: (860) 231-5302
Email: eboucher@usj.edu
*Updated as of August 4, 2023