Health by Design Interactive – Virtual Health Coaching

Narrator

Today, on Health by Design Interactive, we bring you a story about Virtual Health Coaching, a concept in healthcare that became more prominent over the course of the COVID-19 lockdowns.

We’re speaking with Dr. Noah Wayne from NexJ Health, and we’ll explore how health coaching is playing a role in the lives of a growing number of Canadians.

Here’s your host, Greg Bisch

Greg Bisch
Hello and welcome to this edition of Health by Design Interactive.

Today, I’m joined by Dr. Noah Wayne.

Dr. Wayne is the Vice President of Clinical Programs at NexJ Health. He is a Registered Kinesiologist and Clinical Exercise Physiologist. He’s focused his career on health psychology, particularly in motivation and behaviour change. He leads the health coaches and clinical services at NexJ Health, the provider that Manulife is working with to pilot a program that delivers Virtual Health Coaching to selected plan sponsors and their members.

Welcome to Health by Design Interactive.

Dr. Noah Wayne
Very happy to be here.

Greg Bisch
Okay. Let’s dive right in. For the benefit of our listeners can you tell us exactly what health coaching is…and what health coaches do?

Dr. Noah Wayne
So, health coaches are health professionals who work with people to help them reach their health goals. NexJ Health Coaches are extensively trained in a counselling technique called Motivational Interviewing and have deep knowledge and experience working with people with chronic conditions…in management and prevention. Health Coaches focus their approach on helping clients identify their own…what we call…intrinsic motivations for change…help them set up goals that are meaningful to them and use evidence-based techniques and digital tools to maximize our clients’ chances of success…at changing their behaviour…and improving health.

Greg Bisch
Can you give a few examples of how a health coach works with clients?

Dr. Noah Wayne
For example, a health coach may work with a client to help set goals around stepping up an exercise program, or eating a more balanced diet by reducing sodium, perhaps, or trying to cut out processed foods, or adopt strategies to help manage stress by providing education and support on mindfulness.

As anyone who has ever tried to set new health goals knows, it can be hard. And so, working with a coach helps you break down those new behaviours into more manageable steps, and it gives our clients an advantage by taking control of what we call modifiable risk factors for our conditions.

Now, the cornerstone of this coaching relationship is a strong, what we call, therapeutic alliance, which means that the interactions between the coach and the client are based on mutual trust and respect. And an important distinction between coaching and other forms of care is that in coaching, the coach works with the client to co-establish goals, with the client really leading the way in the relationship and in the sessions, The coach is really just there to guide and support.

The objective of these health coaching programs is to help members better manage their chronic conditions and mental health, so that, for those who may be at risk of going on disability, we can help to prevent that from happening; and when people are already on disability, we can help them return to work faster.

Greg Bisch
What kinds of qualifications does a health coach have?

Dr. Noah Wayne
All of NexJ’s health coaches are regulated healthcare providers, and this includes registered kinesiologists, dietitians, social workers, and nurses. That clinical credentialing is really important for our coaches because many of them work with individuals that have some form of chronic condition, like diabetes, or cardiovascular disease, cancer, and depression. It is important that when working with people with these conditions that the coach has that experience and understanding of those clinical considerations as well, which also really includes the right time to refer a client to another clinician.

And now, on top of that clinical credentialling, all of our coaches have extensive training that NexJ layers on in evidence-based behaviour counselling techniques like motivational interviewing and cognitive behavioural therapy – like CBT – as well as the use of digital technology that can provide a digital approach…a virtual approach…to helping our clients with health behavioural change.

Greg Bisch
Let’s chat now about the “virtual” part of health coaching. What does it involve and how

successful is your work when it’s conducted virtually?

Dr. Noah Wayne
The thing about NexJ Health is that we don’t just do health coaching, but we’re also a technology company. And so, we have developed an incredibly robust digital health platform that we call NexJ Connected Wellness. And this platform has been purpose-designed to support health coaching, and support our clients in learning about their health, support them in developing new health behaviours, and improve overall activation around their health.

So, all of our coaches use NexJ Connected Wellness to interact with their clients. And this could include secure messaging and video chat, but also includes educational materials, and allows tracking of different behaviours all within the same platform. The platform itself syncs with over 300 different wearable and medical devices, and so we actually have at our fingertips, as coaches, access to steps and sleep patterns, blood pressure, blood glucose, the meals people eat, and overall signs and symptoms of chronic disease. And now, this ability to see individual-level data, and population data, provides NexJ health coaches with an uncanny amount of information to support their clients to be a success. We know exactly who needs support, when they need it, wherever they are.

