ACE Health Coach cheat sheet

Transtheoretical Model stages: precontemplation (no intention within 6 months), contemplation (intention within 6 months), preparation (intention within 30 days plus small steps), action (behavior change under 6 months), maintenance (over 6 months), and termination.

Relapse is a normal stage in the cycle of change, not a failure; coaches respond by re-assessing stage rather than restarting from zero.

Self-efficacy (Bandura) predicts whether a client attempts and sustains change; it rises through mastery experiences, vicarious modeling, verbal persuasion, and reduced arousal.

SMART goals are Specific, Measurable, Attainable, Relevant, and Time-bound; process goals (actions the client controls) outperform outcome-only goals for adherence.

Decisional balance weighs perceived pros and cons of changing; it is most useful in contemplation and preparation, where pros begin to outweigh cons.

Motivational interviewing (Miller & Rollnick) rests on partnership, acceptance, compassion, and evocation, and targets change talk over sustain talk.

The coach's scope is behavior and lifestyle support; diagnosing conditions, prescribing diets or exercise programs, and interpreting labs are outside the health coach role and require referral.

Coaching is client-led: the client sets the agenda and goals, while the coach supplies structure, reflection, and accountability rather than directives.

Behavior is shaped by antecedents, behavior, and consequences (ABC model); changing cues and immediate rewards is more effective than relying on willpower.

Energy density: carbohydrate and protein supply about 4 kcal per gram, alcohol about 7 kcal per gram, and fat about 9 kcal per gram.

Acceptable Macronutrient Distribution Ranges: carbohydrate 45-65%, fat 20-35%, and protein 10-35% of total daily calories for adults.

The Physical Activity Guidelines for Americans call for 150-300 minutes per week of moderate-intensity aerobic activity or 75-150 minutes of vigorous activity, plus muscle strengthening on 2 or more days per week.

Moderate intensity corresponds to roughly 64-76% of maximum heart rate; estimated max heart rate is commonly calculated as 220 minus age.

The talk test is a practical intensity gauge: a person can talk but not sing at moderate intensity and cannot say more than a few words at vigorous intensity.

Dietary fiber recommendations are about 25 g per day for adult women and 38 g per day for adult men, or roughly 14 g per 1,000 kcal.

Sodium guidance is to keep intake under 2,300 mg per day, with an ideal limit near 1,500 mg per day for adults with hypertension.

A standard serving of alcohol in the United States is 12 oz beer (about 5% alcohol), 5 oz wine (about 12%), or 1.5 oz distilled spirits (about 40%).

FITT-VP organizes exercise prescription as Frequency, Intensity, Time, Type, Volume, and Progression.

OARS core communication skills are Open-ended questions, Affirmations, Reflections, and Summaries; reflections should outnumber questions in a coaching conversation.

Simple reflections restate content; complex reflections add inferred meaning or emotion and tend to deepen client exploration.

Change talk categories are desire, ability, reasons, need, and commitment (DARN-C); commitment language is the strongest predictor of behavior.

The righting reflex is the urge to advise or fix; it can trigger client resistance and is countered by asking permission before offering information.

Elicit-Provide-Elicit is the sequence for sharing information: ask what the client already knows, offer information neutrally, then ask what it means for them.

The decisional balance and importance/confidence rulers are scaling questions (0-10) that invite elaboration on why a client rates themselves as they do.

Active listening includes paraphrasing, reflecting feeling, summarizing, and withholding judgment; it is distinct from passive silence.

The working alliance depends on agreed goals, agreed tasks, and an emotional bond; ruptures should be named and repaired rather than ignored.

Ambivalence is normal and is resolved by the client, not by the coach arguing for change.

Scope of practice is defined by the coach's training and certification; staying within it and referring out is a core ethical duty.

Informed consent covers the nature of coaching, fees, confidentiality and its limits, and the client's right to stop at any time.

Confidentiality has legal limits, including suspected abuse, imminent danger to self or others, and valid court orders.

Mandatory reporting laws require reporting suspected child or elder abuse to designated authorities; coaches should know their state's requirements.

Coaches must avoid dual relationships that impair objectivity and must disclose any conflicts of interest.

Professional liability insurance protects the coach against claims of negligence; it does not replace scope-of-practice compliance.

Business fundamentals include a defined service package, a written coaching agreement, a fee schedule, and a documented record-keeping system.

Marketing claims must be truthful and avoid guarantees of health outcomes; testimonials require client permission.

Continuing education and recertification are required to maintain most health coaching credentials, and ethical codes typically require ongoing competence development.

