Virginia Cooperative Extension (VCE) agents build local relationships with participants and stakeholders to translate evidence-based information to improve "economic, environmental, and social well-being" of Virginians. However, Extension agents have reported high rates of employee burnout and stress. To mitigate the impacts of agent stress and burn-out, application of mindfulness and yoga through health coaching is emergent, but the impact is yet to be empirically tested. To holistically evaluate the individual-level impacts (i.e., behavior) as well as the system impacts (i.e., costs and sustainability), this project tested the initial feasibility, cost, reach, and efficacy of a virtual health coaching program for VCE agents. The CHAT (Coaching for Health and Togetherness) program consisted of nine weekly, one-hour modules including goal setting, self-reflection, behavior change strategies, group yoga and grounding exercises as well as resources on Ayurveda (an ancient Indian system of medicine and sister science to yoga). The program facilitated group dynamics through relationship building, group goal setting, group distinctiveness, and support. The impacts of the coaching module were measured longitudinally (pre, post, and 3-month follow up) through previously validated scales in flourishing (i.e., complete human well-being), group cohesion, physical activity behaviors, and yoga self-efficacy. Additionally, qualitative data were collected at the 6-month follow up point through semi-structured interviews. Participants in CHAT reported increased flourishing scores from baseline to post-program, t(7)=4.42, p=0.003 with a medium effect size (d=0.53) as well as at the three-month follow-up, t(7)=3.06, p=0.018 with a small effect size (d=0.14). Participants significantly increased aerobic physical activity behaviors from pre-program to post program, X2(1, N=11) =7.21, p=0.007, as well as at the three-month follow up, X2(1, N=11) = 4.95, p=0.026. Participants did not show significant changes in yoga self-efficacy or group cohesion. Future implications of this project include sustainability and scalability of virtual group health coaching programs for behavior change. / Master of Science / Virginia Cooperative Extension (VCE) agents build local relationships with participants and stakeholders to translate evidence-based information to improve "economic, environmental, and social well-being" of Virginians. However, Extension agents have reported high rates of employee burnout and stress. To mitigate the impacts of agent stress and burn-out, application of mindfulness and yoga through health coaching is emergent, but the impact is yet to be empirically tested. To holistically evaluate the individual-level impacts (i.e., behavior) as well as the system impacts (i.e., costs and sustainability), this project tested the feasibility (initial implementation cost, reach) and efficacy of a virtual health coaching program for VCE agents. The CHAT (Coaching for Health and Togetherness) program consisted of nine weekly, one-hour modules including goal setting, self-reflection, behavior change strategies, group yoga and grounding exercises as well as resources on Ayurveda (an ancient Indian system of medicine and sister science to yoga). The program facilitated group dynamics through relationship building, group goal setting, group distinctiveness, and support. The impacts of the coaching module were measured longitudinally (pre, post, and 3-month follow up) through previously validated scales in flourishing (i.e., complete human well-being), group cohesion, physical activity behaviors, and yoga self-efficacy. Additionally, qualitative data were collected at the 6-month follow up point through semi-structured interviews. The results showed significant increases in participants' flourishing from pre-program to post-program as well as at the three-month follow up point, as well as significant changes in aerobic physical activity behaviors. Participants did not show significant changes in yoga self-efficacy, group cohesion from pre-program to post-program or at three-month follow up. Future implications of this project include sustainability and scalability of virtual group health coaching programs for behavior change.

No description available.

