The Impact of Nurse Health-Coaching Strategies on Cognitive—Behavioral Outcomes in Older Adults

Abstract

The practice of nurse health coaching (NHC) draws from the art and science of nursing, behavioral sciences, and evidence-based health-coaching methods. This secondary analysis of the audio-recorded natural language of participants during NHC sessions of our recent 8-week RCT evaluates improvement over time in cognitive–behavioral outcomes: change talk, resiliency, self-efficacy/independent agency, insight and pattern recognition, and building towards sustainability. We developed a measurement tool for coding, Indicators of Health Behavior Change (IHBC), that was designed to allow trained health-coach experts to assess the presence and frequency of the indicators in the natural language content of participants. We used a two-step method for randomly selecting the 20 min audio-recorded session that was analyzed at each time point. Fifty-six participants had high-quality audio recordings of the NHC sessions. Twelve participants were placed in the social determinants of health (SDH) group based on the following: low income (