Identifying patients’ health and social needs for preventive interventions within a hospital setting

Abstract Aim To evaluate the referrals by in-hospital lifestyle coaches on satisfaction and adherence, and describe patient characteristics per specific advice. Subject and Methods This prospective cohort study included patients referred to an in-hospital lifestyle coach in a large teaching hospital in the Netherlands from September 6, 2023 to December 12, 2024. Patient demographics, lifestyle- and clinical characteristics assessed prior or during the consultation, Positive Health Questionnaire scores, intrinsic motivation, personal limitations, lifestyle coach’s advice, and adherence to the advice were extracted from the electronic medical record. Other characteristics and satisfaction were obtained through questionnaires. Results Patients referred to in-hospital lifestyle coaches often have a high body mass index, a low income, and low self-efficacy. Most patients need physical functioning and nutrition support. After 4 weeks, 83% of the patients were satisfied with the received advice, and 16% of the patients did not (yet) apply the advice in daily practice. Potentially relevant factors to determine the advice include body mass index, age, income, and smoking. Conclusion This study shows that in-hospital lifestyle coaching provides an opportunity to screen and refer patients to health and social services, particularly for the ones having a low income, low digital health literacy, and low self-efficacy. The link between patient characteristics and domains of the advice indicates which aspects to incorporate in a future digitalized, automated screening and referral tool. Future research should focus on triaging patients for automated referral to effectively use lifestyle coach capacity amid high demand for care and a tight labor market.