Bakgrund: Det finns en mängd forskning som visar på positiva effekter av fysisk aktivitet och vilka hälsorisker som finns vid fysisk inaktivitet. Trots detta så ökar stillasittandet och många individer i samhället idag har hälsoproblem. Syfte: Syftet med denna undersökning är att se hur tre veckors hälsocoaching kan påverka människors mående och motivation. Metod: En kvalitativ interventionsstudie med semistrukturerade intervjuer genomfördes med sex personer med olika mål och startlägen. Resultat: Utifrån intervjuerna gick det att tyda att tre veckors hälsocoaching förändrade respondenternas motivation till fysisk aktivitet. Samtliga respondenter är på väg mot en mer aktiv livsstil. En slutsats som dras i denna undersökning är att många faktiskt kan behöva ta hjälp av en hälsocoach för att komma igång med sin livsstilsförändring. / Background: There is a lot of research showing positive effects of physical activity and the health risks associated with physical inactivity. Despite this, sedentary is increasing and many individuals in society today have health problems. Purpose: The purpose of this study is to see how three weeks health coaching can affect people's well-being and motivation. Method: A qualitative intervention study with semistructured interviews was conducted with six individuals with different goals and starting positions. Result: Based on the interviews, it could be read that three weeks of health coaching changed the respondents' motivation for physical activity. All respondents are on their way to a more active lifestyle. A conclusion drawn in this study is that many may actually need to use a health coach to get started with their lifestyle change.

Physical inactivity is a worldwide public health problem. Applied behavior analysis has demonstrated success in this area; interventions such as goal setting, self-monitoring, and feedback have produced increases in physical activity of adults. Nevertheless, strategies with a more nondirective approach, such as health coaching, are gaining traction in practice independent of behavior analytic approaches. We do not know about the relative effects of nondirective approaches and the established, directive interventions in applied behavior analysis, or about client preference for nondirective and directive approaches. The present study employed a multiple baseline across participants design to evaluate a largely nondirective, client-centered health coaching approach for increasing physical activity of adults and the subsequent introduction of a directive coaching approach. Four adult females participated in the study remotely via telehealth. Active zone minutes were the primary dependent variable in the present study, and physical activity metrics were measured by the Fitbit Inspire 2. Meaningful increases in active zone minutes were observed for 1 of 4 participants, and preference for nondirective and directive coaching styles varied across participants.

BACKGROUND: Rates of maternal mortality and severe maternal morbidity are higher in New York City (NYC) than nationally, with Black birthing people experiencing the worst maternal outcomes, followed by Latina/e and Asian/Pacific Islander birthing people. This study aimed to understand the barriers and facilitators to engaging in maternal self-care and maternal health care to support the design of a stakeholder- informed maternal community health worker (CHW) model in NYC. The study also identified key intervention components and strategies for adoption, implementation, and sustainability. METHODS: In-depth interviews were conducted with prenatal and postpartum people (N=38) from a large teaching hospital in Upper Manhattan serving a racially and ethnically diverse patient population and with a cross-section of professionals (N=15) delivering maternal health care. Interviews took place between November 2020 and August 2022. Thematic analyses were conducted to uncover findings to inform program vii design, with the Intervention Mapping framework guiding this process. RESULTS: Findings reveal a range of barriers and facilitators to maternal self-care and health care engagement. Barriers included lack of transportation and childcare, delayed introduction of resources by the health care team, lack of care continuity, and experience with and concerns about disrespectful or discriminatory care. Additional barriers from the COVID-19 pandemic included disruptions to social support networks, childcare, and health care experience. Facilitators included information and advice from family, friends, and social media, positive coping skills, and trusted relationships with obstetric providers. Prenatal and postpartum participants recommended program components that provide emotional and instrumental support, and viewed the CHW as a someone they can trust to provide support and advice. Maternal health professionals recommended patient education and skills-building, and a focus on patients with high-risk pregnancies and chronic conditions. Maternal health professionals also recommended early staff and patient buy-in, clear definition of the CHW role, strong supervisory structure, and external seed funding. CONCLUSION: A needs and assets assessment using the Intervention Mapping framework was critical to design a stakeholder-informed and evidence-based maternal community health worker model. These findings include lessons learned for similar health systems seeking to develop community-based care models to address maternal health inequities and improve outcomes. / 2026-01-03T00:00:00Z

