Person-centered Health Coaching in a Scottish Prison Population: Findings at Training Completion

Introduction: People in Scottish prisons (PSP) have poorer health than the general population. The promotion of health and wellbeing in prisons is a central aim of Scottish Government policy. Objective: This study was aimed at designing, implementing and evaluating person-centered health coaching (HC) training to improve PSP´s health and related psycho-social skills. Methods: PSP were trained as health coaches, as part of National Health Service (NHS) Scotland’s oral health prison intervention, termed Mouth Matters (MMs). A unit of MM involving HC is named PEPSCOT. Here PSP were trained by a qualified coach over a three-month period to become health coaches; 8, 4 and 4 whole day training took place respectively during the first, second, third month of training. Self-assessment questionnaires and diaries were used before, during and after the HC training to test the extent to which HC works to improve PSP´s health and related psycho-social variables. The outcome measures analyzed in the present study were self-assessed health and behaviors, self-efficacy, self-esteem, depression, and usefulness of the program. Follow-up data will be collected in September 2016 for further assessment of the impact of HC. Results: The baseline data showed that the majority of the participants were from low socio-economic status, and reported a moderate level of health. Data showed later that when compared with baseline levels two of the outcome variables (self-esteem and self-efficacy) improved significantly (p<0.001) at the mid-training point, and that all four outcome variables (also including self-assessed health and depression) improved significantly (at least p<0.05) at the completion of training. Participants’ positive evaluation of the training was significantly correlated with improved health and psychological measures (p<0.05). Conclusions: Health Coaching training represents a new person-centered approach that appears to enhance self-assessed health, mood, self-esteem and self-efficacy among prisoners in Scotland, and also to enable transitions from negative to positive concerning beliefs, values, and self-evaluations. There is however a need for further studies at a larger scale.