We could help them in many ways. Health coaches’ experiences from targeted health dialogues with 70-year-olds: a qualitative study

Abstract

Abstract Background Targeted health dialogues (THDs) have been implemented in primary care in many Swedish regions in an attempt to prevent cardiovascular disease and type 2 diabetes. A THD is a counselling meeting with a specially educated health dialogue coach. It is preceded by blood tests (cholesterol, plasma glucose), blood pressure measuring, anthropometric measures, and a lifestyle questionnaire. Health advice is given based on an illustrative health profile. In southern Sweden, all 40- and 50-year-olds are invited to a THD. Recently, a pilot project with similar THDs for 70-year-olds was performed at 14 healthcare centers. The aim of the present study was to examine the health dialogue coaches’ experiences of THDs in 70-year-olds. Methods Sixteen of 22 coaches consented to participate in the study. Twelve of 14 healthcare centers were represented. Data were collected through three focus groups, and two individual interviews, which were audio-recorded and transcribed verbatim, thereafter analyzed inspired by systematic text condensation. The researchers conducted the analyses separately, whereafter differences were discussed until consensus was reached. Results Support from all co-workers at the healthcare center and time for planning and reflection were mentioned as success factors for the implementation of THDs. The lifestyle questionnaire was perceived to be a bit too extensive for 70-year-olds, especially regarding physical activity and diet. Waist-hip ratio was perceived as a problematic measure. In particular, women often had high values despite a lean body composition and low BMI. Many coaches believed that the 70-year-old participants belonged to the healthier part of the population, and they also had the impression that there was a lower participation rate among immigrants, possibly due to language difficulties. The coaches enjoyed the THDs and believed that the 70-year-olds appreciated them as well. The THDs provided an opportunity to discuss not only cardiovascular risk factors but health issues and life in general. Conclusions The health dialogue coaches valued THDs with 70-year-olds highly, but minor adaptations of the information given, questionnaire and health profile were suggested in what the coaches thought could increase participation and facilitate the dialogues with this age group.