EXAMINATION OF THE ACCEPTABILITY, FEASIBILITY, AND IMPACT OF RDN-TRAINED UNDERGRADUATE HEALTH COACHES SUPPORTING UNINSURED PATIENTS: A DUAL PERSPECTIVE

Abstract

Abstract

Background: The Fresh Start program utilized RDN trained and supervised undergraduate pre-clinical student health coaches to provide individualized goal setting and behavioral support for rural, medically under-served patients with type 2 diabetes within a comprehensive, culinary-focused health literacy program. This study examined the impact on both patients and students.

Methods: A mixed-methods approach was utilized to examine patient and student experiences during the pilot (2021-2022) and second year (2022-2023) of the program, including semi-structured interviews and surveys. Interviews were audio-recorded, transcribed verbatim, and analyzed independently by members of the research team (n=4) using inductive content analysis to identify key themes. Consensus was reached on all reported themes. Survey data were analyzed using descriptive statistics for frequencies and percentages per response.

Results: Patient surveys (n=27) indicated 95.8% satisfaction with health coaches. Qualitative patient interviews (n=15) revealed themes including positive interactions, social support, and goal support. Student surveys (n=25) indicated that 52% of health coaches felt most proficient assisting with nutrition goals, 80% of health coaches picked “rewarding” as the term to describe their experience, and 96% of respondents reported being more likely to offer pro bono services in the future. Student health coach interviews (n=16) revealed key themes including satisfaction as a health coach, building relationships with patients, and gaining counseling skills.

Conclusion: Health coaches trained by an RDN can provide free behavioral support to uninsured patients while also supporting interprofessional educational opportunities for pre-clinical students and providing exposure to nutrition and dietetics.