Concordia University Chicago

Doctoral Program

Student: Julie Richardson

crf_richarj4@cuchicago.edu
1200 E. Byers Ave. Apt A101
Owensboro, KY 42303
Day Telephone: 256-710-4420

Evening Telephone: 256-710-4420

Assignment Title: Literature Review

Date of Submission: 7/15/2023

Assignment Due Date: 7/16/2023

Course: RES 7900- Research Design

Section Number: 1

Semester/Term: Summer 2023

Course Instructor: Dr. Kathleen Hibbert

Certification of Authorship: I certify that I am the author of this paper and that any assistance I
received in its preparation is fully acknowledged and disclosed in the paper. I also have cited any
sources from which I used data, ideas, or words, either quoted directly or paraphrased. I certify
that this paper was prepared by me specifically for the purpose of this assignment, as directed.
Student’s Signature: Julie Richardson
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LITERATURE REVIEW

Literature Review

Julie Richardson

Concordia University Chicago

RES-7900: Research Design

Kathleen Hibbert, PhD

July 10, 2023

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LITERATURE REVIEW
Literature Review

Online coaching programs are more common in the constantly changing world of health

and fitness, giving people easy access to practical means of achieving their dietary and fitness

objectives. Evaluating the efficacy of such digital tools in encouraging client adherence and

achievement is increasingly important as technology evolves to change how we participate in

wellness practices. This study of the literature intends to investigate the effect of check-in

regularity on client compliance during virtual coaching sessions for fitness and nutrition. Does

the number of check-ins, notably whenever possible, make a substantial difference in client

performance and commitment to these mentoring programs? That is the leading research issue

driving this evaluation. We will conclude ten recent scientific, peer-reviewed research works,

concentrating on primary, evidence-based material specifically related to the area of interest, to

answer this question completely.

Numerous virtual training programs have emerged, providing new options for direction in

their wellness and fitness pursuits. With so much information available, clients could struggle to

stay accountable and motivated, resulting in a relapse into sedentary behaviors. The desire to

address this issue has grown crucial to my Ph.D. research as an online nutrition and exercise

training company's owner and an Exercise Science department educator. Studying the elements

that affect client compliance and performance in online training courses can offer priceless

insights for designing and implementing coaching programs. Additionally, understanding the

effect of check-in regularity on client interactions can assist coach interventions to be more

specifically tailored to each person's requirements to maximize motivation and accountability.

Impact of Check-in Frequency on Client Success and Adherence

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Virtual health and fitness tutoring systems depend on effective client compliance, and the

number of check-ins has been recognized as a potential factor impacting this adherence.

Numerous research has looked at the connection between client satisfaction and check-in rate,

offering essential insights into the efficacy of various coaching philosophies. This section will

evaluate and discuss five academic investigations that examine the effect of check-in frequency

on customer adherence in online training programs (Bourne et al., 2019; Davis et al., 2020;

Maher et al., 2020; Sysko et al., 2022; Voth et al., 2016).

To determine the impact of brief exercise coaching and high-intensity interval training

(HIIT) on exercise compliance and cardiometabolic wellness in people at risk of type 2 diabetes,

Bourne et al. (2019) carried out a randomized controlled experiment. The study respondents

were split into various intervention groups that received daily, weekly, and monthly coaching

encounters. According to the results, the everyday check-in group adhered to the suggested

exercise schedule more consistently than the weekly and monthly categories. The daily check-in

group's substantial gains in cardiometabolic markers have indicated a positive correlation

between check-in regularity and compliance and health outcomes. Despite the positive results,

Bourne et al.'s study had a small sample size, which constrained the applicability of the findings.

Furthermore, the study's emphasis on people at risk for type 2 diabetes might not accurately

reflect the larger community looking for guidance in exercise and nutrition. As a result, applying

the consequences of their findings to a more varied clientele may require caution.

A virtual health assistant (VHA) for food and exercise was the subject of a process

review by Davis et al. (2020) in an online tutoring program. The VHA provided personalized

coaching texts and check-ins to improve adherence and accountability. According to the study,

subjects thought the VHA check-ins were acceptable and helpful for encouraging compliance.
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LITERATURE REVIEW
The customers positively perceived the tailored VHA contacts, which enhanced their motivation

and kept them actively involved in the training program. However, the study by Davis et al. was

mainly concerned with how individuals felt about and accepted the VHA check-ins. Although

the study lacked statistical data on the actual rate of compliance and long-term effects, the

subjective insights gave valuable details on the users' perspectives. Future studies could close

this gap by including qualitative and quantitative metrics to provide a thorough picture of the

efficacy of coaching solutions based on VHA.

