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Table 1 Explanatory quotes from focus groups with health coaches

From: Health coaching in primary care: a feasibility model for diabetes care

Theme Explanatory quotes
Physician buy-in “…I think quite a few physicians were ready, and they did refer their clients. They just gave it (their support) freely. ‘oh I spoke to the patient, and I think they would (be a good candidate for health coaching). Can you please get hold of them?” (Quote 1) – FG2, Nurse 1 (C)
“I found that generally there wasn’t a lot of support for it (health coaching) (from the physicians)”. (Quote 2) – FG1, Nurse 2 (L)
Health coach role “I think personally it is hard for the nurse if you run a regular clinic, to be able to take that extra time, to do on top of that the health coaching”. (Quote 3) – FG2, Nurse 1 (C)
“Being a dietitian, sometimes people were just wondering, “Oh how come you’re doing a medication review?’ Some tasks people were not used to see a dietitian doing. But it’s part of coaching….” (Quote 4) – FG1, Dietician 1 (S)
Communication with the health care team “..I think having everybody understand what is a health coach about, why it’s so important, I think that would be very beneficial in the future”. (Quote 5) – FG2, Nurse 1 (C)
“…I still have to go to the doctor and say, ‘What is the target for this patient, what do you want to achieve with this patient?” So for future (health coaching) programs, I wish we had a standard way of communication”. (Quote 6) – FG2, Nurse 1 (C)
“ I was always emailing back the nurse and the GP so they know what is going on. Even if it was minor, they seemed really pleased to know what was happening”. (Quote 7) – FG1, Dietician 1 (S)
Health coach skills “And my finding, I was really, really surprised, is what I got the most from the coaching with the patient is just getting to know them, and not so much focussing on the small goals, and …working with the confidence, with the barrier, and you know using a little bit like the stages of change”. (Quote 8) – FG1, Dietician 1 (S)
“I find the challenge for me is I’m not a dietitian, so I’m being asked to talk about food, etc. etc.” (Quote 9) – FG1, Nurse 2 (L)
"And what I've been doing, I've been doing with the health coaching, indirectly, using the model I've learned in the program, with the new clients, new diagnoses, and also, also some patients with long-term diagnoses but also who were not really getting involved, who are not taking responsibility of their own health. I was more trying to change my approach. And I would say 95% of the time, it did work well, and you could see people getting more, you know, understanding how important it is to take care of themselves". (Quote 10) – FG2, Nurse 1 (C)
Scheduling follow-up “I would see a day I wasn’t as busy, and try to fit them in there”. (Quote 11) – FG1, Nurse 3 (N)
Timing and patient readiness “So once she came here, she was not ready to deal with her diabetes, because she was, she was saying that when you’re depressed you cannot focus on anything else. And so, we had to deal with the depression first, and once we had that stabilized, everything was back to normal she came regularly, saying how helpful (it was)” (Quote 12) - FG2, Nurse 1 (C)
“I strongly believe that if you want to advocate a bit of well-being, people need to be in power. But do we have the system to be flexible enough so somebody can call and ‘Hey, I’m ready to talk about diabetes now!’ ” (Quote 13) – FG1, Dietician 1 (S)
Benefit to patient “Her (a participant) doctor was very happy. And haemoglobin A1c is down ….and she (the participant) was saying ‘Thank you,… for the service you guys are doing, but it helped me to see you regularly, to change my lifestyle too”. (Quote 14) – FG1, Nurse 4 (K)
“I had a patient who none of the numbers changed, but that wasn’t where we were going with this. Just recognizing the relationship between what he eats and what his blood sugars are…It’s like ‘ OK, my blood sugar’s 19, but I went for Chinese food for supper”. OK, so you see that” (Quote 15) – FG1, Nurse 5 (P)
Comprehensive care “So I found I made a lot more referrals to shared mental health and social worker. And that way they can deal with their depression, and we can work with their diabetes at the same time as their depression is improving, be it through counseling or medication, but so is their diabetes”. (Quote 16) – FG1, Nurse 5 (P)
“For sure, because they’re being followed with those calls, so I think for sure they’re getting better care, more comprehensive care, because of the follow-up that they wouldn’t otherwise get”. (Quote 17) – FG2, Admin 1
Sustainability “I think we learned a lot (from the health coaching pilot) and certainly took a lot away from it. And I hope we will be able to implement health coaching in some, in some form at our centre in the next year”. (Quote 18) – FG2, Admin 2
  1. FG1 refers to the first focus group, conducted in December 2012.
  2. FG2 refers to the second focus group, conducted in March 2013.