Meet Mary. She recently decided she wants to get healthy and lose some weight.
So she signs up to work with a personal trainer. Mary likes the sessions but the high cost make them difficult to maintain. She decides to get some workout DVDs and be active on her own. Her sessions quickly start to taper off. She orders a dieting book but never gets past the first few chapters. Her kids give her a Fitbit. She buys a yoga mat.
Mary has almost everything she needs to be healthy. But none of the social support, encouragement, or accountability to actually be healthy.
Then, Mary signs up for digital health coaching.
What the heck is digital health coaching?
It’s no secret that working with a health coach can be a wildly effective behavior change strategy. Research consistently shows that health coaching increases medication adherence, decreases health care costs, enhances perceived happiness, and maximizes overall health related goal achievement (₁,₂,₃,₄). But the price and logistics aren’t always an option for many people.
Enter digital health coaches.
These are real human coaches who are able to scale their services to large groups of people all over the world using digital tools. When coaching services are combined with data from wearables and apps, coaches can provide almost instant feedback on people’s health choices. This feedback is superior to the feedback a user might get from an app alone because a digital health coach is trained to translate the data on both a social and emotional level. Presenting people with large amounts of data about their behavior isn’t always enough. But presenting data in a personally meaningful context can help trigger actionable change.
Efficacy data on digital health coaching is in the early stages, but here are some important lessons from two veteran digital health coaches on how to successfully hook people in creating long term change.
1 – Break cycles of failure.
Let’s go back to Mary. She’s just started working with her digital health coach.
Every time Mary hasn’t succeeded at getting healthy in the past, instead of blaming her diet book or Fitbit or health app, she’s blamed herself. Mary doesn’t think, “These products have failed me”. She thinks, “I have failed.”
Mary’s coach can work to understand her unique history and patterns of failure to support in her in breaking through failure. How?
2 – Create a success story. Fast.
Almost immediately, Mary’s coach need to help her set a goal she can achieve. Common goals we hear from people starting a new digital health coaching program are:
- I want a 6-pack.
- I want to go to the gym five mornings each week.
Coaches can support these as long-term goals, but should quickly help people shift focus to habits and behaviors that have a high likelihood of success. Goals like:
- I will decrease my waist size by one inch.
- I will walk my dog around the block three times this week before dinner.
Immediate goal achievement is critical for self-efficacy. Self-efficacy, or a person’s belief in his/her ability to do something, builds over time with successful practice and directly determines a behavior change outcome.
Keeping people focused on the present and near future also increases likelihood of success. Rather than setting out to do 1000 sit-ups for the next year, set the goal to do 10 minutes of core exercises on Monday mornings for the next two weeks. If a person can do sit-ups for two weeks, they are more likely to do sit-ups for a month and so on. BJ Fogg’s Tiny Habits program teaches this concept of baby steps well. When she first started, Mary’s goal was to go to the gym five mornings each week. Instead, her coach worked with her to walk the dog around the neighborhood after dinner three times this week. Keeping Mary focused on completing something “smaller” in the present and near future increases her likelihood of success.
3 – Provide an enjoyable reason to believe this time will be different.
Most people, like Mary, have been slowly gaining weight pound by pound for years. They often believe – and the diet and fitness industry often tells them – that change can happen fast. But building new habits takes time. Habits are socially, emotionally, and neuroscientifically very difficult to break because they are hard-wired into the habit default center of the brain. It is easier to create a new habit than break an old habit. And to create a new habit well we must find the joy in it.
One of Mary’s new goals is to follow the Mediterranean diet.
She’s been trying the diet long before she started digital health coaching. She’ll stick with the diet for a while, but then her old habits kick in and she’ll head to the bakery for an afternoon pastry.
Instead of focusing on breaking Mary’s established pastry habit, Mary’s coach encourages her to buy some hummus and carrots for her office so she can practice eating those during her afternoon snack break. The hummus she buys is at a market she loves to visit. She soon finds that eating the hummus and carrots make her more energized and notices she’s less tempted to head to the bakery. Her coach validates and celebrates her decision every time she chooses the hummus.
Mary starts to believe that working with a digital health coach is what she needs to learn how to create habits she can maintain. This time will be different. This period of coach-led, data-driven, dynamic experimentation is critical for putting users on a path to success.
4 – Personalize for long-term engagement.
Only after coaches have established social trust do they have the opportunity to really get to know the unique lives and challenges of the people they work with. Now that Mary’s had a taste of success, she’s beginning to trust that her coach can guide her in making better decisions.
One thing we hear over and over again is “I want to know that my coach or my program knows me.” Social trust and personalization is needed for a successful coaching relationship, because
- Frustration results when people really want to do something but cannot;
- Annoyance results when something is really easy to do and people do not want to do it;
- Fear of failure is almost constantly present.
An example of the level of personalization digital coaches should strive for with the people they work with might be:
- Rather than: Have you walked for 30 minutes today?
- Instead: Hi Mary. Are you and Rover going walking along the river this afternoon?
- Rather than: What’s for dinner tonight?
- Instead: Hey Mary! What are you thinking about making for dinner tonight? I’m guessing your avocados are just about ripe by now…
Going Forward In Digital Health Coaching
This year we’ve seen a surge of business announcements related to digital health coaching: In February, MyFitnessPal announced it’s acquisition of Sessions. In April, Omada Health completed a Series B funding round of 23 million dollars. In May, Weight Watchers acquired online fitness startup Wello. In July, Kurbo Health announced that it raised $5.8 million to “use digital health coaches to help fight childhood obesity.”
Each of these companies leverage the power of technology to strengthen and scale human-to-human coaching relationships to make big impacts on people’s journey towards better health.
It’s not all about the technology, though. It’s about leveraging the power of technology to strengthen and scale the human-to-human relationships that can hook people better than an app ever could. Digital health coaches are the human force behind people’s journey to better, sustainable health.