Seeing the bigger picture
CVD
A number of participants talked about “waking up” to their health risks, and this being a major driver for change and long‐term maintenance. Some attributed the process of “waking up” directly to the coaching, saying it brought greater awareness and an ability to see the bigger picture:
“…it's just like [an] awakening of the mind…Everything changes.” (P3, Female, Moderate CVD risk)This participant described how prior to the coaching she only focused on the needs of other people, often to the detriment of her own health needs. She talked about a profound realization that in order to take care of her family, she needed to take care of herself first:
“…before the coaching I just used to think about my children's needs, my family, my husband…this thing just helped to, ok, if I be ok, if I'll be here, if I have got a long life…then I can do things for my kids.” (P3, Female, Moderate CVD risk)In learning to prioritize herself, this participant reported a healthier balance between family commitments, study, and her own health goals, which she was able to maintain in the long term.Some described waking up to their health risks more naturally following diagnosis, with HWC contributing little toward this, whereas others described the timing of HWC as highly significant, being either optimal or not. For instance, P5 attributed his early withdrawal from the coaching to becoming “quite busy” and therefore too “tired” to engage:
“…all I wanted to do was come home and sleep” (P5, Male, High CVD risk)Conversely, P3 described the timing of her coaching as ideal as it came at a time in her life when she really needed it and was ready to make change:
“…and that's the time I started this coaching…which was quite, quite good…that's the time I really needed somebody to you know, help me, help me out…” (P3, Female, Moderate CVD risk)The timing of HWC then may influence the effectiveness of the intervention in terms of a person's ability and readiness to make change as well as their ability and motivation to maintain it.