Becoming a

Health Coach
A career guide for
a growing field.

American Council on Exercise

4851 Paramount Drive, San Diego, CA 92123
800.825.3636 l ACEfitness.org

ACE HEALTH COACH CAREER GUIDE | 1

 Overview
The field of health coaching offers a truly exciting and rewarding opportunity for individuals who are
passionate about health and wellness to actively collaborate with clients and patients, assisting them in unlocking
their full potential to live healthy lifestyles. From managing stress and setting goals, to eating healthy and regularly
engaging in physical activity, the health coach serves the unique role of empowering people to take ownership of
their own health, and to discover their own motivation for lasting behavior change.

Although the health coach profession is continuing to expand, this report offers a guided view of its current state,
and addresses emerging areas of opportunity that will further allow the profession to thrive. Those areas especially
include positions in fitness, healthcare and workplace wellness.

Additionally, this report features unique insights from currently practicing health coaches across a wide variety of
settings who highlight how their knowledge, skills, and passions have translated into diverse, fulfilling careers in an
evolving field.

People dont just need an exercise program

or a diet plan. They need an expert who can
guide and empower them. They need someone
who can connect with them in a way that makes
them believe they have the ability to make
meaningful and lasting changes.
CEDRIC BRYANT
ACE CHIEF SCIENCE OFFICER
SAN DIEGO, CA

ACE HEALTH COACH CAREER GUIDE | 2

 Health Coach Defined
Just over a decade ago, health coaching was broadly described as the practice of health education and health
promotion within a coaching context, to enhance the well-being of individuals and to facilitate the achievement of
their health-related goals.1

As the field has continued to evolve and take greater shape in recent years, the International Consortium for Health
& Wellness Coaching (ICHWC) has arrived at a more formalized definition of health and wellness coaches. The
organization describes them as professionals from diverse backgrounds and education who work with individuals
and groups in a client-centered process to facilitate and empower people to achieve self-determined goals related
to health and wellness. Successful coaching takes place when coaches apply clearly defined knowledge and skills so
that clients and patients mobilize internal strengths and external resources for sustainable change.2

While education-based interventions in which the emphasis is placed on transferring knowledge can serve as a great
complement to primary care, education-based interventions alone prove insufficient.3 The addition of coaching, which
focuses on increasing client and patient internal motivations, skills and confidence to manage their conditions and set
achievable goals has been found to be significantly more effective than health education alone.4

SCOPE OF PRACTICE
Although there are a number of health coach training programs available, each with its own specific standards and
guidelines, the majority of healthcoach programs feature similar key components, such as motivational interviewing,
cognitive-behavioral techniques and solution-focused goal setting.5 Individuals who engage in coaching
relationships are expected to do the following:

+ Apply effective communication skills, such as the use of open-ended questions, affirmations, reflective listening,
and summarizing to help a client or patient increase motivation and ownership of making a change

+ Help clients and patients develop achievable and measurable goals to monitor success and motivate ongoing
behavior change

+ Help clients and patients develop and exploit strengths to support successful behavior change

Health coaches partner with clients and patients using a

collaborative, thought-provoking process to help individuals
discover their internal motivation and enhance their overall
levels of health and well-being.

ACE HEALTH COACH CAREER GUIDE | 3

 Health Coach Defined
Ultimately, a coachs scope of practice is determined by state policies and regulations, as well as credentials,
education, experience, competencies and skills. It is the responsibility of the health coach to adhere to the laws in
his or her geographical region, as well as to abide by the defined scope of practice and avoid legal ramifications of
providing services outside that professional scope. The following actions, among others, are outside defined scope of
practice for health coaches:

+ Counseling or therapy
+ Nutrition prescription and meal planning
+ Exercise prescription
+ Diagnosis of medical or mental health ailments
+ Recommendation or sale of supplementation

Furthermore, health coaches should know and follow the Physical Activity Guidelines for Americans and exercise
programming guidelines from leading professional organizations, such as the American Council on Exercise (ACE),
the National Strength and Conditioning Association (NSCA), the American College of Obstetricians and Gynecologists
(ACOG), the American College of Sports Medicine (ACSM) and the American Heart Association (AHA). Health
coaches should also be familiar with the position statements for specific populations developed by these and other
healthcare organizations, as well as remain up-to-date on current dietary guidelines jointly published by the U.S.
Department of Health and Human Services (HHS) and the U.S. Department of Agriculture (USDA).

