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OBJECTIVE: To explore how clinicians understand coaching and their clinician-coach practice in emergency medicine. METHODS: Participants were surveyed about the value of coaching and their beliefs about the enablers of, and barriers to, being a clinician-coach. RESULTS: Three themes were developed for the value of coaching: empowerment and growth; enhanced interpersonal dynamics; and reflective transformation. Key enablers were supportive infrastructure, self-driven development and recognition of value. Key barriers were time constraints and scheduling conflicts, cultural challenges and financial and structural obstacles. CONCLUSIONS: Fostering a supportive environment for coaching could significantly enhance clinician competence and well-being, healthcare delivery and professional development.

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INTRODUCTION: Emergency department (ED)-based peer recovery coach (PRC) programs can improve access to substance use disorder treatment (SUD) for ED patients. As literature on early stages of PRC implementation is limited, we conducted a qualitative assessment of ED PRC program implementation from several US-based PRC programs focusing on barriers and facilitators for implementation and providing recommendations based on the findings. METHODS: We collected qualitative data from 39 key informants (peer recovery coaches, PRC program managers, ED physicians and staff, representatives of community-based organizations) via 6 focus groups and 21 interviews in February-December 2023. We transcribed audio-recordings and analyzed data using codebook thematic analysis. RESULTS: We identified the following major themes related to specific barriers and recommendations to address them. To facilitate timely linkage to PRCs, programs would regularly inform ED staff about the program and its linkage procedures, establish trust between PRC and ED staff, streamline the linkage procedures, and choose an "opt-out" linkage approach. To address barriers related to external referrals, programs use "warm handoff" and "warm line" strategies, maintain and update a comprehensive catalog of resources, and familiarize peer coaches with local service providers. Telehealth services implementation requires addressing logistical barriers, ensuring patients' privacy, and training peer coaches on building trust and rapport online. Peer coaches' wellness and quality of services can be improved by limiting PRC's workload, prioritizing quality over quantity, facilitating self-, peer- and professional care to mitigate stress and burnout; and, importantly, by providing supportive supervision and training to peer coaches and advocating for PRC team as an equal partner in the ED settings. To facilitate PRC program adoption and sustainment program managers engage local communities and program champions, seek diverse sources of funding, and advocate for structural changes to accommodate recruitment and retention of peer recovery coaches. CONCLUSIONS: We compiled a wealth of best practices used by PRC programs to address numerous implementation barriers and challenges. These recommendations are intended for PRC program planners, managers and champions, hospital leadership, and state and local public health agencies leading SUD epidemic response.

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Peer recovery coaches (PRCs) are increasingly playing a role in helping patients with substance use disorders engage with treatment. PRCs can support and motivate patients in meeting their self-defined recovery goals, engaging in addiction treatment, navigating the health care system, and overcoming barriers to recovery. This support increases patient engagement and is cost-effective. Little has been written about integrating PRCs in health care settings. In this column, the authors describe the implementation of a PRC program with 23 coaches serving 5,662 participants in diverse clinical settings. The authors discuss key facilitators and barriers and opportunities for further research.

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Background: A growing evidence base supports the value of peer recovery support specialists (PRSS), particularly due to shared lived experience with participants (recipients of PRSS services). However, little research has examined whether congruence on certain aspects of "peerness" (e.g., demographics, experiences) matters for PRSS-participant relationships. Methods: Through a pilot study under the NIDA-funded Initiative for Justice and Emerging Adult Populations (JEAP), adults who had recently received PRSS services (N=100) were interviewed. Participants completed a modified version of the Scales for Participant Alliance with Recovery Coach (SPARC), a measure of PRSS-participant relationship quality, and rated themselves as different/similar to their PRSS in several domains using a six-point scale. Results: Participants had met with their PRSS for a median of 10 sessions over two months. SPARC scores were unrelated to participant demographics or lived experiences. However, better-quality relationships were reported by participants who believed their PRSS was similar to them in relationships with family (p=.004), spirituality/religion (p=.001), age (p<.001), and overall recovery pathway (p<.001). Total SPARC scores were not significantly correlated with perceived PRSS-participant similarities on gender, race/ethnicity, substances of choice, and history of incarceration or substance use treatment. Discussion: Results from this pilot study suggest that PRSS-participant alignment on past experiences (e.g., prior incarceration, choice of drugs) may not be needed to establish good-quality working relationships. However, similarities on factors related to current life stage (e.g., age, family relationships) and/or recovery process (e.g., overall pathway, spirituality) may be more important. Future research should employ mixed-methods approaches to elucidate these unique findings.

