Anjana E Sharma1, Rachel Willard-Grace2, Danielle Hessler2, Thomas Bodenheimer2, David H Thom2. 1. Center for Excellence in Primary Care, UCSF Department of Family & Community Medicine, San Francisco, California Anjana.sharma@ucsf.edu. 2. Center for Excellence in Primary Care, UCSF Department of Family & Community Medicine, San Francisco, California.
Abstract
PURPOSE:Health coaching is effective for chronic disease self-management in the primary care safety-net setting, but little is known about the persistence of its benefits. We conducted an observational study evaluating the maintenance of improved cardiovascular risk factors following a health coaching intervention. METHODS: We performed a naturalistic follow-up to the Health Coaching in Primary Care Study, a 12-month randomized controlled trial (RCT) comparing health coaching to usual care for patients with uncontrolled diabetes, hypertension, or hyperlipidemia. Participants were followed up 24 months from RCT baseline. The primary outcome was the proportion at goal for at least 1 measure (hemoglobinA1c, systolic blood pressure, or LDL cholesterol) that had been above goal at enrollment; secondary outcomes included each individual clinical goal. Chi-square tests and paired t-tests compared dichotomous and continuous measures. RESULTS: 290 of 441 participants (65.8%) participated at both 12 and 24 months. The proportion of patients in the coaching arm of the RCT who achieved the primary outcome dropped only slightly from 47.1% at 12 to 45.9% at 24 months (P = .80). The proportion at goal for hemoglobin A1c dropped from 53.4% to 36.2% (P = .03). All other clinical metrics had small, nonsignificant changes between 12 and 24 months. CONCLUSIONS: Results support the conclusion that most improved clinical outcomes persisted 1 year after the completion of the health coaching intervention.
RCT Entities:
PURPOSE: Health coaching is effective for chronic disease self-management in the primary care safety-net setting, but little is known about the persistence of its benefits. We conducted an observational study evaluating the maintenance of improved cardiovascular risk factors following a health coaching intervention. METHODS: We performed a naturalistic follow-up to the Health Coaching in Primary Care Study, a 12-month randomized controlled trial (RCT) comparing health coaching to usual care for patients with uncontrolled diabetes, hypertension, or hyperlipidemia. Participants were followed up 24 months from RCT baseline. The primary outcome was the proportion at goal for at least 1 measure (hemoglobin A1c, systolic blood pressure, or LDL cholesterol) that had been above goal at enrollment; secondary outcomes included each individual clinical goal. Chi-square tests and paired t-tests compared dichotomous and continuous measures. RESULTS: 290 of 441 participants (65.8%) participated at both 12 and 24 months. The proportion of patients in the coaching arm of the RCT who achieved the primary outcome dropped only slightly from 47.1% at 12 to 45.9% at 24 months (P = .80). The proportion at goal for hemoglobin A1c dropped from 53.4% to 36.2% (P = .03). All other clinical metrics had small, nonsignificant changes between 12 and 24 months. CONCLUSIONS: Results support the conclusion that most improved clinical outcomes persisted 1 year after the completion of the health coaching intervention.
Authors: Michael Jelinek; Margarite J Vale; Danny Liew; Leeanne Grigg; Anthony Dart; David L Hare; James D Best Journal: Heart Lung Circ Date: 2009-08-03 Impact factor: 2.975
Authors: R Cooper; J Cutler; P Desvigne-Nickens; S P Fortmann; L Friedman; R Havlik; G Hogelin; J Marler; P McGovern; G Morosco; L Mosca; T Pearson; J Stamler; D Stryer; T Thom Journal: Circulation Date: 2000-12-19 Impact factor: 29.690
Authors: Annette Becker; Corinna Leonhardt; Michael M Kochen; Stefan Keller; Karl Wegscheider; Erika Baum; Norbert Donner-Banzhoff; Michael Pfingsten; Jan Hildebrandt; Heinz-Dieter Basler; Jean F Chenot Journal: Spine (Phila Pa 1976) Date: 2008-03-01 Impact factor: 3.468
Authors: K M Venkat Narayan; James P Boyle; Theodore J Thompson; Stephen W Sorensen; David F Williamson Journal: JAMA Date: 2003-10-08 Impact factor: 56.272
Authors: Jessica L Unick; Christine A Pellegrini; Shira I Dunsiger; Kathryn E Demos; J Graham Thomas; Dale S Bond; Jennifer Webster; Rena R Wing Journal: Contemp Clin Trials Date: 2020-02-01 Impact factor: 2.226
Authors: Gary A Sforzo; Miranda P Kaye; Irina Todorova; Sebastian Harenberg; Kyle Costello; Laura Cobus-Kuo; Aubrey Faber; Elizabeth Frates; Margaret Moore Journal: Am J Lifestyle Med Date: 2017-05-19
Authors: Addie L Fortmann; Athena Philis-Tsimikas; Johanna A Euyoque; Taylor L Clark; Daniela G Vital; Haley Sandoval; Julia I Bravin; Kimberly L Savin; Jennifer A Jones; Scott Roesch; Todd Gilmer; Thomas Bodenheimer; James Schultz; Linda C Gallo Journal: Contemp Clin Trials Date: 2020-10-11 Impact factor: 2.226