Integrating coaching into digital behavioral interventions: a scalable training model and fidelity evaluation

Digital interventions offer scalable solutions for program accessibility but face challenges with engagement and adherence. Hybrid delivery models integrating human support through coaching may enhance engagement outcomes, which can improve intervention or clinical outcomes.

This study describes a structured, intervention-agnostic coaching model and associated training procedures designed to reinforce digital intervention content without requiring specialist expertise. It evaluates the feasibility, fidelity, and acceptability of the coaching model, including participant satisfaction.

Parents of toddlers born very preterm (n = 113) received digital parent training or health education paired with weekly coaching calls. Eleven coaches from diverse educational backgrounds completed a standardized training protocol. Feasibility was assessed via observations and coach self-report of adherence and competence. Acceptability was evaluated through parent satisfaction surveys. Descriptive analyses summarized fidelity, engagement, and program completion.

Coaches demonstrated high adherence (M = 94.9%) and competence (M = 88.9%) across 266 observed calls, with minimal variance. Parent call engagement was rated high (M = 2.70; 3-point scale). Most parents (75%) attended ≥6 of 11 coaching calls, and 64% completed all 6 digital program modules. Satisfaction was strong, with 93.6% of parents reporting being satisfied or very satisfied, and over 70% felt connected to their coach. Calls were brief (M = 12.9 minutes), supporting feasibility for busy families.

An intervention-agnostic coaching model delivered by non-specialists was feasible and acceptable for parent participants. Development of a standardized coaching manual and testing across additional digital interventions are planned to enhance scalability and replication.

NCT05217615; ClinicalTrials.gov.