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The Power of Life Coaching: Helping Individuals with Diabetes Set and Achieve Employment-Related Goals Jean Isip-Schneider, MEd, SPHR & Landry Fukunaga, MA 1 Background Live Healthy… Work Well Issue: National estimated costs for diabetes in 2007 were $174 billion which include $58 billion in indirect costs related to “reduced productivity from work-related absenteeism, reduced productivity at work and at home, unemployment from chronic disability, and premature mortality” (ADA, 2008). Goal: The Live Healthy… Work Well project was designed to test whether a program of medical assistance and other supports could forestall or prevent the loss of employment and independence due to potentially disabling complications of diabetes. Experimental Design: Stratified random assignment based on diabetes type (type I, type II or pre-diabetes) using a 2:1 ratio into treatment (n = 128) or control (n = 62) groups Intervention Components: Flexible access based on individual need for the duration of the intervention period (12 months) What is Life Coaching? “Life coaching is a collaborative, solution-focused, results- oriented and systematic process in which the coach facilitates life experience and goal attainment in the personal and/or professional life of normal, nonclinical clients” (Grant, 2003). In LHWW, life coaches assisted participants with setting goals utilizing an empowerment approach that does not provide advice or health directives. Main Services Additional Services Main Services Life Coaching Pharmacist Counseling Diabetes-Related Medical Costs Diabetes Education Nutrition Counseling 3 Month Fitness Membership Goal Setting Process S specific M measurable A attainable R realistic T timed Online Coaching Tool • Laptop and wireless internet provided • Participants and/or coaches track self-reported progress toward goal/action plan attainment • Online communication with life coach Identify SMART Goal Establish Action Plan Address Obstacles Identify Supports Needed 2 Methods Research Questions Data Sources Data Collection Frequency Sample Size Analysis 1. In what ways do treatment participants feel that diabetes affects their employment? Project Life Coaching Participant Questionnaire Baseline 116 Quantitative & Qualitative 2. What types of employment goals did treatment participants set and/or attain with a life coach? Project Online Coaching Tool Baseline – Month 12 110 Quantitative & Qualitative 3. What did treatment participants think of the life coaching intervention component? Evaluation Satisfaction Surveys Month 6 Month 12 96 93 Quantitative & Qualitative 4. Did treatment participants report making work-related changes and what aspect of the intervention contributed to these changes? Project Life Coaching Participant Questionnaire Evaluation Focus Groups Baseline Month 12 Month 12 89 89 32 Quantitative Qualitative 3 Participant Characteristics N 128 Gender Female Male 65.6% 34.4% Education level High School Graduate or GED Some College or 2 Year Degree Four Year College Graduate More than 4 Year College Degree 8.6% 41.4% 21.1% 28.9% N 128 Mean age 47.6 (SD=10) Gender Female Male 65.6% 34.4% Diabetes type Type I Type II Pre-diabetes 12.5% 85.2% 2.3% Education level High School Graduate or GED Some College or 2 Year Degree Four Year College Graduate More than 4 Year College Degree 8.6% 41.4% 21.1% 28.9% Treatment Participant Demographics Treatment Participant Employment Majority of participants: • Female • Type II diabetes • Some college or 2 yr. degree • Annual income ≥ $40,000 • Professional/technical jobs • Work > 40hrs/wk Evaluation focus group question (Mo. 12): Over the past 12 months, has your participation in this project affected your work or employment in any way? • A majority of participants reported that LHWW did not affect their employment Participants that reported making changes: “I set a goal that I needed to leave work by 4:00 so I could go do my exercise and get it done, and so I found myself telling people at work I have to leave so I can get a checkmark.” “Just setting goals on my own, and then just achieving more balance in my life so that I remember that there’s work and then there’s life outside of work and I have to have balance in order for me to be able to take care of myself well.” “[LHWW] didn’t just affect the work duties, it mostly affected the other stuff, the environment part with the food.” Work-Related Changes Rank* Main Themes 2 Increased diabetes management at work •Exercise •Diet •Glucose monitoring 4 Improved work environment •Disclosed diabetes at work, advocated