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Person-centered Health Coaching in a Scottish Prison Population: Findings at Training Completion

Ayse Basak Cinar


Introduction: People in Scottish prisons (PSP) have poorer health than the general population. The promotion of health and wellbeing in prisons is a central aim of Scottish Government policy.

Objective: This study was aimed at designing, implementing and evaluating person-centered health coaching (HC) training to improve PSP´s health and related psycho-social skills.

Methods: PSP were trained as health coaches, as part of National Health Service (NHS) Scotland’s oral health prison intervention, termed Mouth Matters (MMs). A unit of MM involving HC is named PEPSCOT. Here PSP were trained by a qualified coach over a three-month period to become health coaches; 8, 4 and 4 whole day training took place respectively during the first, second, third month of training. Self-assessment questionnaires and diaries were used before, during and after the HC training to test the extent to which HC works to improve PSP´s health and related psycho-social variables. The outcome measures analyzed in the present study were self-assessed health and behaviors, self-efficacy, self-esteem, depression, and usefulness of the program. Follow-up data will be collected in September 2016 for further assessment of the impact of HC.

Results: The baseline data showed that the majority of the participants were from low socio-economic status, and reported a moderate level of health. Data showed later that when compared with baseline levels two of the outcome variables (self-esteem and self-efficacy) improved significantly (p<0.001) at the mid-training point, and that all four outcome variables (also including self-assessed health and depression) improved significantly (at least p<0.05) at the completion of training. Participants’ positive evaluation of the training was significantly correlated with improved health and psychological measures (p<0.05).

Conclusions: Health Coaching training represents a new person-centered approach that appears to enhance self-assessed health, mood, self-esteem and self-efficacy among prisoners in Scotland, and also to enable transitions from negative to positive concerning beliefs, values, and self-evaluations. There is however a need for further studies at a larger scale.


Health coaching, person-centered approach, oral health, prisons, health promoting prisons, WHO, health and behavior, psychological measures, mood, self-esteem, self-efficacy, people in prison

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. WHO. (2015). WHO global strategy on people-centered and integrated health services. Interim report Geneva, Switzerland: WHO Document Production Services. Available at:

. (WHO/HIS/SDS/2015.6 World Health Organization 2015) (last accessed 26 January 2016).

. WHO. (2016). Types of healthy settings. Available at: (last accessed 26 January 2016).

. WHO (1986). The Ottawa Charter for Health Promotion. Milestones in Health Promotion Available at: (last accessed 26 January 2016).

. Earle S, Lloyd CE, Sidell M, Spurr S (eds) (2007).Theory and Research in Promoting Public Health. London: Sage/Milton Keynes, The Open University.

. Department of Health, UK. Care Act (2014). Statutory guidance for implementation. Available at (last accessed 26 January 2016).

. Woodall J (2012). Health promoting prisons: an overview and critique of the concept. Prison Service Journal. 202: 6-11.

. WHO (1998). Mental health promotion in prisons. Report on a WHO meeting. Copenhagen: WHO.

. WHO. (2014). Europe Guide on Prison and Health. Available at: health/publications/2014/prisons-and-health.pdf] (last accessed 26 January 2016).

. WHO Europe (2007). Health in prisons. A WHO guide to the essentials in prison health. Available at: (last accessed 26 January 2016).

. Everington T. (2013). Healthier people safer communities: working together to improve outcomes for offenders. Available at:] (last accessed 26 January 2016).

. Scottish Prison Service (2011). Better health, better lives for prisoners: A framework for improving the health of Scotland’s prisoners. Available at: (file:///C:/Users/acinar/Downloads/Better%20Health%20Better%20Lives%20Health%20Improvement%20Framework%20Document%20(3).pdf]. (last accessed 26 January 2016).

. Akbar T, Turner S, Themessl-Huber M, Richards D, Freeman R (2012). The health promoting prison can it improve oral health? An evaluation of an oral health improvement project for high security prisoners. International Journal of Health Promotion and Education 50: 169-177

. WHO. (2014). Europe Guide on Prison and Health. Available at: health/publications/2014/prisons-and-health.pdf (last accessed 26 January 2016).

. Cinar AB, Schou L (2014). Health promotion for patients with diabetes: Health coaching or health education? International Dental Journal. 64:20-28.

. Cinar AB, Schou L (2014). The role of self- efficacy in health coaching and health education for patients with type 2 diabetes. International Dental Journal. 64:155-163.

. Mouth Matters. (2014) Available at: (last accessed 26 January 2016).

. Van Ryn M, Heaney C.(1997) Developing Effective Relationships in Health Education and Practice, Health Education Behavior. 24: 683-702.

. International Coaching Community (2007) Coaching Certification Training. Available at: (last accessed 26 January 2016).

. Von Bertalanfly L (1969). General System Theory: Foundations, Development, Applications. New York, NY: George Braziller.

. Rogers C (1951). Client-centered therapy: Its current practice, implications and theory. London: Constable.

. Rogers C (1959). A theory of therapy, personality and interpersonal relationships as developed in the client-centered framework. In (ed.) S. Koch, Psychology: A study of a science. Vol. 3: Formulations of the person and the social context. New York: McGraw Hill.

. Rogers CR (1961). On becoming a person: A psychotherapist’s view of psychotherapy. Houghton Mifflin, 1961.

. Rogers CR, Stevens B, Gendlin ET, Shlien JM, Van Dusen W (1967). Person to person: The problem of being human: A new trend in psychology. Lafayette, CA: Real People Press.

