ArticleBMC public health2025
Health coaching for people with long-term conditions and multimorbidity: a mixed methods prospective service evaluation of Structured Agenda-free Coaching Conversations (StACC) in UK primary care.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundEnhanced patient engagement has been linked to health service sustainability. The Structured Agenda-free Coaching Conversation (StACC) model aims to support people with one or more long-term conditions through a strengths-based approach: emphasising patient ownership and engagement rather than specific health-related knowledge, skills or lifestyle-related goals. The intervention consists of five or six personalised one-to-one coaching sessions with a non-clinical coach. This evaluation explored the impacts of StACC on patient activation, self-management capabilities, patient experience and health service use.
methodsA prospective service evaluation was conducted across seven UK general practices between 2015 and 2018. Patient-reported outcome measures were the Patient Activation Measure (PAM-13) or the Health Education Impact Questionnaire (heiQ). Patient stories and feedback were thematically summarised. Health service usage (encounters) was explored for a small subgroup 12 months before and after the intervention.
resultsA total of 1,031 participants were onboarded, and 630 (61.1%) completed the intervention. Of those, 575 (91.3%) provided paired evaluative data for either PAM-13 (n = 110) or heiQ (n = 465), 586 completed feedback questionnaires (93.0%), and 376 (59.7%) agreed to share their individual stories. Complete health service data were provided for a small subgroup (n = 58, 9.2% of completers). The pre-intervention mean PAM-13 score was 57.1 (SD = 13.6, 95% CI = 54.5-59.7). This increased to 70.8 (SD = 14.7, 95% CI = 68.1-73.6) post-intervention (p < 0.0001). There were improvements across all eight domains of heiQ (effect sizes between 0.36 and 0.66). Health service data suggested a sustained impact. Participants who were previously disengaged reported taking action and gaining more control. Of the 586 feedback questionnaires, 567 (96.8%) were positive.
conclusionsPersonalised health coaching delivered through the StACC model increased patient activation (quantitative evidence) and improved self-management behaviours (qualitative evidence) for participants. This is supported by exploratory health service data. As this was an uncontrolled service evaluation, and the appointment data subgroup was small, follow-up efficacy and economic studies are warranted.
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