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Affordable Coaching for Seniors Needed
Health maintenance is a key longevity factor as well as an essential quality of life component for senior citizens. We have all received the memo that we can influence our health through consistent exercise and good nutrition.
Motivational coaching, personalized feedback, goal setting, and patient education have been used successfully to bring about long-term changes in diet and activity. Delivering these aids by traditional means, such as one-on-one personal training, is expensive and difficult to scale up. A personal exercise coach would benefit any senior citizen, but few can afford it.
New Technologies Become Senior Helpers
There are new health technologies that are effective, accessible, and inexpensive. The following are a few:
- Pedometers are wearable devices that capture step count. They can increase activity levels by up to 2000 steps per day.
- Internet-based information can communicate and deliver information to individuals at relatively low cost .
- Internet-based interventions have demonstrated reductions in weight through a combination of self-monitoring, education, and motivational messaging.
- E-Coaching: A coach can increase accountability and adherence to an exercise program.
There is a documented association between the quality of the professional–client relationship and outcomes. The psychotherapy literature describes this working alliance as the trust and belief that the helper and patient have in each other as team members in achieving a desired outcome.
Virtual Exercise Coach
Coaching need not be face-to-face. A coach need not be human at all. Recent research into the use of animated computer agents has shown that participants can successfully form a working alliance relationship with a nonhuman agent, also known as a virtual coach.
The virtual coach is a computer-animated exercise advisor that runs on software installed on users’ home computers. The virtual coach is entirely automated and follows an algorithm-driven script, using simulated face-to-face conversation, including verbal and nonverbal relationship-building behaviors modeled on best practices from studies of patient–provider health communication with the goal of establishing a working alliance.
Virtual Coach Testing
The scripts in a recent virtual coach test were developed through a collaboration involving physicians, computer scientists, and exercise trainers to ensure adherence to best practices. These strategies include goal setting, shaping, self-monitoring, positive reinforcement, problem solving, education, and social support.
The virtual coach software was integrated with a database containing the participants’ activity data to allow tailored interactions according to each participant’s adherence to step count goals. The interactions all followed a structured pattern, starting with greeting and social interaction, proceeding to review of pedometer step count, feedback and goal setting, tips on activity or diet, and commitment to date of next interaction, and ending with encouragement and farewell.
The dialogue, format, and content of individual utterances were tailored based on each user’s progress in the system–whether they had progressed past baseline, whether they had met their short-term goals, and whether they had just asked the virtual coach a question or asked for help. Those who had not met their activity target would have a different interaction from those who were on track.
Results showed that participants can form a social bond with a computer agent, even though they are aware that the agent does not represent an actual human. It may be best used as a supplement to other forms of automated applications.
Virtual Coaching for Parkinson’s Patients
Developing effective, automated self-management programs, that offer a relationship and personalized feedback, may prove essential to developing scalable solutions to deal with large populations faced with chronic disease.
A recent article in the Wall Street Journal, A Virtual Coach Spurs Patients With Parkinson’s, reported that “patients walked markedly farther and faster after a month of daily motivational chats with a virtual exercise coach.” According to the American Journal of Physical Medicine & Rehabilitation, the technology has been used in studies of healthy adults, but this is the first study to involve patients with a neurological disorder.
Virtual coaching has many applications beyond promoting activity. Coaching is increasingly recognized as an important component in the management of chronic conditions, such as diabetes and heart disease, and in the promotion of healthy behaviors, such as adherence to medication.
Future Healthcare Implications
Given the growing burden of chronic disease and the shortage of providers, such applications may prove useful supplements to conventional office-based care. By linking data from home monitoring devices, health practitioners could encourage patients to develop better self-management skills.
Broader changes in the health care payment system, such as the shift from visit-based to outcome-based reimbursement, may promote adoption of this type of care-delivery platform by clinicians. Pay-for-performance initiatives promote provider innovation around care delivery. An online coaching platform could be used, either as an adjunct to traditional care or as a stand-alone self-management program for patients.
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