Health coaches should maintain the same level of professionalism as others in client-professional relationships, such
as physicians and patients, and clients and attorneys. In fact, health coaches should strictly adhere to all privacy laws
and best practices when handling client information.

Health coaching offers the opportunity

to positively enhance the wellness of individuals
from a more holistic perspective, imparting real,
meaningful, and lasting change.
JESSICA M AT THEWS
ACE CERTIFIED HEALTH COACH AND
ASSISTANT PROFESSOR OF HEALTH AND EXERCISE SCIENCE
AT MIRAM AR COLLEGE IN SAN DIEGO, CA

ACE HEALTH COACH CAREER GUIDE | 4

 Industry Landscape
Economic transition, rapid urbanization, and unhealthy lifestyle practices such as tobacco use, unhealthy diet,
insufficient physical activity, and the harmful use of alcohol are among the risk factors contributing to the burden
of chronic diseases.6 As of 2012, the Centers for Disease Control and Prevention (CDC) reports that approximately
half of all adults117 million peoplehave one or more chronic health conditions, such as heart disease, stroke,
hypertension, diabetes, obesity, and arthritis.7 With 75% of health expenditures in the United States attributed to
treating chronic diseases, it is imperative that this issue be a top priority for the nation.5

ADDRESSING AN EPIDEMIC
Amid the current public health crisis, research clearly
indicates that health coaching produces positive effects
on clients physiological, behavioral and psychological

117
well-being and on their social lives, with statistically
significant results in areas of weight management,
physical activity, and physical and mental health
status.4 Based on the evidence supporting the health

MILLION
benefits of behavior-change counseling, in 2014 the
U.S. Preventive Services Task Force (USPSTF) released
a recommendation that overweight or obese adults with
at least one additional risk factor for cardiovascular AMERICANS WITH ONE
disease be offered or referred for behavior-change
OR MORE CHRONIC
counseling interventions that promoted healthy diet
and exercise for cardiovascular disease prevention,
HEALTH CONDITIONS
specifically identifying health and exercise professionals,
along with a select group of other trained allied health
professionals to provide these services.8

Health coaches are uniquely poised to serve as guides

for sustainable change, due to their knowledge and skills
in helping individuals to preserve and restore their health
and those seeking to enhance overall wellness.

ACE HEALTH COACH CAREER GUIDE | 5

 Industry Landscape
Health coaches are currently enjoying rewarding careers working with individuals and groups. This often
incorporates the utilization of technology in the form of delayed or real-time communication, including the use of
phone, Internet, email, video conferencing, and social media, as well as face-to-face interaction in a wide variety of
settings, including but not limited to:9

+ Clinical settings, such as hospitals and private medical offices

+ Large corporations and small businesses
+ Health insurance companies
+ Community centers
+ Educational institutions
+ Holistic health facilities
+ Health clubs, wellness centers and fitness studios
+ Client and patient homes in the case of self-employed coaches

Given the evolving nature of the field, the hourly rate and yearly salary for health coaches can vary greatly based on
a number of factors, including place of employment, years of professional experience and types of services offered.
A 2013 ACE survey of currently certified professionals nationwide found that part-time health coaches on average
earned $33 per hour whereas full-time health coaches earned an average of $51,219 annually.10 As noted above,
however, pay ranges varied greatly based on previously mentioned variables. The U.S. Bureau of Labor Statistics
reported in 2012 that professionals could earn upward of $86,810,11 demonstrating the notable professional growth
opportunity that exists in the field.

At the time I decided to become a health coach, I was working

in an intensive care unit and many of the patients that I cared for
in the hospital had chronic diseases that left them debilitated,
critically ill or dying. My objective in pursuing the health-coach
certification was to learn additional strategies to assist my clients
in avoiding this side of the healthcare spectrum.

