标题：The Lifestyle Initiative: An Innovative Coaching-Based Quality Improvement Study to Improve the Health of Aurora Health Care Caregivers and Family Members
期刊名称：Journal of Patient-Centered Research and Reviews
电子版ISSN：2330-0698
出版年度：2017
卷号：4
期号：4
页码：260
出版社：Aurora Health Care
摘要：Background: Self-management support has been shown to improve clinical outcomes. Health coaching, one form of self-management support, empowers patients within the health care system by providing information and through collaboratively developed care plans. Purpose: Assess the impact of The Lifestyle Initiative, a coaching-based health program utilized by Aurora Health Care caregivers or family members. Methods: The Lifestyle Initiative is a coaching-based approach for Aurora caregivers or family members enrolled in Aurora’s health insurance network. Individuals were recruited from the care management database, and all participants had an Aurora primary care provider. Participation was limited to those ≥ 18 years of age who had a diagnosis of type 2 diabetes or hypertension (or both), had glycated hemoglobin (A1c) ≤ 8.0, and were not on insulin. The Lifestyle Initiative was rolled out in three phases. Phase I: health coaching sessions through a standard web- and app-based platform (Noom Health), and access to a stress-management program (HeartMath). Phase II: health coaching sessions through a standard web- and app-based platform co-created by Aurora’s Department of Integrative Medicine and Noom Health, and access to HeartMath; Phase III: health coaching sessions through a standard web- and app-based platform (Noom Health), and a customized web- and app-based platform. Those enrolled in each phase acted as their own controls. Paired t-tests were used to compare pre- and postintervention results of each phase. Results: The majority of Phase I participants (n = 23; mean age 54.4 years) were female (91.3%) and white (52.2%). Preintervention A1c and blood pressure were not statistically different postintervention. However, pre- vs postintervention weights were statistically different (228.2 vs 218.5 lb; P < 0.01), as well as pre- vs postintervention body mass index (37.3 vs 35.7 kg/m2; P < 0.01). The majority of Phase II participants (n = 63; mean age 54.8 years) also were female (81.0%) and white (88.9%). Pre- and postintervention blood pressures were not statistically different. However, pre- vs postintervention A1c (7.2 vs 6.6; P < 0.02), weights (229.6 vs 225.7 lb; P < 0.05), and body mass index (37.1 vs 36.5 kg/m2; P < 0.05) were statistically improved. Phase III data collection is underway. Conclusion: The Lifestyle Initiative health coaching program significantly improves certain health metrics when applied to health system employees and family members with diabetes or hypertension. Further study is needed to explore sustainability and the effects of more robust programs.
关键词：health coaching; diabetes; hypertension; stress management; body weight