. Tosey P, Mathison J. (2006). Introducing Neuro-Linguistic Programming [online document]. Centre for Management Learning & Development, School of Management, University of Surrey. Available at: (last accessed December 2015).

. Maturana HR, Varela FJ (1991). Autopoiesis and cognition: The realization of the living. Springer Science & Business Media.

. Elaine Cox (2013). Coaching understood: a pragmatic inquiry into the coaching process. Los Angeles; London: SAGE.

. Beck JS (1955). Cognitive therapy: Basics and beyond. New York: Guilford Press.

. Neenan M, Palmer S. (2001) Rational emotive behavior coaching. Rational Emotive Behavior Therapist. 9(1): 34–41.

. Goleman D (1996). Emotional Intelligence: Why it can matter more than IQ mass market. London: Bloomsbury Publishing.

. Miller R, Rollnick S (2002). Motivational Interviewing – Preparing people for change. New York: the Guilford Press. p. 428.

. Bandura A (1997). Self-Efficacy: The Exercise of Control. New York: W.H. Freeman and Company. p. 604.

. Lars Eric Unestahl. Mental training (1996). Available at: (last accessed 26 January 2016).

. Cinar AB, Oktay I, Schou L (2014). Smile healthy to your diabetes: health coaching-based intervention for oral health and diabetes management. Clinical Oral Investigations. 18:1793-801.

. Bandura A. Self-Efficacy (1997): The Exercise of Control. New York: W.H. Freeman and Company. P. 604.

. Cinar AB, Kosku N, Sandalli N, Murtomaa H. Self-Efficacy perspective on oral health among Turkish preadolescents. Oral Health and Preventive Dentistry. 2005; 4: 209-15.

. Cinar AB, Oktay I, Schou L (2014). Self-efficacy perspective on oral health behavior and diabetes management. Oral Health and Preventive Dentistry. 10:379-87.

. Macgregor IDM, Balding JW (1991). Self-esteem as a predictor of toothbrushing behavior in young adolescents. Journal of Clinical Periodontology. 18: 312-6.

. Cinar AB (2008). Preadolescents and their mothers as oral health-promoting actors: Non-biologic determinants of oral health among Turkish and Finnish preadolescents, doctorate thesis. University of Helsinki, Helsinki.

. Whooley MA, Avins AL, Miranda J, Browner WS (1997). Case-finding instruments for depression. Two questions are as good as many. Journal of General Internal Medicine. 12: 439-45.

. Hoyle Rick H (1999). Statistical Strategies for Small Sample Research. SAGE Publications.

. Etz KE, Arroyo JA (2015). Small Sample Research: Considerations beyond Statistical Power. Preventive Science.16:1033–1036 DOI 10.1007/s11121-015-0585-4

. Faul F, Erdfelder E, Lang A.-G, Buchner A (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods. 39:175-191.

. Faul F, Erdfelder E, Buchner A, Lang A-G (2009). Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods. 41:1149-1160

. NHS. (2014). Does health coaching work? A rapid review of empirical evidence. Available at: (last accessed 12 April 2016).

. Chromy JR, Abeyasekera S (2005). Chapter 19: Statistical analysis of survey data. In Household Sample Surveys in Developing and Transition Countries. United Nations, Department of Economic and Social Affairs.

. Cinar AB (2015). New patient centered approach to unlock the individual`s potential to adopt healthy lifestyles: Health coaching. The International Journal of Person-Centred Medicine. 5: 182-191.

. Bagnall AM, South J, Hulme C, Woodall J,Vinall-Collier K, Raine G, Kinsella K, Dixey R, Harris L, Wright NM (2015). A systematic review of the effectiveness and cost-effectiveness of peer education and peer support in prisons. BMC Public Health. 15: 290.

. Brooker S (2007). New futures Health trainers: an impact assessment. Lincoln: University of Lincoln.

. Sirdifield C (2006). Piloting a new role in mental health – prison based health trainers. Journal of Mental Health Workforce Development. 1(4):15–22.

. Wright N, Bleakley A, Butt C, Chadwick O, Mahmood K, Patel K, Salhi (2011). A. Peer health promotion in prisons: a systematic review. International Journal of Prison Health. 7(4):37–51.

. Höjdahl T, Magnus JH, Mdala I, Hagen R, Langeland E (2015). Emotional distress and sense of coherence in women completing a motivational program in five countries. A prospective study. International Journal of Prison Health. 11(3):169-82.

. Naik S, Khanagar S, Kumar A, Ramachandra S, Vadavadagi SV, Dhananjaya KM (2014). Assessment of effectiveness of smoking cessation intervention among male prisoners in India: A randomized controlled trial. Journal of International Society of Preventive and Community Dentistry. 4(Suppl 2):S110-5.

. Jalali F, Afshari R, Babaei A, Abasspour H, Vahedian-Shahroodi M (2015). Comparing Motivational Interviewing-based treatment and its combination with nicotine replacement therapy on smoking cessation in prisoners: a randomized controlled clinical trial. Electron Physician. 7(6):1318-24.

. Alemagno SA, Stephens RC, Stephens P, Shaffer-King P, White P (2009). Brief motivational intervention to reduce HIV risk and to increase HIV testing among offenders under community supervision. Journal of Correctional Health Care. 15(3):210-21.

. Dunn AL, Trivedi MH, Kampert JB, Clark CG, Chambliss HO (2005). Exercise treatment for depression: efficacy and dose response. American Journal of Preventative Medicine. 28 (1): 1–8.



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