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Obesity is a significant public health issue in Saudi Arabia, contributing to high morbidity and mortality rates. This study aimed to identify the barriers preventing obese patients from adhering to healthy diets and regular exercise while following a health coach in primary healthcare centers in Al-Ahsa. A cross-sectional study of 283 obese adults revealed that major barriers included lack of energy, willpower, and time for exercise, as well as lack of willpower, social influence, and time for maintaining a healthy diet. These barriers were significantly associated with demographic factors such as obesity grade, comorbidities, and educational level. Addressing these barriers is essential for developing effective interventions to support lifestyle changes in obese patients.

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Introduction: This study evaluates the effectiveness of the Project SCORE intervention in fostering Positive Youth Development (PYD) within competitive youth sport settings in Portugal. Project SCORE is an online PYD-focused tool developed to assist coaches in promoting the 4Cs-competence, confidence, connection, and character-within their coaching. Methods: The research involved 13 coaches and 70 youth athletes from football and rowing teams. Methodologically, this study analyzed the pre- and post- Project SCORE intervention data, assessing the perceptions of coaches and athletes towards the development of the 4Cs. Results: Results indicated significant improvements in athletes' perceptions of 4Cs post-intervention, and among coaches' perceptions, there was a significant improvement in the practice and transfer of life skills. Particularly, coaches showed enhanced abilities in fostering life skills and facilitating the transfer of these skills to competitive environments, although some dimensions like sport climate did not sustain positive changes. Discussion: The findings highlight the benefits of customized PYD-based programs in competitive youth sports and suggest the need for further research to enhance their widespread and consistent implementation.

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Purpose: Athlete burnout is an adverse factor that usually decreases athletes' sports performance and reduces their passion for athletic career development. The present study examined the association of coach-athlete relationship, training satisfaction, and athlete burnout, and then explored the training satisfaction as a mediating role of the effect of coach-athlete relationship on athlete burnout among college soccer players. Methods: Soccer players from seven Chinese higher education institutions were recruited for the study. The participants were selected using stratified random sampling and included 218 participants. The Coach-Athlete Relationship Scale, Training Satisfaction Scale, and Athlete Burnout Questionnaire were used to collect data from the participants. Pearson's product-moment correlation analysis, linear regression analysis, and bootstrap method were conducted to analyze the collected data set. Results: The results showed that (1) there was a significant correlation between coach-athlete relationship, training satisfaction, and athlete burnout. (2) coach-athlete relationship and training satisfaction significantly negatively predicted athlete burnout (ß = -0.39, p < 0.001; ß = - 0.29, p < 0.001). (3) training satisfaction had a significantly mediating effect on the relationship between coach-athlete relationship and athlete burnout (ß = -0.15, p < 0.001, ES = 0.28). Conclusion: Coach-athlete relationship can not only directly negative impact athlete burnout but can also negatively influence athlete burnout through the mediating effect of training satisfaction. Therefore, we suggest the following to alleviate athlete burnout: on one hand, coaches can provide more communication opportunities for athletes to improve the coach-athlete relationship. On the other hand, teams can enhance training satisfaction by building team culture.

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Introduction: The autonomy-supportive coaching style is recognized for its positive impact on athletes' well-being and performance. However, the transition of excessive autonomy into a laissez-faire coaching style has not been thoroughly examined within the context of coach evaluation scales. Existing scales focus predominantly on the positive dimensions of autonomy support, and do not possess the capabilities to measure outcomes which may be viewed as negative or other outcomes. This study aims to integrate the autonomy-supportive and laissez-faire coaching styles within the same measurement framework. Methods: Our study developed a comprehensive scale to assess both the autonomy-supportive and laissez-faire coaching styles, drawing on items from the Sport Climate Questionnaire for autonomy support and adapting items from leadership research for laissez-faire coaching. We conducted two studies: the first with 148 athletes to refine the laissez-faire items and the second with 460 athletes to validate the full scale, utilizing exploratory factor analysis, confirmatory factor analysis, and correlation analysis. We also measured internal consistency and split-half reliability. Results: The finalized scale includes a 6-item autonomy-supportive subscale and a 5-item laissez-faire subscale. Validation processes confirmed the scale's construct and criterion validity, alongside its reliability. Discussion: The Chinese Coaches' Autonomy-Supportive-Laissez-Faire Coaching Style Scale effectively captures both the beneficial and potentially detrimental aspects of coaching styles, addressing a critical gap in the literature and providing a reliable tool for evaluating coaching approaches.

