Health Coaching to Enhance Psychological Well-being Among Veterans with Suicidal Ideation: a Pilot Study

Denneson, Lauren M.; Trevino, Amira Y.; Kenyon, Emily A.; Ono, Sarah S.; Pfeiffer, P.; Dobscha, Steven K.

doi:10.1007/s11606-018-4677-2

Cited by 12 publications

(7 citation statements)

References 7 publications

(5 reference statements)

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“…Extending the length of the intervention to six months, for example, would align Peer-WHC with similar peer-based interventions for vulnerable populations. 44,45,46 The current study extends a recent study on use of health coaching with high-risk patients 47 by testing this approach with homeless veterans and integrating the roles of a health coach with those of a peer specialist. Although complementary in many ways, health coaches use patient preferences to develop personal health goals, whereas peers use their lived experience to provide social-emotional support to patients.…”

Section: Discussionmentioning

confidence: 72%

Peer Support and Whole Health Coaching to Address the Healthcare Needs of Homeless Veterans: A Pilot Study

Blonigen

Smelson

Smith

et al. 2022

Preprint

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Background: Homelessness is a robust social determinant of acute care service utilization among veterans. Although intensive outpatient programs have been developed for homeless veterans who are high utilizers of acute care (“super utilizers”), few scalable programs have been implemented to address their needs. Objective: Describe the development and pilot testing of a novel intervention that integrates the roles of a peer and whole health coach (“Peer-WHC”) in coordination with primary care teams to reduce homeless veterans’ frequent use of acute care. Design: Single-arm trial in three outpatient primary care clinics at a Veterans Health Administration (VHA) medical center; pre/post design using mixed-methods.Participants: Twenty veterans from VHA’s homeless registry who were super-utilizers of acute care and enrolled in primary care.Intervention: Weekly health coaching sessions with a peer over 12 weeks, including discussions of patients’ health care utilization patterns and coordination with primary care. Main Measures: Rates of session attendance and intervention fidelity, patient-reported satisfaction and changes in patient engagement and perceptions of health, pre/post utilization of acute and supportive care services, and qualitative interviews with multiple stakeholders to identify barriers and facilitators to implementation.Key Results: On average, patients attended 6.35 sessions (SD=3.5, Median=7). Satisfaction scores (M=28.75 out of 32; SD=2.79) exceeded a priori benchmarks. Patients’ perceptions of health improved from pre to post [t(df)=-2.26(14), p=0.04]. In the 3-months pre/post, 45% (n=9) and 15% (n=3) of patients, respectively, were hospitalized. Qualitative feedback from patients, providers, and peers and fidelity metrics suggested value in increasing the length of the intervention to facilitate goal-setting with patients and coordination with primary care. Conclusions: Findings support the feasibility, acceptability, and utility of Peer-WHC to address the healthcare needs of homeless veterans. A future trial is warranted to test the impact of Peer-WHC on reducing these patients’ frequent use of acute care.

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Section: Discussionmentioning

confidence: 72%

Peer Support and Whole Health Coaching to Address the Healthcare Needs of Homeless Veterans: A Pilot Study

Blonigen

Smelson

Smith

et al. 2022

Preprint

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“…The current study extends a recent study on use of health coaching with high-risk patients [ 48 ] by testing this approach with homeless veterans and integrating the roles of a health coach with those of a peer specialist. Although complementary in many ways, health coaches use patient preferences to develop personal health goals, whereas peers use their lived experience to provide social-emotional support to patients.…”

Section: Discussionmentioning

confidence: 75%

Peer support and whole health coaching to address the healthcare needs of homeless veterans: a pilot study

