The Evidence Behind HealthChange® Methodology
HealthChange Methodology (HCM) has been developed, refined and tested for over two decades, in real health services with real providers.
HCM is not a single intervention you can isolate and test the way you might test a new medication or a standalone program. It is a practical application method: a set of behavioural definitions, communication techniques and a consultation framework that a provider draws on together, in whatever combination the person in front of them needs. That is what makes it useful in a real consultation. It is also why it doesn't reduce easily to a single randomised trial. Most of what follows reflects that: implementation evidence and program evaluation, built up across many settings over many years, rather than one definitive study.
We are the developers of HCM, and we say that plainly. Most of our clients are health services and clinicians whose primary focus is delivering care, not producing research. They rarely have the time, expertise, or resources to formally evaluate or publish their own results, which is part of why the published evidence base is smaller than the practice base. Independent research is needed and we actively invite it.
Real-World Results
Alongside the published literature, a number of programs that have used HCM in their design and delivery report their results. Read a selection of case studies here.
Â
Where This Is Heading
We publish what we find, including where the evidence is still thin. If you are a researcher interested in independently evaluating HCM, or an organisation with outcome data you would like to formally assess, we would welcome the conversation.
Book a Conversation
Peer-Reviewed Literature
Publications about HCM directly
Gale, J., & Skouteris, H. (2013). Facilitating health behavior change for chronic condition prevention and self-management. In M. L. Caltabiano & L. Ricciardelli (Eds.), Applied Topics in Health Psychology (1st ed., pp. 15–28). John Wiley & Sons.Â
The literature review underpinning HCM's design, drawing together the behaviour change evidence the methodology is built on.
Bills, C., & Gale, J. (2026). Lessons learned from the frontline implementing person-centered practice: a practical pathway that addresses known challenges. Frontiers in Health Services, 6:1820620.
Sets out the barriers to implementing person-centred care that HCM was built to address, and how the methodology operationalises person-centred values into consistent frontline practice.
Email me these articles!Evaluations of HCM in practice
Lawford, B. J., Delany, C., Bennell, K. L., Bills, C., Gale, J., & Hinman, R. S. (2018). Training Physical Therapists in Person-Centered Practice for People With Osteoarthritis: A Qualitative Case Study. Arthritis Care & Research, 70(4), 558–570. https://doi.org/10.1002/acr.23314
A qualitative case study finding that HCM training changed physical therapists' beliefs and attitudes about person-centred practice, and positively affected their clinical practice.
Lawford, B. J., Bennell, K. L., Kasza, J., Campbell, P. K., Gale, J., Bills, C., et al. (2019). Implementation of person-centred practice principles and behaviour change techniques after a 2-day training workshop: A nested case study involving physiotherapists. Musculoskeletal Care, 17(2), 221–233. https://doi.org/10.1002/msc.1395
An intervention fidelity study. Physiotherapists' self-rated assessments of their own practice compared well against independent facilitator ratings.
Eyles JP, Bowden JL, Redman S, Redman A, Dawson G, Newell S, et al. Barriers and enablers to the implementation of the Australian Osteoarthritis Chronic Care Program (OACCP). Osteoarthritis Cartilage. (2020). Apr;28:S446. doi:10.1016/j.joca.2020.02.695
Identified HCM training as a significant enabler in the successful implementation of an osteoarthritis management program.
MacDonald, M., Breault, R., & Coutts, K. (2025, April 1–3). Supporting integration of person-centred care and health behavior change skill development in pharmacy student education [Conference abstract]. Behavior Change Conference: Health & Sustainability, Lisbon, Portugal.
A review of 438 pharmacy and health promotion students found increased confidence applying HCM skills, with 88% ready to commit to a goal supporting person-centred care.
Abstract available on email request to Caroline. [email protected]
Hammersley, M. L., Cann, V. R., Parrish, A.-M., Jones, R. A., & Holloway, D. J. (2015). Evaluation of the effects of a telephone-delivered health behaviour change program on weight and physical activity. Nutrition & Dietetics, 72(4), 356–362. https://doi.org/10.1111/1747-0080.12213
An independent evaluation of the Medibank BetterHealth Coaching Program, delivered by health professionals trained in HCM under our previous name, Health Change Australia. Found significant improvements in BMI sustained at 12–18 month follow-up, and an average increase of 157 minutes per week in physical activity.
Joss, N., Brand, M., & Oldenburg, B. (2013). Evaluation of the WorkHealth Coach Program (ISCRR Research Report #1113-008.1-R1C). Institute for Safety, Compensation and Recovery Research, Monash University.
An independent Monash University evaluation of a telephone coaching program for Victorian workers, delivered by coaches with training in HCM under our previous name, Health Coaching Australia. Found the greatest health improvements among participants who completed the full program, and that 75–100% of participants who achieved a goal by the midpoint maintained it through to completion.