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Background: Neuromuscular training (NMT) programs delivered by trained personnel have demonstrated protective effects against anterior cruciate ligament (ACL) injury among high school sports participants, but few studies have investigated the impact of education on high school sports coaches' knowledge and incorporation of NMT programs into daily practice sessions. Purpose: We sought to evaluate changes in knowledge and behavior among high school sports coaches who completed an NMT-based injury prevention training program. Methods: High school sports coaches were invited to complete a free online training course in incorporating NMT into daily practice sessions. Anonymized surveys were administered before and after education and at 3 months to evaluate knowledge level and program effectiveness. Results: Of the 13,640 coaches who enrolled in the training course in 2019, 1641 submitted pre- and post-education and 3-month follow-up surveys. Prior to training, 4.4% reported incorporating NMT into daily training sessions and the mean knowledge score was 1.89 ± 1.55. After training, 92.7% of participants reported that they intended to incorporate NMT into their daily training sessions and the mean knowledge score was 4.87 ± 1.11. At 3-month follow-up, 88.9% of participants reported incorporating NMT into daily training sessions. A chi-square test revealed a significant association between pre- and post-education incorporation of NMT into daily practice sessions, and a multiple regression analysis resulted in a significant model with intent to incorporate NMT into daily practice sessions identified as a significant behavior predictor. Conclusion: These survey results show that completion of a training course significantly improved ACL injury prevention knowledge among a cohort of high school sports coaches and likely contributed to the sustained incorporation of NMT into their daily practice sessions.

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This study illuminates the complex relationship between cultural orientation towards collectivism, emotional regulation skills, cognitive reappraisal ability, sports engagement, perceived coach support, and sports self-efficacy in Chinese athletes' performance satisfaction. Seven hundred and fifty athletes from Guangdong, Jiangsu, and Sichuan completed 5-point Likert scale assessments. The study employed structural equation modeling (SEM) to analyze variable connections. The results reveal significant relationships between performance satisfaction and cultural orientation towards collectivism (ß = 0.35, p < 0.001), emotional regulation skills (ß = 0.28, p < 0.001), cognitive reappraisal ability (ß = 0.32, p < 0.01), sports engagement (ß = 0.20, p < 0.05), perceived coach support (ß = 0.25, p < 0.01), and self-efficacy in sports (ß = 0.30, p < 0.001). These findings underscore the importance of psychological factors in shaping athlete well-being and performance satisfaction. These relationships linked the self-determination theory, social support theory, and the transactional model of stress and coping. Treatments that improve athlete self-efficacy, emotional control, and coach-athlete relationships may improve player happiness, retention, and organizational performance. These actions affect management and the economy. A supportive environment and athlete development initiatives may boost athlete well-being and performance, leading to long-term sports success and competitiveness.

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Tennis coaches display significant influence, catalyzing changes in athlete performance, motivation, and overall well-being. Research on coaches' motivations and their impact on coaching style, work, and well-being is limited, especially in individual sports like tennis. Based on self-determination (SDT) and achievement goal (AGT) theories, the aim of the present study was to examine the relationships of coaches' self-determined motivation (intrinsic, extrinsic, and amotivation), basic psychological needs satisfaction (autonomy, relatedness, and competence), and achievement goals (self-improvement-SI, self-enhancement-SE, self-transcendence-ST) with their coach-created empowering-disempowering motivational climate, work engagement, and well-being (subjective vitality). Participants were 106 tennis coaches from Greece (66 males and 40 females), with an average age of 41.30 ± 12.54 years and coaching experience ranging from six months to 40 years. Data was collected through online questionnaires. Correlation analysis revealed that intrinsic and extrinsic motivation, satisfaction of the three basic psychological needs, and achievement goals were found to be positively related to an empowering climate, work engagement, and subjective vitality. Coaches' amotivation was positively related to a disempowering climate. Multiple regression analyses showed that autonomy and ST achievement goals significantly predicted tennis coaches' empowering motivational climate, while none of the independent variables were significant predictors of the disempowering motivational climate. Additionally, intrinsic motivation and ST goal significantly predicted tennis coaches' work engagement, while autonomy and ST goal significantly predicted their subjective vitality. It is advisable for forthcoming coach education initiatives to consider these findings as an additional justification for tennis coaches to incorporate multiple perspectives into their coaching methodologies.

