CareCoach® and The Get Fit For Active Living (GFAL) Program

Background

The Canadian Centre for Activity and Aging (CCAA) was established in 1989 as a research and community centre, affiliated with the Lawson Research Institute of St. Joseph’s Health Centre and London Health Sciences Centre and the Faculties of Health Sciences and of Medicine and Dentistry at Western University. They provide (and teach people to provide) fitness classes for people over 55 and people over 55 with diabetes. The CCAA specializes in helping seniors evolve from a sedentary state to becoming physically mobile and active through customized and safe exercise practices. Currently, more than 500 London seniors participate in CCAA exercise classes each week and more than 1000 people from across Canada are trained in CCAA leadership training courses each year. These classes and courses are developed around research conducted at the CCAA and introduce physical activity programs for seniors across the mobility spectrum.

Research has shown that while in a program like this people are highly motivated and meet their fitness goals however within one year of completing the program 49% stop their exercise routine. This is partly due to lack of guidance and accountability to maintain positive behaviours.

The CareCoach® Model

In 2005, Sykes introduced the concept of the “CareCoach®”, a proprietary service that offers counselling based programs that are specifically designed to assist people with changing behaviours through bio-psychosocial methods and on-going motivational support. The basic foundation of the CareCoach® counselling approach supports:

  • Access to the right provider at the right time and place supporting community partners and evidence-based interventions
  • Counselling interventions that are made to be measured and designed based on best available practice models
  • Quality assurance and continuous quality improvement initiatives designed to support a high performing and cost-effective service
  • Counselling services that scale both in terms of volume and horizontally in terms of the types of care provided and conditions supported (i.e. alcohol, tobacco, nutrition, physical activity, suicide prevention)
  • Privacy policies and procedures that support privacy regulations, contractual obligations and the ethical guidelines of the professional counsellors involved in the service

What is a CareCoach®?

CareCoaches® are trained lifestyle coaches that specialize in using coaching techniques such as Motivational Interviewing and Mindfulness to engage with clients to help them establish and meet individual health goals. In addition to holding targeted academic preparation, CareCoaches undergo over 200 hours of formal, evidence-based practice training in specific areas of care including (but not limited to) being a Registered Health Coach through the Health Sciences Institute (HSI), taking the Ontario Tobacco Research Unit, Tobacco and Public Health: From Theory to Practice Online course, being Certified Senior Fitness Instructors through the Canadian Center for Activity and Aging, training in Canadian Society of Exercise Physiology (CSEP) concepts and guidelines and receiving certification as an Applied Suicide Intervention Skills Trainer (ASIST) through LivingWorks.

The Working Hypothesis

In 2015 Sykes and CCAA joined together to conduct a pilot in which CareCoach® counselling services were integrated with the CCAA’s “Get Fit for Active Living” (GFAL) fitness program, in order to determine the impact telephonic coaching has on a participant’s adherence to their prescription for exercise. The CCAA completed an evaluation after one year. The hypothesis was that those that received CareCoach® counselling (GFAL +CareCoach® participants) would:

  1. Increase attendance to the fitness classes
  2. Change their behaviour to remain more physically active in the long-term

The CareCoach® & The Get Fit for Active Living Pilot

The Get For for Active Living (GFAL) program is an eight-week exercise and education program that introduces older adults to the benefits of exercise and the importance of leading a healthy and active lifestyle. Each week participants attend three exercise classes and one education session addressing cardio-respiratory exercise, strength training, flexibility, balance, nutrition, disease prevention, exercising at home and community exercise program options. CareCoach® counselling was integrated within the existing GFAL program during the 8-week course and as well post coaching follow up calls were completed to assess how effective the CareCoach® process was in supporting sustained behaviour change. Previous outcomes were used as a baseline to determine the impact of the CareCoach® intervention.

Evaluation

The evaluation to assess the behaviour of the participants of the program was completed using the following measures:

  1. Telephone Assessment of Physical Activity (TAPA) – a scoring tool designed to assess the physical activity of older adults over the telephone. Information collected at 6 weeks, 8 weeks and 12 months.
  2. Measuring Functional Fitness of Older Adults –8 measures that are tested such as arm curls, step test, chair sit and reach and back scratch. We will use previous GFAL results as a baseline.
  3. Attendance – attendance was measured to gauge whether coaching was able to increase participation.

Outcomes

  • Statistically significant changes in Arm curl (2.3 to 5.6), Sit & reach (1.1 to 3.3), Back scratch (0.8 to 3.7), 8 ft Up & Go (decrease of between 0.6 and 1.3 seconds), Weight (mean reduction of 0.9 to 7.8 kg)
  • 83% of participants reach their activity goals over the yearlong study