hi my name is Sarah Zambor and I'm a BCBA at Brett DiNovi & associates today
I'm going to be discussing applied behavior analysis also known as ABA and
health coaching this video cover C1 C9 e2 e3 E4 and e6 on the fifth
edition' bacb task list in their 2020 article titled health coaching fight
behavior analyst and practice how and why Norman and bobert note the urgency
to address many health problems that currently exist in the United States in
2018 fire and colleagues noted that approximately 40% of adults and 18.5
percent of children and adolescents in the United States are clinically obese
and that obesity rates have nearly doubled since the 1980s these statistics
come with an increased number of young adults diagnosed with type 2 diabetes
and an increase in a type of cancers that are most commonly associated with
diabetes the increased obesity rates in addition to the rise of other health
issues comes with an increase in health care costs the current costs related to
obesity in the United States are estimated at 175 billion dollars and are
steadily increasing my weight gain and obesity can sometimes be a common side
effect of some medications or a genetic predisposition in general as a society
we are eating entirely too much and exercising entirely too little according
to the US Department of Health and Human Services the average American diet
contains too much salt calories from fat saturated fats added sugars and refined
grains the US Department of Health and Human Services also notes approximately
78% of adults do not follow the recommended guidelines which include
engaging in at least 150 to 300 minutes of moderate physical activity or 75 to
150 minutes of vigorous activity per week while our society is spending large
amounts of time and money attempting to recover from health complications we are
failing to take the necessary steps to prevent health problems from
occurring in the first place this is especially alarming as a US
Department of Health and Human Services notes approximately half of the u.s.
population is living with a chronic disease that could be prevented or at
least minimized by making lifestyle changes we have the ability to become
healthier without relying on a variety pills or specialist visits yet our
health is actually getting worse the health problems the United States is
currently facing are certainly socially significant and can and should be
addressed through the science of applied behavior analysis however it is
imperative behavior analysts recognize and stay within their scope of
competence when addressing any health related issues in 2014 cavae and
colleagues reviewed 13 studies from 2009 through 2013 that analyzed the impact of
help coaching on improving health outcomes and found that participant
showed an improvement in weight management increased physical activity
levels and improved mental and physical health
in 2011 Simmons and Woolever also found health coaching led to improvements in
cardiovascular health pain management for cancer patients diabetes management
and improved outcomes and individuals with a body mass index or BMI over 30
while the results just mentioned are encouraging the Normand in Bober 2020
article mentioned earlier the authors note that most published evaluations
regarding health coaching include Varian coaching practices employee
non-randomized group designs report high rates of
participant attrition and do not involve direct measures on health behavior while
these limitations make for less than ideal results they can be addressed by
applying the principles of applied behavior analysis to the field of health
coaching another limitation of health coaching is the inconsistent definition
regarding what exactly health coaching entails while definitions vary among
resources most definitions include common elements and place a focus on
helping clients determine what is important to them and include a focus on
collaboration between the coach and client the health coach and client
worked to set goals that are meaningful to the
client and a coach provides resources and support throughout the clients
journey and behavior analytic terms health coaches provide tasks
clarification help individuals set small obtainable goals provide feedback teach
individuals to self monitor and arranges antecedents and consequences to evoke or
reinforce behavior change the principles of applied behavior analysis can also be
utilized in health coaching by helping with the client create operational
definitions of the behavior they want to change helping the client set SMART
goals meaning goals that are specific measurable attainable relevant and
time-bound collecting baseline data regarding the
client's current behavior and monitoring data on a consistent basis to ensure
strategies recommended are effective helping to determine the function of the
client's behavior helping to determine appropriate replacement behaviors the
client can engage in and helping to determine ways in which the client's
replacement behavior will come in contact with reinforcement that occurs
naturally in the client's environment in 2017 Finan wants it noted it may be
valuable to consider the conceptual basis for functional relationships in
the clients environment Finn and Watson noted health behaviors are operant
behaviors and individuals engage in daily habit operating their environment
for better health choices and improve the long-term outcomes behavior analysts
can look at health coaching using the four term contingency including
motivation and a seeded behavior in consequence this can be useful to guide
clients to their own behavior and understanding its relationship on the
environment to be a successful health coach
it is important behavior analysts learn the basic concepts and principles of
diet exercise and fitness and familiarize themselves with health
coaching strategies and evidence supporting them credentials are
available for several professions related to health coaching however at
this time the American Council on exercise is the only organization
accredited by the National Commission for certifying agencies which is the
same body that accredits the bacb Norman and Bluebird note the skills of
the health coach overlap those of the BCBA and that both the
American Council on exercise and bacb describe performance domains and
specific tasks relevant to the respective practices the American
Council on exercise divides their various performance domains into task
statements which are further categorized into knowledge and skill statements and
the BA cv provides a task list that is organized into foundations or underlying
principles and applications or more practice oriented skills for behavior
analysts interested in health coaching understanding their scope of practice
and relying on evidence-based procedures is important however it is also equally
important for behavior analysts to be wary of strategies being promoted that
are not evidence-based well it is likely that behavior analysts practicing at
health coaches may come in contact with strategies that are not empirically
supported Norman and Bober note these situations are really no different than
what behavior analysts may encounter when attending an IEP meeting with an
interdisciplinary team when such situations arise in which it is
suggested that the behavior analyst use a procedure that is not evidence-based
it was a responsibility of the behavior analyst to refrain from using the
recommendation however it is important to note this can be done by respecting
another professionals opinion and working as part of a team while the
principles of a PI behavior analysis are starting to become more widely used
outside the autism spectrum population including areas such as organizational
and behavior management applied animal behavior and mental health there are a
few behavior analysts exploring the health coaching route this is likely due
to the fact that most health coaches start part-time and slowly build their
client base which can be difficult for an individual who is looking for
full-time employment behavior analysts interested in practicing as health
coaches will most likely have to start their own agency which can be a daunting
task well breaking into the field of health coaching can be challenging it
could also help pave the way for other behavior analysts interested in health
coaching niche behavior analysts have the ability to help make the world a
healthier place and make contributions to the
development of practice in a relatively new field and Skinner noted virtually
all the problems facing modern society are problems of human behavior to solve
these problems we need to foster a natural science of behavior and broadly
disseminate the application drive from that science