4. Discussion
diabetes, cardiovascular diseases
MAY
Although the concept of a health coach and peer education model has been well developed, there has been very little empirical research on the effectiveness of peer health coaching programs. Even less is known regarding the effectiveness of health coaching among non-clinical young adult populations in the higher education setting. To the authors’ knowledge, this is the first published study in which multiple health behavior outcomes were evaluated via a health coaching RCT among college students. The most important findings were that the students in the coaching group who worked on PA showed significant intervention effects on vigorous PA and marginally significant improvement on total PA over the 8-week period. This is consistent from previous studies. For instance, a meta-analysis with 27 randomized trials shows a small, significant effect size (SMD = 0.27) in PA improvement achieved by health coaching among people aged 60 years or older [Although there was no significant intervention effect on walking and moderate PA, the improvement of vigorous PA and marginally significant improvement on total PA among the participants indicated that they engaged in more planned exercise behaviors after the intervention. Interestingly, while vigorous and total PA increased among the participants, there was a decrease in vigorous and total PA among the control group. This may be due to the fact that post-assessment was one week before the final examinations, and the increased stress and study time may have made students in the control group less likely to engage in PA [We also found that individuals who worked on stress-management-related goals had an improved positive affect and well-being, compared to those in the control group. This is supported by the previous research indicating that stress evokes a negative affect [Another strength of the study was that it provided the participants with the antonym to self-select the wellness topics and behavioral goals, and the health coaches were in the supporting role in the coaching relationship. This is different from other health coaching intervention studies that involved adults with health conditions (e.g., diabetes, cardiovascular diseases) in which the topics and behavioral goals were often pre-determined, and health outcomes (vs. behavioral outcomes) were often assessed [Although not statistically significant, there was a trend towards the improvement of sleep quality among participants who worked on sleep-related goals, compared to the control group. Type II error due to the small sample size may play a role here. No intervention effect was detected among participants who worked on diet-related goals. This may be because, compared to other behavioral goals, diet-related goals were very diverse, from eating breakfast to drinking more water. This makes the intervention effect very challenging to measure without significant noise. We suggest future studies consider personalized diet measures based on the specific diet goals.Given that first-year students, students of color, students from low-income families, and first-generation students are often disproportionately affected by the pandemic and have a more difficult time transitioning to the academic and social demands of college [There were several limitations of this study. First, the study began in January and ended in May 2022, during which seasonality became a challenge for the participants. That is, the end-of-semester stress may cause college students to have increased stress, worse nutrition, less PA, and poor sleep quality [The current study was conducted in a college campus in which intervention was delivered by students majoring in health science who went through training via two health coaching courses. Although they had limited coaching experiences compared to the professional health coaches, they provided unique peer support that other professional coaches would not be able to provide. This study also set an example of an innovative health promotion program in the higher education setting. Additionally, from the education experiential learning perspective, the peer health coaching programs also served as an education and practice opportunity for students with related majors. The experience and skills they developed through this intervention will further prepare them for their future career, especially those who will work in client-facing settings. 