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Coaches' role in athletes' eating pathology has been largely understood according to athletes' accounts of the coaching behaviors and practices that harmed them. Uniquely, this study engaged coaches as research participants to more fully inform future intervention efforts. Using a multiparadigm approach, this study explored how coaches' understood, constructed, and communicated sport-related body ideals with their female athletes through specific coaching behaviors and practices along with systems of influence and interaction that informed them. Ten coaches (Mage= 35.6) of female aesthetic sport athletes were interviewed. Data were analysed via interpretive description. Results indicated coaches' negative experiences as athletes themselves informed their intention to prevent harm with athletes they coached. Coaches nonetheless emphasized weight, shape, size, and appearance ideals steeped in sport tradition. Dissonance was salient between wanting to prevent harm using strategic approaches to body-related communication, while also reinforcing body ideals believed to promote high performance. Yet, neither athletes' performance goals nor prevention of harm were attained. Influences across coaches' ecosystems explained their behaviors and practices. A novel framework is proposed to describe five intersectional body ideal orientations embodied by the coaches, ranging from body ideal conformity to body diversity advocacy. This framework can inform coach-centered, systems-based education and research.

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The process of athlete selection and deselection in sport involves not only athletes but also coaches, managers, performance directors, talent pathway coordinators and the wider organisation. Athlete selection and deselection can be viewed as the opposite sides of the same coin in that the process may be the same for all athletes but the outcome is very different. The outcome of this process can evoke extremely powerful emotions ranging from elevation to devastation. While selection and deselection are part of competitive sport regardless of type, level, gender or age, research is scarce. Employing the Delphi method, a total of 20 participants comprised the expert panel (coaches, athletes and other key personnel in high performance) from various sports, and ages ranged from 21 to 59 years old. Following three rounds, 60 items reached the pre-determined consensus level of 75%. The 60 items were then further content analysed and grouped with respect to the three key stakeholders: athlete (14), coach (21) and organisation (25). Within each of these categories, subcategories emerged: personal, interpersonal, procedural, educational, supportive, communicative and reviewing behaviours and actions that athletes, coaches and organisations can take to ease the navigation, apply consistency and establish a common ground during this challenging situation.

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Coaching in academic medicine may be used for performance improvement as well as personal and professional growth and development. Medical faculty used to advising and mentoring learners may find it challenging to transition to coaching. Limited information is available about educating physicians to take on the role of coaching. We investigated a faculty coach training program at an academic medical center, using qualitative methods to explore how participants' perceptions of the training aligned with the elements of Self-Determination Theory (SDT) and Intentional Change Theory (ICT) that were taught using the principles of Experiential Learning Theory (ELT). Based on findings that illuminated understanding and practice of coaching, it may be summarized that the application of experiential learning may be an effective approach in helping faculty embrace the principles of SDT and ICT and make the shift to transformational coaching.

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This research examines image and performance-enhancing drug (IPED) use, specifically focusing on the emerging role of IPED coaches. Situating drug use within broader assemblage theory, we investigated how these coaches, often operating in an online context, function as enabling environments, influencing practices, and contributing to harm reduction in a broader social context within and for IPED communities. Ten IPED coaches were interviewed, with this work focusing on their legal, ethical, and moral considerations, risk assessment, and harm reduction strategies of their practices. We employed a critical realist approach, following flexible coding to identify and develop themes which were further framed an enabling environments framework. Coaches operated along an ethical tightrope, emphasising the conscious regulation of conduct within established norms and the nuanced assessment of risks aligned with individual goals and motivations. Power dynamics and responsibility concerns unfolded through the lens of collaborative decision-making, where trust emerged as an essential element of these relations within contextual risk assessments. IPED coaches play a role in harm reduction by fostering trust and informed decision-making, balancing clients' goals with health considerations. These findings emphasise the potential for collaboration between IPED coaches and the health workforce to enhance health promotion and support within IPED communities.

