McGill Bronwyn, O'Hara Blythe J, Phongsavan Philayrath
Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, NSW, Australia,
Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, NSW, Australia.
Public Health Res Pract. 2018 Jun 14;28(2):27451705. doi: 10.17061/phrp27451705.
Objectives and importance of study: Low program completion rates can undermine the public health impact of even the most effective program. Participant experiences with lifestyle programs are not well reported, but are important for program improvement and retention. The purpose of this study was to understand participant perceptions of the Get Healthy Information and Coaching Service (GHS), a 6-month telephone-based health coaching program to promote lifestyle change. We were particularly interested in participants' initial expectations, their actual experience and, for those who did not complete the program, what influenced their withdrawal.
The study included qualitative semistructured interviews and a quantitative sociodemographic survey.
A random sample of GHS participants (n = 59) was recruited to take part in semistructured interviews about their perceptions and experiences of the coaching program. Researchers conducted independent thematic analysis of the interview transcripts. Sociodemographic details were obtained from a quantitative survey of all GHS participants.
Participants expected that coaching would provide support, information and motivation, and would hold them accountable. Coach support was the most valued aspect of the participants' experience. Despite high attrition rates, participants were mostly positive about their coaching experience. Service structure or individual circumstances, rather than the program itself, were the main reasons for withdrawal.
A positive coaching experience was underpinned by good participant-coach rapport, which facilitated participant adherence and motivation to achieve their goals and complete the program. It is possible that participants who start to achieve their goals are motivated to continue with the program, and that their motivation moves from relying on their coach to being more intrinsically motivated. Reasons for high attrition provide insights into the coaching structure and process, and suggest that ensuring an individualised coaching approach and flexibility with follow-up calls (including alternative communication methods) are changes that could be used to improve practice and retain more participants for the duration of the program.
Notwithstanding high attrition rates, participants were mostly positive about their coaching experience. Barriers to participants completing the program could be used to shape service redesign.
研究目的及重要性：低项目完成率可能会削弱即使是最有效的项目对公共卫生的影响。关于生活方式项目参与者的体验报道不足，但对于项目改进和留存率很重要。本研究的目的是了解参与者对“获取健康信息与指导服务”（GHS）的看法，这是一项为期6个月的基于电话的健康指导项目，旨在促进生活方式改变。我们特别关注参与者的初始期望、他们的实际体验，以及对于那些未完成项目的人，是什么影响了他们退出。
该研究包括定性的半结构化访谈和定量的社会人口学调查。
随机抽取GHS参与者样本（n = 59），参与关于他们对指导项目的看法和体验的半结构化访谈。研究人员对访谈记录进行独立的主题分析。社会人口学细节来自对所有GHS参与者的定量调查。
参与者期望指导能提供支持、信息和动力，并让他们承担责任。教练的支持是参与者体验中最受重视的方面。尽管流失率很高，但参与者对他们的指导体验大多持积极态度。服务结构或个人情况而非项目本身是退出的主要原因。
良好的参与者与教练关系是积极指导体验的基础，这有助于参与者坚持并激发他们实现目标和完成项目的动力。开始实现目标的参与者可能有动力继续参与项目，并且他们的动力从依赖教练转变为更内在的动力。高流失率的原因有助于深入了解指导结构和过程，并表明确保个性化的指导方法以及跟进电话的灵活性（包括其他沟通方式）是可以用来改进实践并在项目期间留住更多参与者的改变措施。
尽管流失率很高，但参与者对他们的指导体验大多持积极态度。参与者完成项目的障碍可用于指导服务重新设计。