for self •Increased support from coworkers Rank* Main Themes 1 No effect •No effect on work •Maintaining current work performance/attendance 2 Increased diabetes management at work •Exercise •Diet •Glucose monitoring 3 Managing work related stress •Stress management •Better balance between life and work •Working less hours, taking time off, leaving earlier 4 Improved work environment •Disclosed diabetes at work, advocated for self •Increased support from coworkers 5 Other positive changes •Changed job/position •Increased attendance * Main themes are presented in rank order according to how frequently they were discussed within and across groups 5 Conclusions Aspects of LHWW that Contributed to Work-Related Changes Rank* Main Themes 2 Study participation •Participation general •Data collection activity (tracking hours worked) Rank* Main Themes 1 Life coaching •Developing goals and/or action plans •Life coach insight/perspective •Increased positive outlook •Support •Job training 2 Study participation •Participation general •Data collection activity (tracking hours worked) 3 Dietician •Diet information * Main themes are presented in rank order according to how frequently they were discussed within and across groups Evaluation focus group question (Mo. 12): If you made any work related changes as a result of this project, please explain what aspect of the project brought about these changes. • Life coach most frequently mentioned as contributing to employment changes Participants that reported making changes: “I had regular meetings with my coach and [coach] helped me think about like how to ideas with the stress… think about different ways to deal with the stress that I’m going through at work…. I think that the support that I got from [coach] was really priceless and if anything it has really affected my work or employment positively.” Study Conclusions • More than half of treatment participants reported that diabetes affects their employment • Participants set and achieved employment goals with a life coach • Some participants reported making employment changes and the majority of these participants attributed those changes to meetings with a life coach • Participants were highly satisfied with life coaching services Implications • Employees with diabetes and other chronic illnesses could benefit from life coaching services to set and achieve employment related goals • Employers might consider exploring life coaching as a company-sponsored health initiative Recommendations • Further research is needed to relate participant goal achievement with work performance Study Limitations • Participants perceived LHWW as a health intervention not an employment intervention • The sample population was securely employed at baseline and throughout the project • The sample population was relatively healthy at baseline, therefore perceived effects of diabetes on employment may not represent the greater diabetes population • Data obtained through the Online Coaching Tool may not represent participant interaction with the tool since some life coaches entered and tracked goal attainment for certain participants References American Diabetes Association. (2008). Economic costs of diabetes in the U.S. in 2007. Diabetes Care, 31(3), 1-20. Retrieved from http://care.diabetesjournals.org/content/31/3/596.full.pdf+html Fukunaga, L., Nishita, C Tom, T., & Uehara, D. (2009). Live healthy… work well: A diabetes project for a healthy workforce (Summer 2009 Research Brief #1). Honolulu, HI: University of Hawaii at Manoa, Center on Disability Studies. Retrieved from http://manoa.hawaii.edu/livehealthy/Newsletter-Aug2009.pdf Grant, A. (2003). The impact of life coaching on goal attainment, metacognition and mental health. Social Behavior and Personality, 31(3), 253-264. Hawaii Demonstration to Maintain Independence and Employment (HI-DMIE). (2009). Live healthy… Work Well Program Theory. Honolulu, HI: University of Hawaii at Manoa, Center on Disability Studies. Mechling, Majken. (2005, March 17). Diabetes report should be a wake-up call. Honolulu Advertiser. Retrieved from http://the.honoluluadvertiser.com/article/2005/Mar/17/op/op08p.html. 4 Findings 1. In what ways do treatment participants feel that diabetes affects their employment? Project survey question (Baseline): Does your diabetes affect your work? If yes, how? • 61 (52.6%) diabetes affects work • 55 (47.4%) diabetes does not affect work 2. What types of employment goals did treatment participants set and/or attain with a life coach? Online coaching tool (Baseline - mo. 12) • 1106 total goals set by participants • 133 (12.0%) goals related to employment • 112 (84 2%) employment Rank* Main Themes 2 Diabetes management •Eating habits at work “If I’m not eating properly, sugar levels go up.” •Scheduling doctor visits during work hours “A lot of time spent out of work seeing doctors.” Rank* Main Themes 1 Blood sugar fluctuations •Fatigue “Feeling tired, exhausted, weak and sometimes sleepy.” •Concentration “Energy, concentration, understanding” 2 Diabetes management •Eating habits at work “If I’m not eating properly, sugar levels go up.” •Scheduling doctor visits during work hours “A lot of time spent out of work seeing doctors.” 