A Randomized Controlled Pilot Trial of Health Coaching to Improve Functioning and Reduce Suicidal Ideation Among Veterans Reintegrating Into Civilian Life

INTRODUCTION: The year following military service separation is a high-risk period for suicide among reintegrating veterans, those transitioning from military service member to veteran. This randomized controlled pilot trial examined the feasibility and acceptability of health coaching, a non-clinical health behavior change modality, among reintegrating veterans and evaluated change in measures of identity coherence, reintegration functioning, and suicidal ideation. METHODS: Reintegrating veterans (n = 95) were randomized to receive either enhanced current reintegration services (eCRS) only or health coaching plus eCRS. Participants completed assessments at baseline, month 2, month 4, and month 9. Health coaching participants completed up to 12 health coaching sessions within 4 months of randomization. RESULTS: Feasibility was strong, indicated by a 23% enrollment rate, participant session completion (mean = 8), and intervention fidelity ratings ≥ 88%. Participants reported high acceptability; 95% indicated that health coaching met their approval. Significant treatment effects were observed for reintegrating functioning, with moderate-to-large effect sizes (d = 0.58 among the health coaching group and d = -0.11 among eCRS). Promising effects were observed for identity coherence measures and suicidal ideation prevalence. CONCLUSIONS: Additional research is warranted to test the efficacy of health coaching on these outcomes in a fully powered randomized controlled trial and to evaluate implementation procedures. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT05199467.