THERESA BROSCHE
ACE CERTIFIED HEALTH COACH AND
ADJUNCT NURSING INSTRUCTOR IN SPOTSYLVANI A, VA

ACE HEALTH COACH CAREER GUIDE | 6

 Future of the Profession
One of the primary goals of healthcare reform and the Studies have shown that health coaching can be highly
Patient Protection and Affordable Care Act (PPACA) effective when focused on developing self-efficacy
of 2010also referred to as the ACAis to achieve and skills such as goal setting, problem solving and
the triple aim of better health, better care, and reduced managing cognitive and emotional barriers.5
cost. Part of this includes primary care redesign. In the
old model, healthcare providers struggle to deliver With expertise in delivering individualized treatment
high-quality care to patients with chronic diseases based on a non-judgmental, personal relationship,
in 15-minute visits, especially when many of these coupled with expertise in behavior change, fitness,
patients do not or cannot follow through on provider and nutrition, health coaches can serve as invaluable
recommendations. 12
members of the healthcare team, supporting both
physicians and patients in increasing quality of care
In light of this, the CDC recommends that self- while decreasing costs.
management training serve as a key step in improving
patient-centered outcomes, including quality of life.13 Given the importance of addressing behavioral factors
Health coaches are perfectly poised to help clients and habits that negatively affect health and well-being,
acquire the knowledge, skills and confidence they such as physical inactivity and chronic stress, there
need to reach their own health and wellness objectives exists a great opportunity for qualified health coaches
in a meaningful and personalized manner that is to fill a much-needed role in the patient-centered model
aligned with their unique individual values. With a of care. Studies have shown health coaching to be a
focus on establishing healthy eating habits, consistent particularly effective method for the management of
engagement in physical activity and implementing chronic diseases, with documented success in changing
strategies and solutions to overcome perceived barriers, chronically ill lifestyle behaviors and improving self-
this aim of health coachingreferred to as patient efficacy and physical and mental health status among
activationhas been linked to positive change in patients.4
behaviors relevant to chronic disease.14

EMERGING OPPORTUNITIES IN HEALTHCARE I foresee health coaches being widely

As a result of the high financial and societal costs that accepted as part of the healthcare continuum,
preventable chronic disease places on the U.S. economy working directly with physicians and nurse
coupled with the need to offer affordable, high-quality, practitioners, as well as in the corporate fitness
readily accessible health-related interventions as
arena, to assist individuals with improving their
outlined by the healthcare reform law, there is an
health and well-being, not only for themselves,
imperative need to re-examine the way in which chronic
diseases are treated and managed.15 A shift must be
but also for society at large.
made toward personalized strategies based on patient DEBI PILL ARELL A
preferences, readiness to change, and psychosocial ACE CERTIFIED HEALTH COACH AND
variables, all of which are approaches utilized by health PROGRAM DIRECTOR AT COMMUNIT Y HOSPITAL FITNESS POINTE,

coaches to facilitate long-term behavioral changes. 16 A MEDICALLY-BASED FITNESS CENTER IN MUNSTER, IN

ACE HEALTH COACH CAREER GUIDE | 7

 Future of the Profession
EMERGING OPPORTUNITIES IN WORKPL ACE WELLNESS
About 67% of employers say poor employee health habits are a top challenge with regard to maintaining affordable
insurance coverage, as individuals with chronic diseases cost up to an estimated four times more in health insurance
expenses than healthy individuals. The insurmountable burden on employers required to pay for increasing
healthcare costs has resulted in a widespread search by organizations of various sizes to enlist the services of health
coaches to craft solutions that offer long-term, cost-saving results.

From healthier food options offered in on-site cafeterias to physical-activity programs tailored to employee
preferences, nearly half of all employers that have instituted workplace wellness programs report a cost savings,
with 69% of them citing a marked improvement in employee health. With expertise in motivational interviewing,
positive psychology and effective goal-setting, health coaches are able to effectively facilitate workplace wellness
programs that accurately address the behaviors that have held team members back from making real change,
resulting in increased workforce productivity and decreased healthcare costs.

To enhance the health and wellness of individuals around the world, the mission of ACE is to ensure that all people
have access to well-qualified professionalssuch as health coachesto facilitate sustainable change that leads to
weight loss, healthy eating, regular physical activity, and overall well-being. To achieve this mission, ACE has served
for 30 years as the largest nonprofit health and fitness certification, education, and training organization in the world,
with more than 70,000 certified professionals worldwide.

