The purpose of this study is to determine whether health coaching initiated in the emergency department (ED) reduces subsequent ED visits, increases primary care visits, and positively impacts health outcomes in patients with diabetes and/or hypertension.
Patients will be recruited by health coaches from the Highland Hospital Emergency Department. Eligible patients who agree to participate will be randomized to the control and experimental groups in a 2:1 ratio respectively because experimental group size is limited by health coach availability and greater loss-to-follow up is expected among the control group. Repeated measures analysis will be used to compare each outcome over the study period. In addition, subgroup analyses will be performed in order to stratify by baseline survey measures or amount of ED visits in the pre-observation period.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
295
The Alameda County Health Coach program pairs patients with a language-concordant health coach for six months following an ED visit. Health coaches are young adults from the local community employed through Alameda County and trained for three months in topics such as self-management support and motivational interviewing. Health coaches work one-on-one with participants in order to develop an action plan in order to achieve patient-identified health goals. Communication between the health coach and participant includes text messages (weekly), phone calls (twice a month), face-to-face visits (at least once), and accompaniment to a primary care visit (at least once). Health coaches may also assist participants in accessing community resources as related to the individualized action plan.
Highland Hospital - Alameda Health System
Oakland, California, United States
Number of emergency department visits
Self-reported measure collected via follow-up phone surveys at 1, 3, and 6 months.
Time frame: 6 month period after enrollment
Number of primary care visits
Self-reported measure collected by follow-up phone surveys at 1,3, and 6 months.
Time frame: 6 month period after enrollment
Physical health and mental health (Validated measure - SF-12v2)
Validated measure (SF-12v2) collected at baseline and follow-up phone surveys.
Time frame: Baseline, 1 month, 3 months, and 6 months after enrollment
Medication adherence (Validated measure - Morisky Medication Adherence Scale, MMAS-8)
Validated measure (Morisky Medication Adherence Scale, MMAS-8) collected at baseline and follow-up phone surveys.
Time frame: Baseline, 1 month, 3 months, and 6 months after enrollment
Patient activation (Validated measure - Patient Activation Measure, PAM)
Validated measure (Patient Activation Measure, PAM) collected at baseline and follow-up phone surveys.
Time frame: Baseline, 1 month, 3 months, and 6 months after enrollment
Type and frequency of health coach contact
Health coach documentation notes will be analyzed to determine the average percent of each type of contact (text, phone, or in-person) and frequency of contact.
Time frame: 6 months after enrollment
Percent of action plan goals achieved (Health coach documentation notes)
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Health coach documentation notes will be analyzed to determine the percent of goals achieved during the intervention.
Time frame: 6 months after enrollment
Qualitative analysis of action plans (Health coach documentation notes will be analyzed, data will be coded to identify themes such as type of goals, barriers to care, and resources identified in the action plan)
Health coach documentation notes will be analyzed using a grounded theory approach, where transcribed data will be coded to identify themes such as type of goals, barriers to care, and resources identified in the action plan.
Time frame: 6 months after enrollment