3 Diabetes related absences •Pain ”Once my right toe became infected and [I] was hospitalized.” Participant-reported affects of diabetes on employment Participant employment goals Rank* Main Themes 2 Completing work responsibilities •“Create flashcards by this Thursday, Dec. 4, to use at work with a couple of our clients for the next 3 weeks. •“Build memory skill so I have less work come back to me that needs to be corrected after I have turned it in.” •“Solve staff conflict by analyzing, documenting, and conferring with resources before responding.” 4 Education •“Attend meeting with West Oahu University counselor for BA degree.” •“Graduate by Spring 2010!!!” Rank* Main Themes 1 Improving employment situation or status •“Find 5 new potential employers who offer comprehensive health plans by December 31, 2008.” •“Relieve stress by generating more income by researching other ways to make more money.” •“To prepare strategically for the Practicum Director interview on 12/30 at 9:30am.” 2 Completing work responsibilities •“Create flashcards by this Thursday, Dec. 4, to use at work with a couple of our clients for the next 3 weeks. •“Build memory skill so I have less work come back to me that needs to be corrected after I have turned it in.” •“Solve staff conflict by analyzing, documenting, and conferring with resources before responding.” 3 Balancing work and life •“Deny at least one request for volunteer meeting, or task every day!” •“I will limit my work hours to 50/week.” 4 Education •“Attend meeting with West Oahu University counselor for BA degree.” •“Graduate by Spring 2010!!!” Participant Goals 3. What did treatment participants think of the life coaching intervention component? Evaluation survey question (Mo. 12): How satisfied are you with your life coaching experience overall? • Participants reported being completely satisfied with the life coaching services overall 93 3.80 (0.54) N M (SD) 93 3.80 (0.54) 4. Did treatment participants report making work-related changes and what aspect of the intervention contributed to these changes? Project survey question (Baseline and mo. 12): On a scale of 1-10, how well are you doing at work? • Paired t-test comparing pre and post-treatment means Missing data points (21) and dropped (18) participants were excluded from analysis • Participant self-reported ratings of work performance improved Participant Self-reported Work Performance 89 7.77 (1.59) 8.36 (1.47) -0.97, -0.21 -3.12 .002 N Baseline M (SD) 12 month M (SD) 95% CI t (88) p 89 7.77 (1.59) 8.36 (1.47) -0.97, -0.21 -3.12 .002 Completely Dissatisfied Completely Satisfied 1 2 3 4 1 2 3 4 5 6 7 8 9 10 7.76 at baseline 8.35 at 12 months Poor Excellent * Main themes are presented in rank order according to frequency * Main themes are presented in rank order according to frequency Evaluation survey question (Mo. 6): Comments about your Live Healthy Work Well life coaching experience. • 91% (N = 68) of comments about life coaches were positive • Positive comments related to: • Life coach support • Life coaching service was helpful/motivating • Positive attributes of life coach • Life coach insight/perspective * Baseline demographics of treatment and control groups were statistically similar (Fukunaga et al., 2009) Occupaon 50.8% 19.5% 12.5% 17.2% Professional, Technical, and Managerial Occupa ons Clerical and Sales Occupa ons Service Occupa ons Other Family Income 2.3% 10.9% 12.5% 35.2% 35.9% 3.1% $1 to $9,999 $10,000 to $19,999 $20,000 to $29,999 $30,000 to $39,999 $40,000 to $74,999 $75,000 or more Weekly Hours Worked 57.8% 38.3% 3.1% 0.8% ≥ 40 hours ≥ 20 hours to < 40 hours ≥ 1 hour to < 20 hours Not working Types of Goals Set 12% 32% 21% 25% 10% Work Staying Ac ve Healthy Ea ng Medical/Health Personal Types of Employment Goals 36% 33% 17% 10% 4% Improve/Increase Employment Comple ng Work Responsibili es Work/Life Balance Educa on Other [email protected] [email protected] Contact Us:
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