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Objective: In this paper, we examine client perspectives of health coaching programs and differences by insurance type. Methods: We used descriptive coding and directed content analysis to analyze semi-structured qualitative in-person interviews that assessed preferred health coach qualifications and experience, desirable attributes for coaches, and interest in having a coach. We recruited participants (N = 140 adults: 61 commercial insurance, 79 Medicaid) without consideration of prior health coaching experience. Results: Participants viewed physicians as the experts on health and valued coaches as supporters of behavior-change efforts that could take a patient's life context into account. Empathetic coaches were expected to motivate and hold patients accountable without taking too much time or being too "pushy." Participants preferred some in-person interaction and differed in preferences for program referral and enrollment approaches. Medicaid beneficiaries had less prior exposure to health coaching, more interest in having a coach, and preferred coaches to provide medical education. Conclusions: Irrespective of prior coaching experience or insurance type, participants agreed on many preferred characteristics of coaches and coaching programs. Understanding client preferences and expectations can help refine the role of health coaches, making them more effective and shaping the way they are presented to potential participants to enhance their appeal and use. [ABSTRACT FROM AUTHOR]

In this study, we conducted telephone interviews with patients in community clinics who had abnormal fecal immunochemical test (FIT) results to identify follow-up colonoscopy challenges. The FIT is an effective colorectal cancer screening method, but its value is contingent on follow-up diagnostic colonoscopy. Methods: We explored barriers at 3 timepoints: (1) abnormal FIT-result communication, (2) scheduling/completion of colonoscopy, and (3) receipt of results. We sought to understand variation in experience by both Spanish and English language patients. Results: We interviewed 32 patients (16 English; 16 Spanish), 66% of whom were women. There were 13 early completers (≤ 2 months after FIT result), 14 later completers (> 2 months after FIT result), and 5 non-completers of the colonoscopy. The greatest challenge was fear of the procedure, expressed more often by Spanish language (SL) participants and later completers. SL participants also cited cost and lack of clear communication about the need for a colonoscopy. English language (EL) participants experienced lack of reliable transportation. Conclusions: Barriers to timely colonoscopy completion following an abnormal FIT can occur at different transitions in care and vary by patient characteristics. Our findings may inform the design of programs to improve colonoscopy completion in safety net clinics. [ABSTRACT FROM AUTHOR]

Objectives: Adolescent health behaviors may be linked to elevated morbidity and mortality in adulthood. This study examines relationships between broad concepts for adverse childhood experiences (ACEs) and adolescent substance use outcomes among youth participating in a statewide, school-based survey. Methods: Data are from 8th, 9th, and 11th graders participating in the 2016 Minnesota Student Survey (N = 126,868). Logistic regression was used to determine whether 10 types of adversity related to abuse, household dysfunction, and food and housing hardship, and 7 types of bully victimization were associated with youth tobacco, alcohol, and marijuana use after adjustment for demographics, risk perceptions, academic engagement, parent communication, self-esteem, and health perceptions. Results: Individual and cumulative measures for adversity were significantly associated with youth increased odds of early substance initiation, binge drinking, and daily tobacco, alcohol, and marijuana use, even with adjustment for demographics and other contextual factors. Conclusions: Findings suggest a significant link between broad concepts for ACEs and adolescent tobacco, alcohol, and marijuana use. Consideration of information related to ACEs may inform timing and content of substance use prevention and intervention activities directed at youth. [ABSTRACT FROM AUTHOR]

The article discusses the authors' assessment of a network of 159 community agencies in Illinois that promote healthy eating and lifestyles among the state's populations with limited resources, and it mentions examinations of the communications, funding, cooperation, and collaboration networks between various agencies in Illinois. According to the article, agencies such as healthcare service providers, housing complexes, and schools need to work together to promote health eating and lifestyles.