Transforming the Veterans Affairs to a Whole Health System of Care

Bokhour, Barbara G.; Haun, Jolie; Hyde, Justeen; Charns, Martin P.; Kligler, Benjamin

doi:10.1097/mlr.0000000000001316

Cited by 101 publications

(112 citation statements)

References 17 publications

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“… 10 , 12 – 14 To date, there is little research examining the effectiveness of VA’s Whole Health Coaching Program in supporting behavior change or improving veterans’ health and wellbeing. 15 …”

Section: Introduction Background and Significancementioning

confidence: 99%

How VA Whole Health Coaching Can Impact Veterans’ Health and Quality of Life: A Mixed-Methods Pilot Program Evaluation

Purcell

Zamora

Bertenthal

et al. 2021

Glob Adv Health Med

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Purpose To examine the impact of a pilot VA Whole Health Coaching program, including whether and how the program helps veterans improve their health and quality of life. Intervention Whole Health Coaching is a structured program to support veterans in making healthy behavior changes to promote holistic well-being. Design This mixed-methods quality-improvement evaluation combined surveys (pre- and post-coaching) with follow-up qualitative interviews. Setting The setting was a large VA healthcare system, encompassing a medical center and six community-based clinics in Northern California. Participants 65 veterans completed surveys at both time points; 42 completed qualitative interviews. Method Telephone surveys administered at baseline and 3 months assessed global health (PROMIS-10), perceived stress (PSS-4), and perceived health competency (PHCS-2). Pre- and post-scores were compared using t-tests. A subsample of participants completed a qualitative interview evaluating program experience, goal attainment, and the coaching relationship. Results Surveys showed significant improvements over baseline in mental health (p = 0.006; d = 0.36), stress (p = 0.003; d = –0.38), and perceived health competence (p = 0.01; d = 0.35). Interviewees were highly satisfied with their coaching experience, describing both effective program components and improvement opportunities. Conclusion Whole Health Coaching can help participants make meaningful progress toward health goals, reduce stress, and improve quality of life. The Whole Health model’s emphasis on holistic self-assessment; patient-driven goal-setting; supportive, non-judgmental inquiry; and mindful awareness contributed to program success and enhanced participants’ experience.

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Section: Introduction Background and Significancementioning

confidence: 99%

How VA Whole Health Coaching Can Impact Veterans’ Health and Quality of Life: A Mixed-Methods Pilot Program Evaluation

Purcell

Zamora

Bertenthal

et al. 2021

Glob Adv Health Med

View full text Add to dashboard Cite

show abstract

“…Providing Veterans with an opportunity to start health care planning with a mindful process to identify what matters most to them in their lives may empower them to engage in their own health care and self-care practices. 18 Our study provides preliminary support for such an approach, as participation in TCMLH positively impacted several important patientreported health outcomes. Veterans reported lower perceived stress at post-test, which is an important finding since Veterans often endure stress related to physical and mental health, and to nonclinical issues such as housing and unemployment.…”

Section: Discussionmentioning

confidence: 55%

“…[11][12][13][14][15][16][17] However, much of the research in this area is disease specific, and more research is needed to determine the impact of peer-led group programs on whole-person health and well-being. 18 We conducted a pilot study to assess the impact of one approach to the Whole Health Pathway, a person-driven peer-led group program called Taking Charge of My Life and Health (TCMLH), which fosters Veterans' empowerment and engagement in behaviors to improve their health and well-being. The key objective of our study was to determine whether this nine-week program could impact Veterans' engagement in their own health care, as well as their mental and physical health and well-being.…”

Section: Introductionmentioning

confidence: 99%

Examining the Impact of a Peer-Led Group Program for Veteran Engagement and Well-Being

Abadi

Barker

Rao

et al. 2021

The Journal of Alternative and Complementary Medicine

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Objectives: Veterans often suffer from multiple chronic illnesses, including mental health disorders, diabetes, obesity, and cardiovascular disease. The improvement of engagement in their own health care is critical for enhanced well-being and overall health. Peer-led group programs may be an important tool to provide support and skill development. We conducted a pilot study to explore the impact of a peer-led group-based program that teaches Veterans to become empowered to engage in their own health and well-being through mindful awareness practices, self-care strategies, and setting life goals.Design: Surveys were collected before and immediately after participation in the Taking Charge of My Life and Health (TCMLH) peer-led group program.Settings/location: Sessions were held in non-clinical settings within a VA medical center in the Midwest. Subjects: Our sample comprised 48 Veteran participants who were enrolled in TCMLH and completed a pretest and post-test survey.Intervention: TCMLH is a 9-week peer-led group program with an established curriculum that leverages the power of peer support to improve patient engagement, empowerment, health, and well-being among Veterans through Whole Health concepts, tools, and strategies. Programs were led by 1 of 12 trained Veteran peer facilitators.Outcome measures: Program impact on Veteran well-being was assessed by pre-post measures, including the Patient Activation Measure (PAM), the Perceived Stress Scale (PSS), the Patient-Reported Outcomes Measurement Information System Scale (PROMIS-10), the Perceived Health Competency Scale (PHCS), and the Life Engagement Test (LET).Results: There was a significant decrease in perceived stress (PSS score). Significant improvements were also seen in mental health and quality of life (PROMIS-10), participant accordance with the statement ''I have a lot of reasons for living'' (LET), and patient engagement (PAM score).Conclusions: As the Whole Health movement expands-both in VA and elsewhere-our findings suggest that guiding patients in an exploration of their personal values and life goals can help in key areas of patient engagement and mental and physical health outcomes. Further study is warranted, and expansion of the TCMLH program will allow for a more rigorous evaluation with a larger sample size.

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“…The Whole Health initiative involves both the expansion of CIH and wellness services, and a reorientation of the way care is directed and provided by engaging individuals in developing a ''personal health plan''. 23,24 In this way, the program illustrates how the central TIC tenets of choice and empowerment can enrich the delivery of CIH modalities. Program evaluation data underscore the importance of having strong leadership and a clear implementation plan when proposing to change system's culture and care delivery Models.…”

Section: The Widespread Impact Of Traumamentioning

confidence: 99%

A Call to Action: Adoption of Trauma Informed Care in Complementary and Integrative Health Services

Hansen

Walsh

Price

2021

The Journal of Alternative and Complementary Medicine

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This is the seventh commentary through the JACM column partnership with the Osher Collaborative for Integrative Medicine. Our goal with these commentaries is to stimulate critical conversations in the field through perspectives from the leaders of the Collaborative's seven prominent academically-based integrative centers. This commentary elevates a theme that is tangled up in all kinds of human troubles: prior trauma. Trauma Informed Care (TIC) proposes that outing this powerfully determinant force is key to untangling and healing. The overlaps of this model with the integrative health model are significant.

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Transforming the Veterans Affairs to a Whole Health System of Care

Cited by 101 publications

References 17 publications

How VA Whole Health Coaching Can Impact Veterans’ Health and Quality of Life: A Mixed-Methods Pilot Program Evaluation

How VA Whole Health Coaching Can Impact Veterans’ Health and Quality of Life: A Mixed-Methods Pilot Program Evaluation

Examining the Impact of a Peer-Led Group Program for Veteran Engagement and Well-Being

A Call to Action: Adoption of Trauma Informed Care in Complementary and Integrative Health Services

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