Published trials using HCM
(Externally led studies where HCA trained delivering staff, developed protocols, or both)
Hunter, D. J., Bowden, J. L., Hinman, R. S., Egerton, T., Briggs, A. M., Bunker, S. J., French, S. D., Pirotta, M., Shrestha, R., Schofield, D. J., Schuck, K., Zwar, N. A., Silva, S. S. M., Heller, G. Z., & Bennell, K. L. (2023). Effectiveness of a New Service Delivery Model for Management of Knee Osteoarthritis in Primary Care: A Cluster Randomized Controlled Trial. Arthritis Care & Research. https://doi.org/10.1002/acr.25037
A cluster RCT comparing GP care alone with GP care plus telephone support for knee osteoarthritis. HCA trained the staff delivering the telephone support.
Hinman, R. S., Campbell, P. K., Lawford, B. J., Briggs, A. M., Gale, J., Bills, C., et al. (2019). Does telephone-delivered exercise advice and support by physiotherapists improve pain and/or function in people with knee osteoarthritis? Telecare randomised controlled trial. British Journal of Sports Medicine. https://doi.org/10.1136/bjsports-2019-101183
HCA trained the delivering physiotherapists and co-developed the consultation protocols, scripts and patient education materials.
Bennell, K. L., Campbell, P. K., Egerton, T., Metcalf, B., Kasza, J., Forbes, A., Bills, C., Gale, J., Harris, A., Kolt, G. S., Bunker, S. J., Hunter, D. J., Brand, C. A., & Hinman, R. S. (2017). Telephone Coaching to Enhance a Home-Based Physical Activity Program for Knee Osteoarthritis: A Randomized Clinical Trial. Arthritis Care & Research, 69(1), 84–94. https://doi.org/10.1002/acr.22915
HCA developed the intervention protocols, consultation scripts and patient education materials, and trained and audited delivering staff.
Skouteris, H., McCabe, M., Milgrom, J., Kent, B., Bruce, L., Mihalopoulos, C., Herring, S., Barnett, M., Patterson, D., Teale, G., & Gale, J. (2012). Protocol of a randomised controlled trial of a specialised health coaching intervention to prevent excessive gestational weight gain and postpartum weight retention in women: the HIPP study. BMC Public Health, 12, 78. http://www.biomedcentral.com/1471-2458/12/78
HCA developed the intervention protocols, scripts and patient education materials, and trained and audited delivering staff.
Larizza, M., Speight, J., Lamoureux, E., Gale, J., Saeed, M., Fenwick, E., & Rees, G. (2016). A novel personalised eye consultation to lower HbA1c and risk of diabetes-related vision loss in adults with type 2 diabetes and diabetic retinopathy: protocol. International Journal of Behavioral Medicine, 23, S240.
HCA trained delivering staff, designed consultation protocols, and conducted fidelity audits.
Wong, S., Hassett, L., Koorts, H., et al. (2022). Planning implementation and scale-up of physical activity interventions for people with walking difficulties: study protocol for the process evaluation of the ComeBACK trial. Trials, 23, 40. https://doi.org/10.1186/s13063-021-05990-3
HCA provided the patient education booklet for this trial. HCA did not train the delivering staff.
The wider literature on person-centred care implementation
(Context for the problem HCM addresses, not studies of HCM itself)
Moore, L., Britten, N., Lydahl, D., Naldemirci, Ö., Elam, M., & Wolf, A. (2017). Barriers and facilitators to the implementation of person-centred care in different healthcare contexts. Scandinavian Journal of Caring Sciences, 31(4), 662–673. https://doi.org/10.1111/scs.12376
Documents a pattern seen repeatedly: providers who believe they are practising person-centred care often are not, at least not in ways the person receiving care would recognise.
Fridberg, H., Wallin, L., & Tistad, M. (2021). The innovation characteristics of person-centred care as perceived by healthcare professionals: an interview study employing a deductive-inductive content analysis guided by the consolidated framework for implementation research. BMC Health Services Research, 21, 1. https://doi.org/10.1186/s12913-021-06942-y
Finds wide variation in how healthcare professionals understand and value person-centred care, shaped by its ethical grounding, how it is turned into concrete routines, and individual recognition of its worth.
Edgar, D. A., Wilson, V. J., & Moroney, T. (2020). Which is it, person-centred culture, practice or care? It matters. Faculty of Science, Medicine and Health – Papers: Part B. https://ro.uow.edu.au/smhpapers1/1654
Highlights that the focus should be on person-centred cultures and on how these can be developed and embedded.
O'Leary, S., Gale, J., Volker, G., Kuipers, P., Dalton, M., & McPhail, S. (2020). Fostering patient uptake of recommended health services and self-management strategies for musculoskeletal conditions: A Delphi study of clinician attributes. Musculoskeletal Care, 18, 161–168. https://onlinelibrary.wiley.com/doi/abs/10.1002/msc.1448
Highlights that influencing uptake of advice is a specific skillset that needs to be taught, not something assumed to come with clinical training.
Forsgren, E., Feldthusen, C., Wallström, S., Björkman, I., Bergholtz, J., Friberg, F., & Öhlén, J. (2025). Learning from the implementation of person-centred care: a meta-synthesis of research related to the Gothenburg framework. Frontiers in Health Services, 5:1589502. https://doi.org/10.3389/frhs.2025.1589502
Describes implementation of the Gothenburg model for person-centred care, concluding that deliberate and emergent strategies, and top-down and bottom-up approaches with co-creation at all levels, are needed.