And we’ve proven this, actually, in a number of clinical research trials across a number of different conditions. We have almost two dozen peer-reviewed papers describing various health coaching approaches for different populations and showing the evidence of that success.

Greg Bisch
How is a health coach different from other ‘traditional’ health providers?

Dr. Noah Wayne
Well, you know, the coach is connected to their client through the platform 24 hours a day, 7 days a week. Our clients can message their coach at any time and can actually, expect a response, within a reasonable amount of time.

And with this wealth of information, such as steps, and meals, and how they feel, the coach is empowered with so much more data when they’re helping their client. And clients actually really appreciate this because it makes them feel like they have that support from their coach even when they’re not on the call or in the clinic.

In one of our published research studies, where we interviewed clients that had gone through a health coaching program…interviewed them about their experience, one participant referred to this as a tether with their coach.  And it made them feel like they weren’t in this alone. And we’ve had a number of anecdotal responses from participants who go through the program and who feel…who say that they feel for the first time that someone in the health care system was on their side.

Greg Bisch
Having someone on your side is so important to feel when you’re trying to make big changes in your life, particularly around chronic conditions where you might feel alone, so that’s so important.    Sometimes, coaches have to push their clients though…in a good way! How do you manage that and maintain the coach-client relationship?

Dr. Noah Wayne
As I mentioned before, the coaching relationship…or the coach – client relationship… is the cornerstone…the essential component of really driving successful, sustained behaviour change. Your coach ends up becoming the support that you need. And so, sometimes you may need someone to problem solve…sometimes you need someone to help you break down your goals into really manageable steps…so you know what the next thing you can do is to get that long-term goal…and sometimes you just need someone to keep you accountable. So, your coach adapts their approach to doing all of these things, when you need them.

So, the base of that coaching relationship always stems from a spot of empathy and compassion and what we call, “unconditional positive regard.” And so, we’re on your team, we don’t judge or chastise in any way. We’re simply there to help you achieve your goals, and we totally understand when they don’t go as planned. We’re just here to help you get back on track.

Greg Bisch
Health is such a personal thing…and I imagine some clients may be nervous when first working with a health coach. How do you approach clients when they’re a little bit hesitant at first?

Dr. Noah Wayne
I guess I like to try to remind people, if they’re timid of trying the health coaching, that they’re in control the entire time. And what I mean by that is that they can choose how much they want to engage and how little they want to engage in the overall coaching experience. So, they can choose what information they share with their coach, they can choose how frequent and what kinds of interactions they have with their coach.

We have some clients who do video chat sessions with their coaches, and some clients who only do message-based coaching. And our goal is really to give the right amount of coaching for the person, and not more, not less.

Greg Bisch
As we wrap up, can you share a story from your own personal experience that shows how health coaching can help patients have healthier outcomes?

Dr. Noah Wayne
A client that comes to mind is an individual I coached a few years ago who had type-2 diabetes…not managing his sugars well…and had recently had a stroke. When he started coaching with me our focus was really on the diabetes. But what he had said was that he really missed being able to play with his grandchildren. Since the stoke, he hasn’t been able to kneel down on the ground. And so, we started to set up goals around exercise. Specifically, balance exercises and strength exercises.

And, over the course of the program, helping to keep him on track with being consistent with those specific exercises, he ended up being able to kneel down and play with his grand kids.

I guess the reason I bring this story up, is because it really…I always come back to this one…because it shows me how interconnected our health outcomes really are with the rest of our lives. And how…the impact that those health outcomes and achieving those outcomes can have on our overall quality of life.

Greg Bisch
Well, I can really relate to that because my parents love playing with my children. So, that would be a very powerful thing for a lot of grandparents…

Dr. Noah Wayne
Absolutely.

Greg Bisch
Noah, on behalf of everyone listening, we really appreciate you joining us to talk about virtual health coaching. It’s a fascinating innovation, and one that I expect will just grow in popularity.

As a reminder to our listeners: you can find more content on organizational mental health and other workplace wellness issues at Manulife.ca/groupbenefits—click on the news tile and Group Benefits