After more than two decades of helping patients cope with preventable chronic diseases, Lucy Hoblitzelle decided that her nursing degree could be put to better use by motivating people to lead healthier lives.

She recently completed training to become a wellness coach, a new breed of health professional who works, one-on-one, with people needing to change behavior that's adversely affecting their health.

Wellness coaches, also known as health coaches, are likely to play an increasingly important role as corporations, insurers, hospitals and clinics try to rein in medical spending by paying the coaches to motivate people to take better care of themselves and use fewer medical services.

Wanting to cut health costs wasn't the reason Hoblitzelle decided to make her career move. Instead, she'd been asking herself why some of her patients couldn't follow the doctor's orders on exercise, eating and medications following a heart attack, for example.

"What's different is that people make changes that they need if somebody helps them, one step at a time, to be healthy. Doctors are so time-pressed" that they can't take on this duty, she says. As a result some insurance companies and employee assistance programs are now turning to wellness coaches to help people lead healthier and more productive lives.

Wellness coaches tap into clients' personal strengths and build motivation and confidence to help them create a vision for change and, over time, slowly meet whatever their health-related need or dream might be.

Margaret Moore began developing that vision a decade ago when she set up what is believed to have been the first coaching program. A biologist with an MBA, she worked in the biotech field for 17 years, helping to develop and run companies, before starting Wellcoaches Corp. in Massachusetts. It has trained more than 6,000 coaches through distance learning, with basic training and certification costing about $1,600. Basic training lasts a minimum of six months, and advanced training takes a year. In addition to individuals, such as Hoblitzelle, Moore's company trains corporate employees to coach other workers. In addition to nurses, she says, counselors, social workers and therapists are moving into coaching.

"They enjoy doing it because it's a different skill. The way we describe it is that therapists follow the trail of tears, but coaches follow the trail of dreams. Sometimes you can get tired of working with people who are broken, and coaching is a much more positive experience."

Moore says some studies by major universities and hospitals show that coaches have been successful in improving health outcomes in connection with a range of issues, including bariatric surgery, obesity, diabetes and hypertension.

"Historically you tend to see results showing that about one in 10 people are successful in make lasting changes from cardiac rehab, diabetes education and chronic pain," she says. She says with her company's approach "well over half (of clients) make changes. That's a big improvement." But she notes that no studies are yet available to show the long-term benefits of coaching.

What is clear to her, however, is one prime reason people tend to remain in a rut when they try to lose weight, cope with diabetes, overcome depression or cope with many other illnesses. The overlooked variable that leaves people spinning their wheels, she says, is chronic stress.

"Everyone wants to be healthy and everyone knows generally what to do. They know you need to exercise, eat fruits and veggies, don't eat doughnuts and drink Coca Cola. But I hope people appreciate how hard it is to take care of yourself these days when you are under enormous stress resulting from the economy, raising your family, working and trying to hold everything together."

A major part of what coaches do, she says, is "help people get to a place where they can cope with the stress. And then the rest gets easier."

Coaches help people understand what's stressing them and how to make it more manageable. Moore encourages outsiders to bring a level of compassion and appreciate how difficult it might be for some people to refrain from smoking or to shed weight to ease a medical condition, such as heart disease.

"As long as we make people feel guilty about it, all we do is make it worse. Then their inner critic is more severe, and that makes them feel even more stress."

She says, people make promises to improve their health the same way they make New Year's resolutions.

"Helping people make lasting changes is our specialty."