Jill Breyen

Date of Award

January 2017

Document Type


Degree Name

Master of Science (MS)


Nutrition & Dietetics

First Advisor

Desiree Tande


Despite increased interest in client-directed counseling methods to manage chronic disease, limited data exists about utilization of counseling skills and attitudes towards these methods among health care providers, specifically those providing care to at risk populations. The aim of this qualitative study was to explore the beliefs and practices of a multidisciplinary group of health practitioners who were trained in health and wellness coaching (HWC) that included motivational interviewing (MI) techniques. The training was sponsored by the Bemidji Area Indian Health Service Health Promotion Disease Prevention (BAO IHS HPDP) program. Forty-seven trained coaches from the BAO IHS HPDP working with American Indian health programs in Illinois, Minnesota, Michigan, and Wisconsin were invited to participate. Participants completed an anonymous, online survey exploring perceptions about and use of HWC in practice. Twenty-seven of the 47 IHS Bemidji Area coaches who qualified for the study completed it. Participants represented nine different health practice areas with the majority working for Tribal Health Programs (22 of 27). Frequent use of coaching techniques, high self-efficacy with the use of HWC skills, and observed improved adherence to treatment and client outcomes were reported. Practitioners believed HWC was an effective method for providing care to patients participating in American Indian health programs. Future research is needed to examine relationships between HWC practice and patient outcomes in populations who are from diverse cultures.