Sammanfattning Syftet med denna kvalitativa interventionsstudie var att undersöka hur anställda med stillasittande kontorsarbete upplever hälsocoaching med fokus på fysisk aktivitet och stillasittande. Arbetet har utgått från följande tre frågeställningar: ·      Vilka fördelar upplever de anställda med hälsocoachinterventionen på arbetsplatsen? ·      Vilka faktorer i hälsocoachinterventionen upplever de anställda som stöttande för att upprätthålla hälsosamma vanor på arbetsplatsen?  ·      Vilken roll upplever de anställda att en hälsocoach på arbetsplatsen kan ha för deras hälsovanor?   Semistrukturerade intervjuer genomfördes med samtliga sju deltagare/anställda med stillasittande kontorsarbete, för att undersöka hur de upplevt hälsocoachinterventionen på arbetsplatsen.   Kvalitativ innehållsanalys användes för att analysera datainsamlingen. Resultatet besvarar studiens forskningsfrågor enligt följande teman: Fördelar: En arena för hälsofrågor, Hälsocoachens breda kunskap, Individuellt samtal på de anställdas arbetsplats.  Stöttande faktorer: Hälsocoachingens individanpassning, Styrkan med målsättning. Hälsocoachens roll: Förebyggande roll, Holistisk roll, Pushande och stöttande roll.    Slutsatsen som dras i denna interventionsstudie är att anställda med stillasittande kontorsarbete upplever både fördelar och stöttande faktorer i hälsocoachinterventionen för att upprätthålla hälsosamma vanor på arbetsplatsen. De har därmed en positiv upplevelse av hälsocoachinterventionen på arbetsplatsen. De uttrycker att det finns ett stort behov av fortsatt hälsocoaching som kan integreras på fler arbetsplatser. De anställda upplever att hälsocoachen kan ha både en förebyggande-, holistisk, stöttande och pushande roll, för deras hälsovanor på arbetsplatsen. / Abstract The purpose of this qualitative intervention study was to investigate how employees with sedentary office work experience health coaching with a focus on physical activity and sedentary behavior. The work has been based on the following three questions: • What benefits do the employees experience with the health coach intervention in the workplace? • Which factors in the health coach intervention do the employees perceive as supportive in maintaining healthy habits in the workplace? • What role do employees feel that a workplace health coach can have for their health habits?   Semi-structured interviews were conducted with all seven participants/employees with sedentary office work, to investigate how they experienced the health coach intervention at the workplace.   Qualitative content analysis was used to analyze the data collection. The results answer the study's research questions according to the following themes: Advantages: An arena for health issues, The health coach's broad knowledge, Individual conversation at the employees' workplace. Supporting factors: Individual adaptation of health coaching, Strength with goal setting. The health coach's role: Preventive role, Holistic role, Pushing and supporting role.   The conclusion drawn in this intervention study is that employees with sedentary office work experience both benefits and supportive factors in the health coach intervention to maintain healthy habits in the workplace. They thus have a positive experience of the health coach intervention in the workplace. They express that there is a great need for continued health coaching that can be integrated in more workplaces. The employees feel that the health coach can have both a preventive, holistic, supportive and pushing role for their health habits in the workplace.

Health coaching is a relatively new integrated health role in which practitioners use a combination of behavioral interventions to evoke health-related behavior changes; however, there is a lack of valid evidence to support health-based claims. We investigated the effect of an approximation of a health coaching intervention on three college students' number of steps per day. We provided participants with weekly telehealth coaching sessions focused on goal-setting and feedback and used Fitbits to track the results. We used a multiple baseline across participants design to compare daily steps across four phases; self-monitoring, self-monitoring with experimenter-set goals and feedback, self-monitoring with participant-set goals and feedback, and finally, a choice phase in which participants could continue to set their own goals or have the experimenter set goals for them. All experimenter-set goals were selected using a weekly percentile schedule. In aggregate, all participants took more steps in the goal-setting phases than during the self-monitoring only phase. However, there was no notable difference between self-set goals and experimenter-set goals. When offered, all participants chose to continue the intervention for an additional one to two weeks.