Maher et al. (2020) performed proof-of-concept research that used an artificially

intelligent simulated health trainer in an online coaching session. According to each person's

progress and objectives, the VHA customized messaging and check-ins. The results showed that

participants had reasonable adherence rates, and the VHA offered them specialized criticism and

encouragement. The study showed how AI-based coaching interventions could increase client

success and commitment to online dietary and fitness courses. The study by Maher et al. did not

examine the long-term viability of the reported compliance rates because it concentrated on a

relatively short period. Designing coaching treatments that promote ongoing engagement and

success necessitates having a thorough understanding of the longevity of the beneficial impacts

and probable drop-off in compliance over time.

Sysko et al. (2022) used Noom Health, a virtual counseling platform, to perform a

randomized controlled experiment to evaluate the efficacy of a 2.5-year weight-control program.

Periodic assessments and assistance were part of the program, which sought to encourage long-

term weight loss. When contrasted with a control group, the study found that respondents in the

Noom Health initiative significantly lost weight and improved their adherence. According to the

results, regular and planned check-ins may be essential for promoting weight control regimens'
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LITERATURE REVIEW
longevity. The absence of specific details on the duration and structure of the check-ins

employed in the Noom Health initiative is one of the study's limitations, according to Sysko et al.

Furthermore, because the study's primary focus was weight management, it left a gap in our

knowledge of the broader influence of check-in regularity on different exercise and nutrition

outcomes.

Voth et al. (2016) investigated how well a theory-based fitness app may improve exercise

compliance. The study used a mixed-methods research methodology to assess the app's

effectiveness using qualitative and quantitative information. According to the results, the app's

periodic updates and notifications positively impacted exercise adherence. According to the

participants, the app's interactive components and individualized feedback gave them a sense of

duty and drive, which helped them stick with their workout regimens over time. The

concentration on a single exercise app, which could not accurately represent the variety of

internet-based training courses available, is a weakness of Voth et al.'s study. Furthermore, the

study did not examine the possible effects of various check-in frequencies, making it difficult to

compare different coaching philosophies directly.

Client Motivation and Adherence in Online Coaching

To better understand how live video dietary and physical activity treatments affect

compliance and cardiovascular wellness in overweight and obese young people, Nourse et al.

(2015) undertook a study. The interventions made use of online coaching with ongoing

assistance. The results showed that the live video treatments improved adherence, with

participants actively participating in the coaching program and demonstrating high levels of

engagement. The study also emphasized the value of in-person encounters with coaches since

they helped participants feel accountable and motivated. Nourse et al.'s study showed the
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LITERATURE REVIEW
positive impact of live video consultations on compliance. However, it only looked at a

particular group of overweight and obese young people. Future studies could examine the

efficacy of these strategies across various client categories and goals to fully grasp the broader

effects of check-in recurrence and desire for commitment.

Painter et al. (2016) retrospectively analyzed a weight-loss program to evaluate

adherence results at six, twelve, and twenty-four months. The program included check-ins and

participant support to encourage long-term weight loss. The results showed that those who

maintained a high program adherence lost more weight significantly and permanently. The study

also found a “high performers” category that faithfully followed the coaching program for a year,

highlighting the significance of ongoing inspiration and encouragement. Despite the insightful

findings of Painter et al.'s study, real-time data throughout the coaching program were not

collected for the research, which was retrospective. The correlation between check-in rate, client

drive, and persistent participation in virtual mentoring interventions may be better understood in

an upcoming investigation with continuous assessments.

The importance of client inspiration and commitment to virtual training courses is

emphasized by both research (Nourse et al., 2015; Painter et al., 2016). According to Nourse et

al. (2015), online engagements and immediate assistance are two successful ways to increase

customer involvement and accountability. Additionally, it was discovered that continued

adherence was essential for achieving favorable results in calorie reduction therapies (Painter et

al., 2016). These results imply that coaching contacts and check-in regularity directly impact

client drive, which improves commitment to suggested exercise and dietary regimens. However,

both studies have flaws, such as limited target groups and retroactive designs. Future studies

should use prospective and longitudinal methodologies across several cohorts to build a more
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LITERATURE REVIEW
thorough knowledge of the connection between check-in rate, client motivation, and

commitment. Additionally, examining the effects of various coaching interactions and styles on

client drive could offer insightful information for improving training treatments and modifying

them to meet the needs of specific clients.