et al. 2022

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Background Homelessness is a robust social determinant of acute care service utilization among veterans. Although intensive outpatient programs have been developed for homeless veterans who are high utilizers of acute care (“super utilizers”), few scalable programs have been implemented to address their needs. Objective Describe the development and pilot testing of a novel intervention that integrates the roles of a peer and whole health coach (“Peer-WHC”) in coordination with primary care teams to reduce homeless veterans’ frequent use of acute care. Design Single-arm trial in three outpatient primary care clinics at a Veterans Health Administration (VHA) medical center; pre/post design using mixed-methods. Participants Twenty veterans from VHA’s homeless registry who were super-utilizers of acute care and enrolled in primary care. Intervention Weekly health coaching sessions with a peer over 12 weeks, including discussions of patients’ health care utilization patterns and coordination with primary care. Main measures Rates of session attendance and intervention fidelity, patient-reported satisfaction and changes in patient engagement and perceptions of health, pre/post utilization of acute and supportive care services, and qualitative interviews with multiple stakeholders to identify barriers and facilitators to implementation. Key results On average, patients attended 6.35 sessions (SD = 3.5, Median = 7). Satisfaction scores (M = 28.75 out of 32; SD = 2.79) exceeded a priori benchmarks. Patients’ perceptions of health improved from pre to post [t(df)=-2.26(14), p = 0.04]. In the 3-months pre/post, 45% (n = 9) and 15% (n = 3) of patients, respectively, were hospitalized. Qualitative feedback from patients, providers, and peers and fidelity metrics suggested value in increasing the length of the intervention to facilitate goal-setting with patients and coordination with primary care. Conclusion Findings support the feasibility, acceptability, and utility of Peer-WHC to address the healthcare needs of homeless veterans. A future trial is warranted to test the impact of Peer-WHC on reducing these patients’ frequent use of acute care.

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“…The Whole Health initiative is focused on making VA healthcare personalized, proactive, and patient-driven and targets all the elements of an individual’s health and wellness (e.g., community, professional care, and self-care; Krejci et al, 2014). Early research on Whole Health suggests positive benefits, but to our knowledge, no articles have yet evaluated peer-delivered Whole Health Coaching (Denneson et al, 2019; Hull et al, 2019; Mori et al, 2019). In fact, the reviews cited previously suggest a need for more rigorous evaluation of peer-delivered Whole Health Coaching, including the need to disentangle the unique contributions of the peers and interventions (Cabassa et al, 2017).…”

Section: Aimsmentioning

confidence: 99%

Engagement, experience, and satisfaction with peer-delivered whole health coaching for veterans with PTSD: A mixed methods process evaluation.

Johnson

Possemato

Khan

et al. 2022

Psychological Services

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To describe the process of peer delivered Whole Health Coaching, a primary care based intervention in which peers provide patients with individualized support to set and work toward wellness goals. Fifteen primary care Veterans with PTSD participated in peer delivered Whole Health Coaching during a multiple baseline design study. This is a planned mixed methods concurrent equal status analysis of the process of peer delivered Whole Health Coaching including patient engagement, patient experience, fidelity to the coaching and peer roles, and patient satisfaction. Data sources were feedback interviews, electronic medical record reviews, self report assessments, and observer fidelity ratings of session recordings. Qualitative data were used to expand the interpretation of quantitative descriptive data. A rapid assessment approach was used for qualitative analysis. Retention in peer delivered Whole Health Coaching was 11 of 15 participants, and factors facilitating engagement were peers as providers and flexibility in scheduling/modality of sessions. Peers demonstrated high fidelity to coaching skills, Whole Health Coaching phases and stages, and the peer role. Participants expressed high satisfaction and perceived peer delivered Whole Health Coaching as helpful with making progress on individualized wellness goals. Results build on the literature describing the expansion of peer services into primary care and implementation of interventions such as wellness coaching. This initial small study suggests that peers can deliver high quality wellness coaching, and this description of the process can guide the integration of peers doing wellness coaching in similar clinical settings and for future research trials. Impact StatementPeer providers can deliver high quality wellness coaching to Veterans with PTSD in a manner that is satisfactory to those Veterans. These findings can help inform integration of peers in settings where wellness coaching is performed.

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Health Coaching to Enhance Psychological Well-being Among Veterans with Suicidal Ideation: a Pilot Study

Cited by 12 publications

References 7 publications

Peer Support and Whole Health Coaching to Address the Healthcare Needs of Homeless Veterans: A Pilot Study

Peer Support and Whole Health Coaching to Address the Healthcare Needs of Homeless Veterans: A Pilot Study

Peer support and whole health coaching to address the healthcare needs of homeless veterans: a pilot study

Engagement, experience, and satisfaction with peer-delivered whole health coaching for veterans with PTSD: A mixed methods process evaluation.

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