Jordan Meg
California Institute of Integral Studies, San Francisco, United States.
Glob Adv Health Med. 2013 May;2(3):75-82. doi: 10.7453/gahmj.2013.025.
Twelve individuals (four homeless, two formerly homeless, and six low-income) received 12 weeks of free health coaching, an intervention normally undertaken by clients who pay $40 to $200 out of pocket for coaching services. The health coaching relationships were conducted with protocols developed for managing executive health at a Fortune 100 firm. This experimental model was constructed to explore what happens when coaching conversations for change and possibility are delivered to marginalized and underserved communities that typically undergo vastly different interactions with authorities in law, healthcare, and social services. Phase 1 of the project recruited the homeless individuals from street sites throughout San Francisco, California, and a temporary shelter. Phase 2 of the project worked with low-income and formerly homeless individuals who occupied a subsidized housing complex. Of the coaching recipients, three were black, five were Hispanic, three were of mixed race, and one declined to disclose his ethnicity. Half were Spanish speaking; immigrant status was recent for five of the 12. None had ever talked with a health coach before; only three knew how to utilize low-cost public health clinics. This case report illustrates how the motivational power of coaching conversations was a modestly useful methodology in breaking through the social isolation and loneliness of street-dwelling adults with chronic health problems. It also was a useful methodology for developing capacity for accomplishing short-term goals that were self-identified. Additionally, health coaching presented an opportunity for transitioning poverty-level individuals from passive recipients using public health sector services to more empowered actors with first-stage awareness who initiated preventive health actions.
12个人（4名无家可归者、2名曾经无家可归者和6名低收入者）接受了为期12周的免费健康指导，这一干预措施通常由那些自掏腰包支付40至200美元接受指导服务的客户来进行。健康指导关系是按照为一家财富100强公司管理高管健康而制定的方案开展的。构建这个实验模型是为了探索，当为变革和可能性而进行的指导对话被提供给那些在法律、医疗保健和社会服务方面通常与当局有着截然不同互动的边缘化和服务不足的社区时会发生什么。该项目的第一阶段从加利福尼亚州旧金山的街头地点和一个临时收容所招募无家可归者。项目的第二阶段与居住在一个有补贴的住房小区的低收入者和曾经无家可归者合作。在接受指导的人中，3人是黑人，5人是西班牙裔，3人是混血，1人拒绝透露自己的种族。一半人说西班牙语；12人中有5人是新移民。之前他们都从未与健康指导师交谈过；只有3人知道如何利用低成本的公共卫生诊所。本病例报告说明了指导对话的激励力量是如何成为一种适度有用的方法，来打破患有慢性健康问题的街头成年人的社会孤立和孤独状态的。它也是一种有用的方法，用于培养实现自我确定的短期目标的能力。此外，健康指导为处于贫困水平的个人提供了一个机会，使他们从被动接受公共卫生部门服务的人转变为更有能力的行动者，这些行动者具有初步意识并开始采取预防性健康行动。