Role of eHealth Coaches and Artificial Intelligence in Online Coaching

To create a person-centered training infrastructure, Ryan et al. (2022) undertook a study

to comprehend how eHealth trainers customize support for weight loss. To learn more about the

mentoring methods and techniques used by eHealth coaches, the researchers used qualitative

methodologies and interviewed them. According to the research, eHealth coaches use a

combination of tailored encounters and AI-driven data evaluation to cater their assistance to the

requirements of each unique client. The coaches were able to find trends in the actions and tastes

of their customers by utilizing AI algorithms, which made coaching sessions more specific and

successful. The research was primarily concerned with the coaches’ opinions, even if Ryan et

al.'s research offered insightful information about the function of eHealth educators and AI in

individualized instruction. Future studies could examine how AI-driven coaching affects client

motivation, program adherence, and overall results. It may also be possible to learn more about

the viewpoints and experiences of customers who obtain tutoring from AI-driven systems by

investigating their experiences with them.

The use of interviews in studies on public health was investigated by Wood et al. (2019),

who focused on the tales of novice investigators collaborating with eHealth coaches. When

novice researchers interacted with eHealth coaching platforms, they used qualitative

methodologies to collect their findings. The results showed how eHealth coaching can help

researchers better understand participant experiences by improving data gathering. The eHealth
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LITERATURE REVIEW
coaching systems allowed the researchers to interact with individuals virtually and gain

insightful knowledge about their driving forces, obstacles, and successes in following their

recommended regimens. The focus of Wood et al.'s (2019) research, nevertheless, was restricted

to the experiences of new researchers using eHealth coaching systems. A more thorough

knowledge of the function of eHealth instructors in online training programs would result from

extending the investigation to include seasoned researchers and clients taking part in eHealth

coaching treatments.

The importance of eHealth coaches and AI in boosting the efficacy and customization of

online coaching programs is emphasized in both research (Ryan et al., 2022; Wood et al., 2019).

Coaches can more effectively target their help by integrating AI-driven research with

individualized coaching encounters, which provides valuable insights into clients' habits and

preferences (Ryan et al., 2022). Additionally, eHealth coaching platforms give researchers a vital

tool for communicating with participants online and gathering in-depth qualitative information

on their perspectives and intentions (Wood et al., 2019). Despite the encouraging results, both

studies include research gaps that must be filled. A client's perceptions of AI-driven tutoring

interventions may have been explored in Ryan et al.'s study as it primarily concentrated on the

viewpoints of eHealth coaches. While the investigation conducted by Wood et al. (2019) is

informative concerning the challenges of beginning researchers, it would be advantageous to

expand the study to include professional researchers and customers actively participating in

eHealth training sessions.

Mixed Methods Approach in Studying Client Experiences

A mixed-methods study format offers a thorough and all-encompassing approach to

analyzing customer interactions in the framework of internet-based coaching initiatives. To

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LITERATURE REVIEW
obtain a more excellent knowledge of the nuances of client motives, adherence, and overall

program effectiveness, we will review the results of three studies (Doyle et al., 2009;

Onwuegbuzie & Leech, 2005; Onwuegbuzie et al., 2007) that use mixed methods.

A study by Doyle et al. (2009) focused on the fusion of quantitative and qualitative

methodologies and offered a summary of mixed methods research. The study's authors stressed

using mixed methods research, which combines several data types to provide a more

comprehensive insight into customer experiences. Investigators can triangulate data and verify

their conclusions by combining qualitative and quantitative information, increasing the study's

overall rigor. The study by Doyle et al. serves as a cornerstone for illustrating the advantages of

mixed methods research. However, the study does not explicitly cover online coaching

programs; instead, it focuses on the general benefits of blended techniques. To better understand

the variables that affect client motivation and adherence, future studies might investigate the use

of mixed methods to examine the efficacy of online coaching programs.

In their 2005 article, Onwuegbuzie and Leech emphasize the value of developing into a

pragmatic researcher and the significance of integrating quantitative and qualitative approaches.

They stress that applying mixed techniques enables researchers to address challenging research

problems more thoroughly. Researchers can examine phenomena from various perspectives

using multiple data sources, leading to a more nuanced view. Although Onwuegbuzie and

Leech's (2005) work provides insightful information about the broad advantages of combining

methods in the investigation, it needs to explore studies about online coaching programs.

Applying a pragmatic strategy to research the influence of mixed methodologies in analyzing

client experiences in online coaching settings is a direction for further investigation. It could help

uncover elements that promote motivation and adherence.

