The mean level of patient trust in the PCPs were nearly identical at baseline but increased significantly more at 12 months in patients assigned to receive health coaching compared to those in usual care. Similarly, the proportion of patients who reported they would highly recommend their PCP was similar at baseline but increased significantly

more in health coach group. Adjustment for number of visits did not substantially change the association between health coaching and increased patient trust. Additional adjustment for patient demographic characteristics and baseline levels of Rapamycin manufacturer trust and satisfaction did not change these results (results not shown). To our knowledge, this is the first randomized controlled trial to address the question of the impact of health coaching on

selleck the patients’ relationship with their PCP. We found no evidence that the addition of health coaches to the patient care team adversely affected the patients’ trust in, or satisfaction with, their PCPs; in fact both were higher at 12 months for patients in the coaching group. This improvement was not explained by the greater number of patient visits during the 12 month intervention. While the study was not designed to investigate the possible mechanisms by which health coaching could increase patients’ trust in their PCPs, one possibility is that health coaches improve communication between patients and providers. Improved communication has been shown to increase interpersonal trust in [24] and [25]

and is often mentioned as an important factor in building trust by both patients Ribonucleotide reductase and providers [8] and [26]. A strength of the current study is the randomized controlled design which avoided the potential biases due to the patient self-selecting to receive health coaching or usual care. The study also had several limitations that should be considered when interpreting the results. Participants were primarily poor and Spanish-speaking; the impact of health coaching on the patient provider relationship might be different in a different population. Patient trust is only one aspect of the patient–provider relationship. The increases in patient trust and satisfaction seen in the coaching group, while significant, were relatively modest. Results from the current study suggest that health coaches may increase patients’ trust in their PCPs. This finding is reassuring as we move toward a more team-based approached to primary care, with other members of the health care team (medical assistants, nurses, pharmacists, patient educators and health coaches or patient navigators) sharing more responsibility for patient care. Clinicians should be reassured that working with health coaches does not appear to compromise, and may in fact enhance, their relationships with their patients.