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It is an open question to which degree compassion-noticing, engaging with, and acting to alleviate suffering in self and others-is (considered) advantageous in elite sports. Addressing this question, we herein provide insights into high-performance coaches' perceptions on the role of compassion in elite sports environments. Specifically, 12 coaches working at the highest level of their respective sport (in Denmark) partook in semi-structured interviews focusing on the utilization, implications, as well as barriers for implementing compassion in elite sports environments. Following a thematic analysis, three themes comprising various subthemes were identified and discussed. The first theme - Benefits of compassion - focuses on coaches' perception of the use and implications of compassion and comprises four subthemes: Compassion is important when times are tough; Compassion stimulates human connection; Compassion fosters unity in competitive environments; and Compassion promotes performance. The second theme - Increasing compassionate competence - focuses on how a compassionate approach can flourish and comprises three subthemes: Reflection; Awareness and knowledge; and Keeping up with the times. The third theme - Barriers to compassion - focuses on barriers to implementing and enhancing compassion in elite sports environments and comprises four subthemes: Compassion is soft; Power dynamics can stand in the way; Requires prioritization; and Performance outcome orientation. We conclude that while compassion (beyond self-compassion) can be beneficial in elite sports, coaches still perceive barriers for successful implementation, and that research should further investigate the outcomes and consequences of compassion in the elite sport context.

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Purpose: This study investigated the relationships between perceived autonomy support, coach-athlete relationship, team efficacy, aggressive behavior, and athlete burnout among team sports athletes. It verified the mediating effects of the coach-athlete relationship and team efficacy on the relationship between autonomy support and athlete burnout. Design methodology and approach: A questionnaire survey on autonomy support, coach-athlete relationships, aggressive behavior, and athlete burnout was administered to 336 team sports athletes (292 male athletes and 44 female athletes). A cross-sectional research design was used to collect the data. To analyze the collected data, frequency, reliability, descriptive statistical, and correlation analyses were performed using SPSS version 26.0. In addition, confirmatory factor analysis, convergent validity tests, and structural model analysis were conducted using AMOS version 24.0. Bootstrapping was used to examine the mediating effects. Results: The fit of the measurement model was assessed by calculating the fit indices as follows: x 2 = 329.689, df = 124, p < 0.001, TLI = 0.945, CFI = 0.956, RMSEA = 0.070 (90% CI = 0.061-0.080), and SRMR = 0.060. Autonomy support positively affected the coach-athlete relationship (ß = 0.841) and team efficacy (ß = 0.338). The coach-athlete relationship positively affected team efficacy (ß = 0.479). Furthermore, autonomy support did not significantly influence aggressive behavior (ß = -0.053), and negatively affected athlete burnout (ß = -0.305). The coach-athlete relationship also did not significantly affect aggressive behavior (ß = 0.054), and negatively affected athlete burnout (ß = -0.303). Team efficacy negatively affected aggressive behavior (ß = -0.516) and athlete burnout (ß = -0.201). Finally, autonomy support was found to affect athlete burnout through the coach-athlete relationship and team efficacy. Conclusion: Considering that autonomy support affects athlete burnout through coach-athlete relationship and team efficacy, coaches need to enhance the quality of the coach-athlete relationship and improve team efficacy to reduce athlete burnout. Above all, the study findings suggest that coaches need to provide autonomy-supportive behaviors.

