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. 2021 Mar;104(3):642-648.
doi: 10.1016/j.pec.2020.08.040. Epub 2020 Sep 9.

Development of an observational tool to assess health coaching fidelity

Stephanie J Sohl  1 , Deborah Lee  2 , Heather Davidson  3 , Blaire Morriss  4 , Rebecca Weinand  4 , Katherine Costa  4 , Edward H Ip  1 , James Lovato  1 , Russell L Rothman  5 , Ruth Q Wolever  6
Affiliations

Development of an observational tool to assess health coaching fidelity

Stephanie J Sohl et al. Patient Educ Couns. 2021 Mar.

Abstract

Objective: This study describes the development of the Health Coaching Index (HCI), an observational tool for assessing fidelity to implementing health coaching practical skills.

Methods: Initial HCI items were developed, adapted following cognitive interviews, and refined during coding training. Participants (n = 42) were trainees who completed a National Board for Health and Wellness Coaching (NBHWC)-approved training program and coached a standardized patient. Interrater reliability for the HCI was determined by calculating interclass correlations from ten videos coded by three raters. Construct validity was evaluated from 42 recordings using Spearman's Rho between HCI and Roter Interaction Analysis System (RIAS) codes.

Results: The interclass correlation (ICC) for HCI total score was 0.81, considered an excellent level of inter-rater agreement. Some significant correlations between HCI and RIAS codes supported construct validity (e.g., patient activation: Rho = 0.32; empathy: Rho = 0.36).

Conclusion: The HCI total score can reliably be used to assess fidelity to health coaching skills, and the HCI has construct validity similar to the RIAS as a measure of patient activation.

Practice implications: Adoption and further study of the HCI tool will allow for a more consistent implementation of health coaching skills, and may facilitate more robust training of health coaches for clinical practice and research.

Keywords: Coaching fidelity; Coaching practical skills; Health coaching; Patient activation; Roter Interaction analysis system; Wellness coaching.

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Conflict of interest statement

Declaration of Competing Interest RQW serves as the Chief Science Officer for eMindful Inc., is on the Board of Directors for the National Board for Health and Wellness Coaching, and has grant funding from the National Institutes of Health, Abbie Vie and Meharry Medical College. RLR has previously been (not currently) a paid consultant for Abbott and edLogics and has grant funding from the National Institutes of Health, Patient-Centered Outcomes Research Institute, Food and Drug Administration/Nest Coordinating Center, Centers for Medicare and Medicaid Services, and Agency for Healthcare Research and Quality, not specifically related to this research. SJS and EHI have other grant funding from the National Institutes of Health, not specifically related to this research.

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