Healthy lifestyle behaviors can prevent the onset of chronic illness and help manage existing conditions. Health coaching interventions are increasingly being incorporated into health management programs, which are implemented in a variety of settings, from physician practices to the broader population level (e.g. throughout health plans, employer groups). To date, motivational inter vie wing-based health coaching is the only technique to have been fully described and consistently demonstrated as causally and independently associated with positive behavioral outcomes. In order for a health coaching intervention to be effective (i) individuals at risk must be correctly identified; (ii) recruitment efforts must be maximized; (iii) a valid coaching technique should be chosen; (iv) the delivery mechanism must ensure adequate participant engagement; and (v) the program evaluation must be sufficiently robust to mitigate threats to validity, and demonstrate a causal association between the intervention and outcomes. Given the rapid expansion in the field of health coaching within the larger context of health management programs, more studies employing rigorous evaluation designs are needed to advance the science and application of the concept.