This project is about trying to apply machine learning theories on a selection of data points in order to see if an improvement of current methodology within stress detection and measure selecting could be applicable for the company Linkura AB. Linkura AB is a medical technology company based in Linköping and handles among other things stress measuring for different companies employees, as well as health coaching for selecting measures. In this report we experiment with different methods and algorithms under the collective name of Unsupervised Learning, to identify visible patterns and behaviour of data points and further on we analyze it with the quantity of data received. The methods that have been practiced on during the project are “K-means algorithm” and a dynamic hierarchical clustering algorithm. The correlation between the different data points parameters is analyzed to optimize the resource consumption, also experiments with different number of parameters are tested and discussed with an expert in stress coaching. The results stated that both algorithms can create clusters for the risk groups, however, the dynamic clustering method clearly demonstrate the optimal number of clusters that should be used. Having consulted with mentors and health coaches regarding the analysis of the produced clusters, a conclusion that the dynamic hierarchical cluster algorithm gives more accurate clusters to represent risk groups were done. The conclusion of this project is that the machine learning algorithms that have been used, can categorize data points with stress behavioral correlations, which is usable in measure testimonials. Further research should be done with a greater set of data for a more optimal result, where this project can form the basis for the implementations. / Detta projekt handlar om att försöka applicera maskininlärningsmodeller på ett urval av datapunkter för att ta reda på huruvida en förbättring av nuvarande praxis inom stressdetektering och  åtgärdshantering kan vara applicerbart för företaget Linkura AB. Linkura AB är ett medicintekniskt företag baserat i Linköping och hanterar bland annat stressmätning hos andra företags anställda, samt hälso-coachning för att ta fram åtgärdspunkter för förbättring. I denna rapport experimenterar vi med olika metoder under samlingsnamnet oövervakad maskininlärning för att identifiera synbara mönster och beteenden inom datapunkter, och vidare analyseras detta i förhållande till den mängden data vi fått tillgodosett. De modeller som har använts under projektets gång har varit “K-Means algoritm” samt en dynamisk hierarkisk klustermodell. Korrelationen mellan olika datapunktsparametrar analyseras för att optimera resurshantering, samt experimentering med olika antal parametrar inkluderade i datan testas och diskuteras med expertis inom hälso-coachning. Resultaten påvisade att båda algoritmerna kan generera kluster för riskgrupper, men där den dynamiska modellen tydligt påvisar antalet kluster som ska användas för optimalt resultat. Efter konsultering med mentorer samt expertis inom hälso-coachning så drogs en slutsats om att den dynamiska modellen levererar tydligare riskkluster för att representera riskgrupper för stress. Slutsatsen för projektet blev att maskininlärningsmodeller kan kategorisera datapunkter med stressrelaterade korrelationer, vilket är användbart för åtgärdsbestämmelser. Framtida arbeten bör göras med ett större mängd data för mer optimerade resultat, där detta projekt kan ses som en grund för dessa implementeringar.

