Process evaluation of the HealtheSteps™ lifestyle prescription program

Physical inactivity, sedentary behavior, and poor diet are contributing to the rise in chronic disease rates throughout the world. HealtheSteps™ is a lifestyle prescription program focused on reducing risk factors for chronic disease through in-person coaching sessions, goal setting and tracking, and technology supports. A process evaluation was conducted alongside a pragmatic randomized controlled trial to: (a) explore the acceptability of HealtheSteps™ program from coach and participant perspectives; and (b) identify where the program can be improved. Participants at risk or diagnosed with a chronic disease were recruited from five primary care/health services organizations into HealtheSteps™. Participants met with a trained coach bi-monthly for 6 months and set goals for physical activity (step counts), exercise (moderate to vigorous activity), and healthy eating. Coaches were interviewed at month 6 and participants at month 12 (6 months postprogram). All coach interviews (n = 12) were analyzed along with a purposeful sample of participant interviews (n = 13). Coaches found that HealtheSteps™ was easy to deliver and recommendations for exercise and healthy eating were helpful. Including discussions on participant readiness to change, along with group sessions, and more in-depth healthy eating resources were suggested by coaches to improve the program. Participants described the multiple avenues of accountability provided in the program as helpful. However, more feedback and interaction during and postprogram from coaches were suggested by participants. HealtheSteps™ is an acceptable program from the perspectives of both coaches and participants with suggested improvements not requiring significant changes to the core program design.