Transtheoretical Model stages: precontemplation (no intention within 6 months), contemplation (intention within 6 months), preparation (intention within 30 days plus small steps), action (behavior change under 6 months), maintenance (over 6 months), and termination.

Relapse is a normal stage in the cycle of change, not a failure; coaches respond by re-assessing stage rather than restarting from zero.

Self-efficacy (Bandura) predicts whether a client attempts and sustains change; it rises through mastery experiences, vicarious modeling, verbal persuasion, and reduced arousal.

SMART goals are Specific, Measurable, Attainable, Relevant, and Time-bound; process goals (actions the client controls) outperform outcome-only goals for adherence.

Decisional balance weighs perceived pros and cons of changing; it is most useful in contemplation and preparation, where pros begin to outweigh cons.

Motivational interviewing (Miller & Rollnick) rests on partnership, acceptance, compassion, and evocation, and targets change talk over sustain talk.

The coach's scope is behavior and lifestyle support; diagnosing conditions, prescribing diets or exercise programs, and interpreting labs are outside the health coach role and require referral.

Coaching is client-led: the client sets the agenda and goals, while the coach supplies structure, reflection, and accountability rather than directives.

Behavior is shaped by antecedents, behavior, and consequences (ABC model); changing cues and immediate rewards is more effective than relying on willpower.

Energy density: carbohydrate and protein supply about 4 kcal per gram, alcohol about 7 kcal per gram, and fat about 9 kcal per gram.

Acceptable Macronutrient Distribution Ranges: carbohydrate 45-65%, fat 20-35%, and protein 10-35% of total daily calories for adults.

The Physical Activity Guidelines for Americans call for 150-300 minutes per week of moderate-intensity aerobic activity or 75-150 minutes of vigorous activity, plus muscle strengthening on 2 or more days per week.

Moderate intensity corresponds to roughly 64-76% of maximum heart rate; estimated max heart rate is commonly calculated as 220 minus age.

The talk test is a practical intensity gauge: a person can talk but not sing at moderate intensity and cannot say more than a few words at vigorous intensity.

Dietary fiber recommendations are about 25 g per day for adult women and 38 g per day for adult men, or roughly 14 g per 1,000 kcal.

Sodium guidance is to keep intake under 2,300 mg per day, with an ideal limit near 1,500 mg per day for adults with hypertension.

A standard serving of alcohol in the United States is 12 oz beer (about 5% alcohol), 5 oz wine (about 12%), or 1.5 oz distilled spirits (about 40%).

FITT-VP organizes exercise prescription as Frequency, Intensity, Time, Type, Volume, and Progression.

OARS core communication skills are Open-ended questions, Affirmations, Reflections, and Summaries; reflections should outnumber questions in a coaching conversation.

Simple reflections restate content; complex reflections add inferred meaning or emotion and tend to deepen client exploration.

Change talk categories are desire, ability, reasons, need, and commitment (DARN-C); commitment language is the strongest predictor of behavior.

The righting reflex is the urge to advise or fix; it can trigger client resistance and is countered by asking permission before offering information.

Elicit-Provide-Elicit is the sequence for sharing information: ask what the client already knows, offer information neutrally, then ask what it means for them.

The decisional balance and importance/confidence rulers are scaling questions (0-10) that invite elaboration on why a client rates themselves as they do.

Active listening includes paraphrasing, reflecting feeling, summarizing, and withholding judgment; it is distinct from passive silence.

The working alliance depends on agreed goals, agreed tasks, and an emotional bond; ruptures should be named and repaired rather than ignored.

Ambivalence is normal and is resolved by the client, not by the coach arguing for change.

Scope of practice is defined by the coach's training and certification; staying within it and referring out is a core ethical duty.

Informed consent covers the nature of coaching, fees, confidentiality and its limits, and the client's right to stop at any time.

Confidentiality has legal limits, including suspected abuse, imminent danger to self or others, and valid court orders.

Mandatory reporting laws require reporting suspected child or elder abuse to designated authorities; coaches should know their state's requirements.

Coaches must avoid dual relationships that impair objectivity and must disclose any conflicts of interest.

Professional liability insurance protects the coach against claims of negligence; it does not replace scope-of-practice compliance.

Business fundamentals include a defined service package, a written coaching agreement, a fee schedule, and a documented record-keeping system.

Marketing claims must be truthful and avoid guarantees of health outcomes; testimonials require client permission.

Continuing education and recertification are required to maintain most health coaching credentials, and ethical codes typically require ongoing competence development.