One of the things I love about

my job is the chance to learn about

67%
peoples current habits and help
them change their behaviors so
their overall health and quality OF EMPLOYERS SAY
of life improve. POOR EMPLOYEE
HEALTH HABITS ARE A
ANGEL CHELIK TOP CHALLENGE
ACE CERTIFIED HEALTH COACH AND
OWNER OF WORKBE T TER WELLNESS, OFFERING ON-SITE
WORKPL ACE WELLNESS PROGRAMS,
IN SAN DIEGO, CA

ACE HEALTH COACH CAREER GUIDE | 8

 Becoming a Health Coach
KNOWLEDGE AND SKILLS OF A HEALTH COACH + Professionalism and CompetencyFulfill
Certification exams should provide an objective responsibilities through ongoing education,
evaluation of an individuals ability to safely perform the collaboration, and awareness of professional
job in question. A critical component of the certification standards and practices necessary to protect clients
process for any profession, including health coaching, and patients, the profession, stakeholders, and oneself.
is to first conduct a role delineation study in order to
identify the primary tasks performed by professionals An expanded version of this framework ultimately
on a regular basis. The specific tasks and accompanying serves as the blueprint from which the certification exam
knowledge and skill-related components are initially to become a certified health coach is developed.
established by a role delineation panel of health
coaching subject matter experts, whose work is then THE IMPORTANCE OF CERTIFICATION
validated by a sampling of currently practicing health One of the most important decisions an aspiring health
coaches across a wide variety of settings. coach will make as he or she embarks on a career as a
health coach is which certification to obtain. While there
The end result is an outline of domains (which represent are a number of certifications available, ranging in title
the major areas of responsibility of the profession), tasks from health coach to wellness coach, the reality is not
(individual functions for certain aspects of the job), and all offer the same level of professional credibility that is
associated knowledge and skills (necessary to perform imperative in this evolving field.
the indicated tasks) that serves as the minimum level
of proficiency and theoretical knowledge required to
practice as a competent and safe health coach.

+ Build Rapport and Facilitate Behavior ChangeUse

effective communication strategies to build and
I became a certified health coach
sustain relationships with individuals and groups by
coaching behavioral change.
to enhance my skills as a registered
dietitian and personal trainer in order
+ Program Design and ImplementationCreate to help my clients obtain their lifestyle
individual and group structured behavior-change
goals by empowering them to make
programs that focus on lifestyle and weight
management through physical activity, nutrition, and
positive changes.
education. GIN A CROME
ACE CERTIFIED HEALTH COACH, REGISTERED DIE TITI AN,
+ Program Progression and AdjustmentsMonitor, AND OWNER OF LIFEST YLE M AN AGEMENT SOLUTIONS

evaluate and modify individual and group structured BASED IN GLENDORA, CA

behavior-change programs designed to improve and

maintain health, fitness, weight, body composition,
and metabolism.

ACE HEALTH COACH CAREER GUIDE | 9

 Becoming a Health Coach
UNDERSTANDING NCCA-ACCREDITED CERTIFICATIONS
Professional certifications should obtain third-party validation from an independent organization that explicitly
accredits certification programs. Originally formed as the National Commission for Health Certifying Agencies with
initial funding from the U.S. Department of Health and Human Services, the now National Commission for Certifying
Agencies (NCCA) has reviewed and accredited certifications for most allied healthcare professions, including
credentials for registered dietitians, athletic trainers, nurse practitioners, and pharmacists, among many others.

ACE, along with other leaders in the health and fitness industry, believes that individuals who are primarily
compensated in their role as a coach should attain a nationally accredited professional certification. This can include
a health or wellness certification accredited by the NCCA or International Coach Federation (ICF). Presently, ACE
is leading the charge in terms of offering a quality solution to the health care crisis by offering the only NCCA-
accredited health coach certification.

Obtaining a reputable health-coach certification demonstrates the highest standard of competence for a coaching
professional and provides assurance to the general population that you have mastered foundational principles
necessary to empower people to positive, long-term, healthy change.

The nations most respected thinkers

in health and fitness
agree that NCCA accreditation
is the gold standard.

ACE HEALTH COACH CAREER GUIDE | 10

 Becoming a Health Coach
ELIGIBILIT Y REQUIREMENTS
Given the pivotal role health coaches play in positively impacting the overall health and well-being of the population
at large, many reputable health-coaching certifications have specific eligibility requirements that individuals
must meet in order to sit for an accredited professional examination. Below are two examples of the pre-requisite
requirements for health-coaching certifications offered by respected organizations.