Abstract The purpose of the study was to describe and evaluate the effectiveness of health coaching on health promotion (health-related quality of life, adherence to health regimens, clinical health outcomes and lifestyle factors) among frequent attenders of primary healthcare. The aim was to generate new information to promote frequent attenders’ health and to improve the care and education of patients with chronic diseases. The study consisted of three sub studies. A systematic literature review (sub study I) described the effects of health coaching on adult patients with chronic diseases. The data were collected from the databases and through a manual search. The data (n=13) were analyzed using narrative synthesis. Conceptual analysis (sub study II) identified frequent attenders of primary healthcare. The data were collected from databases and through a manual search. The data (n=59) were analyzed using synthesis and content analyses. The quasi-experimental research method (sub study III) evaluated the effectiveness of health coaching among frequent attenders (n=110) in primary healthcare. The experimental group received the health coaching and the control group received the usual care. The data were collected before the intervention and 12 months afterwards using a questionnaire on FINRISKI2012, RAND-36 and ACDI and clinical health outcomes measured by health-coaching nurses. The data were analyzed using statistical methods. According to the systematic review, health coaching produced positive effects on patients’ physiological, psychological and behavioural conditions and on their social life. In particular, weight management, physical and mental status improved, and physical activity increased. Conceptual analysis identified four attributes of frequent attenders: the feelings of symptoms, perceived poor health status, lower quality of life and frequent visits to a primary healthcare provider. Health coaching had statistically significant effects on the blood pressure and health-related quality of life among the experimental group, especially in emotional role limitation and energy during the 12 months. There were no statistically significant differences between the experimental and control groups on health-related quality of life, adherence to health regimens and lifestyle factors. / Tiivistelmä Tutkimuksen tarkoituksena oli kuvata ja arvioida terveysvalmennuksen vaikuttavuutta perusterveydenhuollon paljon terveyspalveluita käyttävien asiakkaiden terveyden edistämiseen (terveyteen liittyvään elämänlaatuun, hoitoon sitoutumiseen, kliiniseen terveydentilaan ja elintapoihin). Tavoitteena oli tuottaa uutta tietoa paljon terveyspalveluita käyttävien asiakkaiden terveyden edistämiseen ja pitkäaikaissairaiden hoidon ja ohjauksen kehittämiseen. Tutkimus koostui kolmesta osatutkimuksesta. Systemaattisella kirjallisuuskatsauksella (osatutkimus I) kuvattiin terveysvalmennuksen vaikutuksia pitkäaikaissairaille. Aineisto kerättiin viitetietokannoista ja manuaalisella haulla. Aineisto (n=13) analysoitiin narratiivisella synteesillä. Käsiteanalyysilla (osatutkimus II) määriteltiin paljon terveyspalveluita käyttävä asiakas perusterveydenhuollossa. Aineisto kerättiin viitetietokannoista ja manuaalisella haulla. Aineisto (n=59) analysoitiin synteesillä ja sisällönanalyysilla. Kvasikokeellisella tutkimusmenetelmällä (osatutkimus III) arvioitiin terveysvalmennuksen vaikuttavuutta perusterveydenhuollon paljon terveyspalveluita käyttäville asiakkaille (n=110). Koeryhmä sai terveysvalmennusta ja kontrolliryhmä tavanomaista hoitoa. Aineisto kerättiin FINRISKI 2012-, RAND-36- ja ACDI-kyselylomakkeilla sekä kliinisen terveydentilan mittauksilla ennen ja 12 kuukautta intervention jälkeen. Aineisto analysoitiin tilastomenetelmin. Kirjallisuuskatsauksen mukaan terveysvalmennuksella oli positiivisia vaikutuksia pitkäaikaissairaiden fyysisiin, psyykkisiin, sosiaalisiin ja käyttäytymistekijöihin. Erityisesti painonhallinta sekä fyysinen ja psyykkinen terveydentila paranivat ja fyysinen aktiivisuus lisääntyi. Käsiteanalyysilla tunnistettiin neljä ominaispiirrettä perusterveydenhuollon paljon terveyspalveluita käyttävälle asiakkaalle: oireiden tunne, kokemus terveydentilan heikkenemisestä, alhaisempi elämänlaatu ja useat käynnit perusterveydenhuollossa. Terveysvalmennusinterventio edisti tilastollisesti merkitsevästi koeryhmän terveyteen liittyvän elämänlaadun psyykkisistä syistä johtuvien ongelmien roolitoimintaa, tarmokkuutta ja verenpainetta 12 kuukauden aikana. Koe- ja kontrolliryhmän välillä ei havaittu tilastollisesti merkitseviä eroja terveyteen liittyvässä elämänlaadussa, hoitoon sitoutumisessa ja elintavoissa.