Wellness Coaching for People With Prediabetes: A Randomized Encouragement Trial to Evaluate Outreach Methods at Kaiser Permanente, Northern California, 2013

Xiao, Hong; Adams, Sara R.; Goler, Nancy; Sanna, Rashel S.; Boccio, Mindy; Bellamy, David; Brown, Susan D.; Neugebauer, Romain; Ferrara, Assiamira; Schmittdiel, Julie A.

doi:10.5888/pcd12.150251

Cited by 11 publications

(5 citation statements)

References 19 publications

(16 reference statements)

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“…However, while the number of consenters to the wellness coaching program was low, participant characteristics did not differ significantly from non-participants, and response rates reflect similar recruitment challenge seen in other studies. For example, Kaiser Permanente's encouragement trial that evaluated outreach methods (secured email, letter or phone) to recruit patients into Wellness Coaching Centers (SCC) showed a 1.9% overall uptake rate across the three intervention arms ( Xiao et al, 2015 ). Reaching out to potential subjects during clinic visits and bringing wellness coaching into the community are ways of possibly increasing participation rates among the high risk individuals who may benefit from it; further research on identifying barriers and facilitators to recruitment would be helpful.…”

Section: Discussionmentioning

confidence: 99%

Impact of a 12-week wellness coaching on self-care behaviors among primary care adult patients with prediabetes

DeJesus

Clark

Rutten

et al. 2018

Preventive Medicine Reports

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This single arm prospective study assessed the impact of individualized wellness coaching intervention for primary care patients with prediabetes on self-reported changes in physical activity level and food choices. Five hundred sixty adult patients 18 years and older with prediabetes, seen in primary care clinic, were invited to participate in 12 weeks wellness coaching sessions delivered by certified coaches. Responses from questionnaires at baseline, 6 and 12 weeks were analyzed. Of 168 consented patients, 99 completed at least one coaching session; majority was elderly, female, overweight or obese. At baseline, 50% had <60 min aerobic exercise/week. At 6 and 12 weeks, average aerobic exercise time significantly increased from 117 min to 166 and 199 min respectively. Effect was sustained at 24 weeks. Success in making healthy eating choices also statistically improved from baseline. Significant effects on both activity level and eating behavior persisted even after adjusting for age, sex and baseline glucose/A1c values. Secondary outcomes of self-efficacy and quality of life likewise showed significant improvement. Results suggest that integration of wellness coaching in primary care practice among individuals at high risk for diabetes is feasible and may be useful as part of diabetes prevention management strategies in target populations. Future randomized clinical trials are needed to further explore this issue.

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Section: Discussionmentioning

confidence: 99%

Impact of a 12-week wellness coaching on self-care behaviors among primary care adult patients with prediabetes

DeJesus

Clark

Rutten

et al. 2018

Preventive Medicine Reports

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 98%

“…While WO participation fell short of our target, the 23.6% (321 of 1358) uptake is considerable when contrasted with participation in PR by Medicare beneficiaries (4%) with COPD 13 or among those who had a recent COPD hospital discharge (2.7%) 12 or among patients exposed to lighter-touch no-cost behavioral programs (2%). 50 Nonetheless, health systems need to weigh the resources associated with broad outreach efforts and the yield in patient engagement, especially in response to the recent PA guidelines recommending that all older adults and those with chronic conditions engage in some level of PA. 16 When contacted, approximately 34.6% (471 of 1358) of patients in our study expressed no interest in the WO program. However, the rate of disinterested patients would increase to 57.7% (784 of 1358) if passive declines (patients who did not return our calls despite 3 contacts) were included.…”

Section: Discussionmentioning

confidence: 99%

Effect of Physical Activity Coaching on Acute Care and Survival Among Patients With Chronic Obstructive Pulmonary Disease

et al. 2019

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Key Points Question What is the real-world effectiveness of a 12-month community-based physical activity (PA) coaching intervention on reducing all-cause acute care use and death in patients with a history of a chronic obstructive pulmonary disease (COPD) exacerbation? Findings In this multisite, randomized clinical trial that included a population-based sample of 2707 patients with COPD, 321 of 1358 patients participated in the PA coaching intervention and increased PA significantly, but there were no significant differences in the all-cause primary outcome (compostite measure of all-cause hospitalizations, observation stays, emergency department visits, and death) at 12 months. Meaning Most patients with a COPD exacerbation did not engage in PA, and the limited PA did not lead to significant benefit in 12-month health care use.

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“…In that trial, women were twice as likely as men to engage in the program, and the odds of a patient enrolling increased as the patient aged. 30 Another study of insurer-initiated outreach found that completion of an HRA did not significantly increase the likelihood of member participation in telephone-based health coaching. 31 A study of primary care physician-initiated referral to a smoking cessation program found that 7.8% of patients who were proactively contacted and asked to enroll in a program did so, while only a All the confounders are controlled by the matching process, therefore the final logistic regression only included group effect (indicator variable with 1 being Prescription for Wellness and 0 being control).…”

Section: Lessons Learnedmentioning

confidence: 99%

Impact of Physician Referral to Health Coaching on Patient Engagement and Health Risks: An Observational Study of UPMC’s Prescription for Wellness

et al. 2020

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Purpose: Evaluate impact of physician referral to health coaching on patient engagement and health risk reduction. Design: Four-year retrospective, observational cohort study with propensity-matched pair comparisons. Setting: Integrated delivery and finance system in Pittsburgh, Pennsylvania. Sample: 10 457 adult insured members referred to health coaching by their physician; 37 864 other members identified for health coaching through insurer-initiated outreach. Intervention: Practice-based, technology-supported workflow and process for physician prescribing of health coaching during regular office visit, with follow-up on patient’s progress and implementation supports. Measures: Patient engagement based on completion of pre-enrollment assessment, formal enrollment in health coaching, completion of required sessions, health risk levels, and number of health risks pre- and post-health coaching referral. Analysis: Difference-in-difference analysis to assess change in health risk levels and number of health risks pre- and post-health coaching and probability weighting to control for potential confounding between groups. Results: Members referred by a physician were significantly more likely to enroll in a health coaching program (21.0% vs 6.0%, P < .001) and complete the program requirements (8.5% vs 2.7%, P < .001) than when referred by insurer-initiated outreach; significant within group improvement in health risk levels from baseline ( P < .001) was observed for both the groups. Conclusions: Patients are significantly more likely to engage in health coaching when a referral is made by a physician; engagement in health coaching significantly improves health risk levels.

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Wellness Coaching for People With Prediabetes: A Randomized Encouragement Trial to Evaluate Outreach Methods at Kaiser Permanente, Northern California, 2013

Abstract: Introduction

Cited by 11 publications

References 19 publications

Impact of a 12-week wellness coaching on self-care behaviors among primary care adult patients with prediabetes

Impact of a 12-week wellness coaching on self-care behaviors among primary care adult patients with prediabetes

Effect of Physical Activity Coaching on Acute Care and Survival Among Patients With Chronic Obstructive Pulmonary Disease

Impact of Physician Referral to Health Coaching on Patient Engagement and Health Risks: An Observational Study of UPMC’s Prescription for Wellness

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