An individual sitting for the ACE Health Coach Certification exam:

+ Must be at least 18 years of age; and

+ Must hold a current adult CPR/AED certification with a live skills check; and
+ Must submit supporting documentation for one of the following:

+ Current NCCA-accredited certification or license in fitness, nutrition, healthcare, wellness, human

resources, or a related field; or
+ Hold an associates degree or higher from an accredited college or university in fitness, exercise science,
nutrition, healthcare, wellness, human resources, or a related field; or
+ Completed a Health Coach training and education program approved by the International Consortium for
Health and Wellness Coaches (ICHWC); or
+ A minimum of 2 years of documented work experience in coaching, leading, designing, implementing,
or facilitating one or more of the following: behavior or lifestyle change, exercise, wellness, nutrition, or
physical activity

A list of NCCA-accredited certification programs can be found via the following link: www.credentialingexcellence.org/p/cm/ld/fid=121

A list of ICHWC-approved training and education programs can be found via the following link: http://ichwc.org/organizations/

The health and wellness coach certification offered through Wellcoaches has the following general requirements:

+ A bachelors degree or higher in an area of health and wellness study; or

+ A license or license equivalent related to an area of health and wellness study or health profession; or
+ A bachelors degree or higher in an area of study unrelated to health and wellness and a reputable health- or
fitness-related certification; or
+ A reputable health- or fitness-related certification and a minimum of 2,000 hours of work experience in the field
with individuals or groups

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 Becoming a Health Coach
AN OPPORTUNIT Y FOR IMPACT
In the face of an epidemic of lifestyle-related diseases, the impact of health coaching is great. Research shows that
adopting sustainable healthy behavior patterns, including regular physical activity and sound nutrition, is key to
addressing the obesity epidemic and other lifestyle-related medical conditions.17, 18 In light of this, ACE seeks public
policies that make highly qualified, science-based, interdisciplinary coaching, counseling, and support for sustainable
behavioral change a functional, integral component of the nations healthcare continuum.

ACE has pressed federal and state government officials to advance public policies that effectively move obesity
prevention and intervention into the healthcare system. Specifically, ACE calls for policies that create lasting impact,
including, but not limited to:

+ Ensure that obesity intervention and prevention is supported and paid for

+ Recognize and utilize NCCA-accredited health coaches, fitness professionals and other weight-management and
behavior-change experts in communities as part of the healthcare continuum

+ Incentivize medical professionals to utilize behavior-change facilitation by well-qualified health and fitness
professionals for the large and growing segment of the population at risk for obesity and its co-morbidities

For individuals passionate about shifting the global culture of wellness, there is no better time than now to take the
initiative to become a certified health coach, and to guide others toward meaningful health behavior change.

Hope is the foundation on which all change begins.

Being a health coach allows me to experience
the unique joy of helping people break the chains
of obesity and live the full lives they deserve.
LEE JORDAN
ACE CERTIFIED HEALTH COACH AND CREATOR OF 30 SECONDS TO VICTORY,
A PHYSICI AN-ENDORSED WELLNESS PROGRAM
BASED IN JACKSONVILLE BEACH, FL

ACE HEALTH COACH CAREER GUIDE | 12

 Next Steps
To fulfill the growing need for health coaches in a variety of settings, health coaching certifications have been
introduced by a variety of organizations. Only one is accredited by the NCCA, the same body that accredits
certifications for pharmacists, nurse practitioners, registered dietitians and many other health professions.

Pursuing an ACE Health Coach Certification means pursuing a quality solution to the healthcare crisis from a trusted
name. In addition to being part of the largest nonprofit health and fitness certification, training and education
organization in the world, becoming an ACE Certified Health Coach will make you part of an organization that
advocates on your behalf every dayamong policymakers, among partners who share our vision of eliminating the
obesity epidemic, and among employers exploring workplace wellness solutions.

M AKE MOVEMENT YOUR MISSION

For more information on how to become an

ACE Certified Health Coach contact us at
888.825.3636 or visit ACEfitness.org

ACE HEALTH COACH CAREER GUIDE | 13

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Copyright 2017 American council on Exercise

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