Mobile Behavioral Health Coaching as a Preventive Intervention for Occupational Public Health: Retrospective Longitudinal Study (Preprint)

Abstract

BACKGROUND Researchers have recently proposed Behavioral Health Coaching (BHC) to be effective in promoting proactive care among employees. To qualify as a preventive workplace intervention, however, more research is needed to evaluate whether BHC can further elevate well-being among moderately mentally healthy employees. OBJECTIVE Using real-world data, this retrospective study evaluates the preliminary effectiveness of virtually-delivered BHC against a non-randomized control group with open access to self-help tools in improving well-being (i.e., mood levels and perceived stress). The study also explored which BHC components mediate well-being improvements over time. METHODS Employees residing across Asia-Pacific countries (N = 1,025, Mage = 30.85, SDage = 6.97) who reported “moderately positive mood” and “medium levels of perceived stress” in their first week of using the mental health application (“Intellect”) were included in this study. Users who were provided access by their organizations to Intellect’s BHC services were assigned to the “Coaching” condition (N = 512, Mage = 31.09, SDage = 6.87), while other employees remained as “Control” participants (N = 513, Mage = 30.61, SDage = 7.06). To evaluate preliminary effectiveness, monthly scores from the validated mood and stress sliders were examined using repeated measures conditional growth models. To test the “active ingredients” of BHC, scores from a large subset of “Coaching” users (N = 341, Mage = 31.52, SDage = 7.21) who completed post-coaching items on “Perceived Usefulness of the BHC session” and “Working Alliance with my Coach” were examined using 1-1-1 multilevel mediation models. RESULTS Growth curve analyses revealed significant time by group interaction effects for both mood and perceived stress, where “Coaching” users reported significantly greater improvements in mood and perceived stress than “Control” participants across time (Mood: F1, 1647 = 16.7, ηp 2 =. 02, p = <.0001; Stress: F1, 770 = 4.60, ηp 2 =. 01, p = <.0001). Among the “Coaching” participants, dependent sample t-tests revealed significant improvements in well-being outcomes from baseline to 11 months (Mood: t512 = 2.33, d = .21, p = <.05; Stress: t512 = -2.47, d = -.22, p = <.05). Improvements in client-rated perceptions of “Usefulness of the BHC session” (Mood: ab = .016 – .026, p<.001, 95% Cl .006 – .039; Stress: ab = -.012 – -.011, p<.01, 95% Cl -.024 – -.003) and “Working Alliance” (Mood: ab = .016 – .018, p<.01, 95% Cl .007 – .032; Stress: ab = -.010 – -.009, p<.01, 95% Cl -.021 – -.002) fully mediated within-level well-being enhancements overtime. CONCLUSIONS We found preliminary evidence that BHC is an effective, preventive workplace intervention. At the individual level, clients’ perceived usefulness of each BHC session and working alliance with their coach fully mediated well-being improvements. Mobile-based coaching may be a convenient, cost-effective, and scalable means for organizations and governments to boost public mental health.