Virtual coaching program transforms chronic disease prevention and management

In late 2020, Sandi Reis was at home on Cortes Island reading her local paper when she noticed an article about a program encouraging people to live a healthy lifestyle through physical activity and wellness. Called HealtheSteps, the free, evidence-based program is now delivered virtually, adapting to the reality brought about by the COVID-19 pandemic. It was just what Sandi had been looking for.

Sandi Reis and friends

“I had gained 30 pounds during the pandemic that I called the ‘COVID 30’ and I felt like I needed to get moving,” Sandi recalls. “The program sounded perfect for me.”

Dr. Robert Petrella, head of the faculty of medicine’s department of family practice, developed HealtheSteps with funding from the Public Health Agency of Canada to address the need for a program focused on physical activity and healthy eating as a preventative measure and treatment for many chronic diseases.

“Despite some evidence from controlled research studies supporting the impact of adopting a healthy lifestyle, there was very little research overall and very few programs available for patients and their physicians to apply the research,” Dr. Petrella says. “This gap led to my own research to develop simple, evidence-based tools and skills for family doctors, their health-care teams and patients to implement lifestyle change that was effective and long lasting.”

Dr. Petrella says HealtheSteps, which sees participants set their own goals, is effective in improving a range of important health indicators over the short term – about six months – and longer term. The program was designed to be delivered by health care providers working in existing team-based care settings.

Coach-participant partnerships

Dr. Robert Petrella

Participants like Sandi are screened before enrolling to ensure it is safe for them to participate. After being screened, participants are matched with a coach before beginning six interactive sessions. Coaches work with participants to create prescriptions in four key areas: exercise levels (moderate to vigorous activity), physical activity levels (daily step counts), healthy eating and mindfulness.

Sandi’s HealtheSteps coach, Arielle Roberts, took part in the program while she was a fourth-year medical student at the faculty of medicine’s Island Medical Program. As Arielle has had a longstanding interest in exercise and studied kinesiology, the HealtheSteps coaching opportunity was a well-suited course elective for her.

“As we counsel patients about exercise, we need to meet people where they’re at and learn about the process of helping patients be more active,” she says. “I’ve always wanted to include this in my practice. This was a great opportunity to dive into that world.”

Sandi says the coaching element is a real strength of the HealtheSteps program.

Arielle Roberts

“I really liked having someone to talk to and encourage me,” she says. “What I loved about Arielle was that she always gave me good ideas. If I was struggling with something, she always had suggestions about what I could do.”

Each session has evidence-based resources to support participants making changes to their lifestyle. Participants can also download the HealtheSteps app, which includes a built-in fitness tracker, a virtual coach, and the STEP test, which can be conducted at home.

Sandi says the virtual format of HealtheSteps was helpful, particularly during the COVID-19 pandemic.

“It’s a nice framework without the pressure of a rigidly prescribed program,” she says. “It guided me, it didn’t obsess me. I could really focus and take the time to be healthy.”

Improving health across Canada

The HealtheSteps program is now expanding across educational groups of allied health learners and practitioners at clinics and is being adopted by divisions of family practice across B.C. and other provinces.

“In addition to training family physicians and allied health providers already in practice, we grasped the opportunity to have formal undergraduate experiences for medical and kinesiology students at UBC and Western University, and are expanding to other medical schools, while patients are being referred by an expanding network of primary care teams,” Dr. Petrella says. “This has met the need for university curricula to address healthy lifestyles and also increased access for patients wherever they live through virtual delivery of HealtheSteps.”

Arielle is now a UBC family medicine resident on Vancouver Island and says she hopes to recommend future patients to the HealtheSteps program.

“People may look at a healthy lifestyle as a huge Mount Everest-sized challenge, but we know from the literature that anything a person does to be more active, every step on that journey has health benefits,” she says. “HealtheSteps has someone go with you on the first steps of that journey.”

To learn more or to become a coach or participant, visit HealtheSteps.ca.