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OBJECTIVES: Dyadic peer support helps patients make health behavior changes for improved outcomes, yet the impact of matching dyads on demographic characteristics such as race or gender is unknown. Therefore, we investigated associations of concordant characteristics with peer outcomes in a diabetes prevention intervention and qualitatively examined participant perspectives on matching. METHODS: Binary variables for peer-supporter concordance on 6 demographic characteristics were created for 177 peers and 69 supporters. Regression models compared changes in weight, HbA1c, perceived social support, patient activation, and formal diabetes prevention/education program participation for concordant and non-concordant dyads. Semi-structured qualitative interviews were conducted with 39 peers and 34 supporters. RESULTS: Concordance on demographic characteristics was not significantly associated with outcomes. Qualitatively, peers and supporters emphasized that more important than shared demographic characteristics was a supporter's empathic, non-judgmental communication style. CONCLUSIONS: Demographic characteristics for matching supporters with adults with prediabetes are less important than ensuring high-quality coach training in goal setting and communication style, supporting prior research on the necessity of autonomy supportive communication for effective behavioral change interventions. PRACTICE IMPLICATIONS: Existing peer support programs should incorporate fidelity assessments into practice to ensure peer supporter skill in motivational interviewing-based, autonomy supportive communication and brief goal setting.

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BACKGROUND: A growing body of research has examined lifestyle-based interventions for dementia prevention. Specifically, health coaching interventions have been linked to decreased risk of Alzheimer disease (AD) comorbidities, such as diabetes. Despite the association, there is a lack of research examining the efficacy and perception of digital health coaching on reducing AD risk. Understanding the perceived benefits of participating in a digital health coach program is critical to ensure long-term use, including participant adherence and engagement. OBJECTIVE: The purpose of this study is to examine the initial attitudes toward a digital health coaching intervention aimed at preventing cognitive decline among at-risk, rural participants. METHODS: This exploratory qualitative study is part of the ongoing Digital Cognitive Multidomain Alzheimer Risk Velocity Study (DC-MARVel; ClinicalTrials.gov NCT04559789), a 2-year randomized control trial examining the effects of a digital health coaching intervention on dementia risk, cognitive decline, and general health outcomes. Participants were recruited from the northwest region of Arkansas via word of mouth, email, local radio, and social media. At the time of the analysis, 103 participants randomly assigned to the health coaching group completed an average of 4 coaching sessions over a 4-month period. The intervention included asynchronous messages 1-2 times per week from their health coach that contained health education articles based on the participant's goals (eg, increase physical activity), unlimited access to their coach for questions and recommendations, and monthly meetings with their coach via videoconference or phone to discuss their goals. Participants were asked 2 open-ended questions, "What were your top 1 or 2 takeaways from your recent Health Coaching session?" and "Is there anything you would change about our Health Coaching sessions?" A thematic analysis was conducted using feedback responses from 80 participants (mean age, SD 7.6 years). RESULTS: The following four themes emerged from participants' feedback: (1) healthy lifestyle and behavioral changes, (2) a sense of self-awareness through introspection, (3) value in coach support, and (4) a desire for a change in program format (eg, frequency). In total, 93% (n=74) of participants expressed that the intervention needed no changes. CONCLUSIONS: Initial participation in the digital cognitive health coaching intervention was well received, as evidenced by participants reporting value in goal setting and strategies for healthy lifestyle and behavioral changes as well as self-reflection on their personal lifestyle choices. Feedback about their assigned coach also offers insight into the importance of the coach-participant relationship and may serve as a significant factor in overall participant success. Given the exploratory nature of this study, more robust research is needed to elicit more information from participants about their experiences to fully understand the acceptability of the digital health coaching intervention. TRIAL REGISTRATION: ClinicalTrials.gov NCT04559789; https://clinicaltrials.gov/show/NCT04559789. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/31841.

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Peer recovery coaches utilize their lived experiences to support overdose survivors, a role gaining prominence across communities. A convergent mixed methods design, informed by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework, was used to evaluate the Recovery Opioid Overdose Team Plus (ROOT +), through an iterative evaluation using web-based surveys and qualitative interviews. Reach: Over 27 months, ROOT + responded to 83% of suspected overdose referrals (n = 607) and engaged with 41% of survivors (n = 217) and 7% of survivors' family/friends (n = 38). Effectiveness: Among those initially engaged with ROOT +, 36% of survivors remained engaged, entered treatment, or were in recovery at 90 days post-overdose (n = 77). Adoption: First responders completed 77% of ROOT + referrals (n = 468). Implementation: Barriers included lack of awareness of ROOT + , working phones, and access to treatment from community partner interviews (n = 15). Maintenance: Adaptations to ROOT + were made to facilitate implementation. Peer-led teams are promising models to engage with overdose survivors.