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LITERATURE REVIEW
A typology for doing mixed analyses in research is presented by Onwuegbuzie et al.

(2007), exhibiting diverse amalgamations of qualitative and quantitative methods. The

researchers discuss the benefits of adopting different approaches in a study's methodology,

especially when handling challenging research issues. Researchers can take advantage of the

advantages of qualitative and quantitative information by using mixed methods, which gives rise

to a more thorough knowledge of consumer experiences and the efficacy of programs. The

typology developed by Onwuegbuzie et al. is a helpful framework for mixed-methods research.

Still, it must tackle the complexities of researching client interactions in online coaching

sessions. Further studies could use the typology to create studies investigating the interaction

between clients' motives, commitment, and tutoring program results, giving researchers a more

profound knowledge of the elements that make effective online coaching treatments.

The investigations (Doyle et al., 2009; Onwuegbuzie & Leech, 2005; Onwuegbuzie et al.,

2007) looking at the application of mixed-methods investigation in a setting of client experiences

highlight the significance of a thorough and adaptable methodology. By combining quantitative

and qualitative approaches, researchers can better grasp the intricacies of client motives and

compliance in virtual training programs. Combining data sources enables triangulation of results,

which raises the reliability and validity of study conclusions. These studies need to explicitly

address the unique qualities of online coaching treatments, even though they clearly show the

overall advantages of mixed methods research. Additional research is required to explore

customer interactions in online coaching situations. By doing this, researchers can pinpoint the

elements that support effective online coaching interventions, guiding the creation and execution

of subsequent coaching initiatives.

Enhancing Educational Approaches for Unhealthy Adults in Online Training Programs

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LITERATURE REVIEW
LaPelle (2004) underlines the value of adopting all-purpose software tools to streamline

qualitative data processing. The author discusses the difficulties in presenting findings in a way

that will be useful for future study and policymaking. Researchers can effectively arrange and

evaluate enormous amounts of qualitative data using software tools, which enables them to spot

trends and themes pertinent to the perspectives of unwell adults participating in e-learning

courses. However, the setting of online training courses for ill adults is not a particular emphasis

of LaPelle's work. To comprehend how educational techniques might be maximized for this

specific group, more research may investigate the utilization of qualitative evaluation tools,

filling in the gaps in the existing body of knowledge.

Scott and Sutton (2008) investigated the feelings and changes that instructors go through

when undergoing professional growth. The study emphasizes the importance of comprehending

emotional factors in the learning process, even though it is not explicitly related to e-learning

courses for ill people. Emotional factors influence the motivation and adherence of unwell

people participating in online training courses. To improve teaching approaches and promote

long-lasting changes in health behavior, further study may examine individuals' psychological

reactions in online coaching settings. Virtual training courses could better serve the needs of

unwell people and boost overall program performance by considering the psychological elements

of learning.

Tran et al. (2016) concentrated on data exhaustion in an online survey with open-ended

questions. Even though it has nothing to do with online training programs specifically, this study

sheds light on recognizing when data gathering has reached saturation, suggesting that adding

more data may not materially change the results. Addressing data saturation in Internet training

courses can be essential for guaranteeing thorough data collection from unwell people.
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Researchers can use this data to gauge when they have acquired enough information to make

valid judgments about instructional strategies for this demographic. Future studies could further

examine the idea of data saturation about online training therapies for unhealthy people,

elucidating the ideal volume of data required to discover successful interventions.

The research by Scott and Sutton (2008), LaPelle (2004), and Tran et al. (2016) provide

important insights into how to improve educational strategies for overweight adults in e-learning

initiatives. Although these studies don't specifically address the circumstances of virtual

mentoring treatments, they offer a solid platform for future research in this field. To comprehend

the experiences of unwell adults participating in virtual coaching programs, LaPelle's study

emphasizes the value of streamlining qualitative data analysis utilizing digital tools. Scott and

Sutton strongly emphasize the importance of recognizing emotional variables in the learning

process and propose that emotional considerations should be considered while developing

teaching strategies for unhealthy adults in virtual tutoring programs. Tran et al.'s work suggests

data saturation, which can help researchers determine when they have received enough

information from clients in settings for online coaching.

For the area to grow, further study is required on using qualitative methods to analyze

data, the role of emotion in learning, and the idea of data saturation in virtual training

interventions for ill adults. Researchers may create evidence-based instructional strategies

tailored to this community's unique requirements and backgrounds by filling in these gaps,

ultimately resulting in more effective virtual training.

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