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Health coaching helps community health workers overcome barriers

Community health workers

As anyone who has ever tried to set and achieve a health goal knows, making change is almost never easy. Help can come from community health workers (CHWs), who serve as “a guide by the side of patients,” in the words of Megan Nieto, co-founder of MN-based CHW Solutions. Their team of community health workers helps people navigate the complexities of appointments, diagnoses, insurance, medications, and ongoing self-management of their health conditions. 

But Megan described that even with the support of a community health worker, patients sometimes hit a wall. Renee Gust, Senior Health Promotion Specialist with Hennepin County Public Health, teaches health coaching techniques that enable community health workers to break through barriers and help patients feel ready and able to change. 

When “advise and prescribe” isn’t enough

A registered nurse, Renee first became interested in health coaching in 2013. At the time, she was helping healthcare providers better manage their patients’ health through preventive care. Clinicians knew how to “advise and prescribe," but they needed better tools and language to help their patients with chronic conditions like high blood pressure or diabetes. 

The county brought in an expert from the Center for Excellence in Primary Care (CEPC) at University of California-San Francisco to train Renee and several colleagues on health coaching. Health coaching uses motivational interviewing techniques, action plans, and frequent follow-up. These tools help people clarify their health goals, create a plan to achieve them, and then deal with challenges as they arise.

That same year, Renee began offering one-day trainings on health coaching at clinics across the county. The trainings were a hit: From 2013 to 2020, Renee trained about 100 people annually. Trainees learned and practiced the skills needed to support their patients through the ups and downs of managing their health. 

Adapting to a virtual training model

When the pandemic started in early 2020, safety concerns and staffing issues meant clinics could no longer hold day-long, in-person trainings. But Renee knew there was as much need as ever, especially as evidence grew that people with chronic health issues like diabetes were more vulnerable to COVID-19's worst effects. In 2021, she took the most critical points from her day-long training and created a one-hour, virtual training on health coaching. She supplemented the health coaching training with one-hour trainings on nutrition and physical activity.

health coaching open ended questions

A slide from Renee’s introduction to health coaching training shows the four fundamental questions of health coaching.

Renee initially offered the virtual trainings in partnership with the Minnesota Department of Health. After these first sessions, she received many requests from clinics to offer the virtual trainings for their staff. She has since trained hundreds more people at dozens of organizations.

Health coaching helps people overcome health barriers

For CHW Solutions’ Megan Nieto and co-founder Megan Ellingson, Renee’s health coaching trainings have given their team a whole new set of tools. Over the past 6 months, Renee has met with the community health workers twice each month to take the trainings even deeper.

Renee delivers the trainings in an engaging, accessible, and motivating way. Nieto and Ellingson say Renee's training style helps the community health workers feel confident that they have what they need to be good coaches. Community health workers don't have to know everything about every health condition. Instead, Renee encourages community health workers to model behaviors like being curious about a health condition and seeking out reputable information about it. These behaviors help patients navigate uncertainty and feel empowered.

Nieto described health coaching as a method for community health workers to “roll with resistance” and keep moving through the challenging parts of a patient’s health journey. Some of these challenges are when they may not want to change, not know where to start, or feel that they cannot overcome a barrier. 

While Renee will retire in the spring of 2023, the impact of her work will continue through the hundreds of people she has trained and the thousands of patients’ lives that they touch through health coaching.

If you’re interested in learning more about health coaching training or Public Health Promotion’s other healthcare-related work, please reach out to Alissa Walden at