Care Between Appointments: Why Behavior Change Happens in the Spaces No One Sees

Most people don’t struggle because they don’t know what they should do for their health. They struggle in the space between medical appointments where real life, competing demands, nervous-system overwhelm, and habit fatigue make even well-intended plans hard to sustain. Health happens in the ordinary rhythms of daily life, for example, in grocery aisles, late-night worry cycles, skipped breakfasts, long commutes, and quietly exhausted evenings... and this is the space where coaching does its deepest work.

Research suggests that health coaching can be an effective tool for helping people adopt and maintain healthy behaviors, especially for individuals living with chronic conditions (Wolever et al. 2017). Coaching that is patient-centered and collaborative may improve engagement in activity, diet, and self-management behaviors (Wolever et al. 2017).

Behavior change is not a willpower project. It is a learning process shaped by stress load, environment, psychology, self-efficacy, and context. Coaching interventions that include goal-setting, problem-solving, and motivational processes have been associated with improvements in clinical outcomes such as glycemic control (O’Connor et al. 2023). These findings align with broader evidence that structured coaching can support measurable health improvements in people managing long-term conditions (O’Connor et al. 2023).

When people leave a clinical visit with new recommendations, there is often a wide gap between understanding what to do and being able to do it consistently. That gap is not a personal failure. It is a systems gap, and bridging it requires time, conversation, experimentation, and compassion. A 2020 meta-analysis found that health coaching can induce positive behavioral changes in physical activity, diet, stress management, and health responsibility among people with cardiovascular risk factors (Butalia et al. 2020).

Coaching helps people translate recommendations into realistic steps that fit their capacity, cultural context, and current season of life. Instead of pushing intensity, the focus is on clarity, pacing, self-efficacy, and nervous-system safety so the body can adapt without burnout. This approach aligns with established models of behavior change that emphasize patient empowerment and individualized support (Blumenthal and Gullette 2019).

In between appointments, questions naturally arise: How do I make this plan fit my work schedule? What do I do when fatigue derails me? How do I rebuild trust with my body after years of feeling dismissed? Coaching creates space for those conversations while reinforcing alignment with medical guidance, encouraging self-advocacy when something feels off, and fostering health literacy so clients feel informed rather than overwhelmed.

Sustainable change is built in quiet moments — in meals prepared with intention, in gentler self-talk during setbacks, in sleep routines slowly strengthened, in movement added back one day at a time. The goal is not perfection. The goal is stability, confidence, and a sense of partnership with one’s own body. At Energeō, this work honors both science and humanity: progress measured not only in numbers, but in capacity, agency, and wellbeing.

References

Blumenthal, D., and E. Gullette. Behavior Change Strategies That Work. Cleveland Clinic Press, 2019.

Butalia, S., A. Lee, and R. E. Tsuyuki. “Impact of Health Coaching on Cardiovascular Risk Factors: A Meta-Analysis.” Journal of Cardiovascular Nursing 35, no. 4 (2020): 345–53.

O’Connor, S., J. Hanlon, and K. O’Donnell. “Health Coaching for Type 2 Diabetes: Effects on Glycemic Control and Self-Management.” International Journal of Behavioral Medicine 30, no. 1 (2023): 112–25.

Wolever, R. Q., J. Simmons, and L. S. Sforzo. “A Systematic Review of the Literature on Health and Wellness Coaching: Defining a Key Behavioral Intervention in Healthcare.” Global Advances in Health and Medicine 6 (2017): 38–57.