Health Coach Program to Improve Chronic Disease Outcomes Following an Emergency Department Visit
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Diabetes Mellitus
- Sponsor
- Alameda County Medical Center
- Enrollment
- 295
- Locations
- 1
- Primary Endpoint
- Number of emergency department visits
- Status
- Completed
- Last Updated
- 7 years ago
Overview
Brief Summary
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.
Detailed Description
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.
Investigators
Harrison J. Alter
Associate Chair for Research, Department of Emergency Medicine, Highland Hospital
Alameda County Medical Center
Eligibility Criteria
Inclusion Criteria
- •Willing to work with a health coach
- •Plans to reside in Alameda County for the next year
- •Has a reliable phone number
- •Speaks English or Spanish
- •18 years of age or older
- •Meets at least one of the following three criteria: (1) Low medication adherence defined as a continuous medication gap of at least 1 month in the past year OR a new diagnosis of diabetes and/or hypertension; (2) No patient-identified primary care provider (PCP) or no visit to PCP in 1 year; (3) One or more visits to the ED in the last 6 months.
Exclusion Criteria
- •Life-expectancy less than 1 year
- •Poorly controlled psychiatric illness
- •Active and frequent use of illicit substances
- •Currently incarcerated
- •Already enrolled in a program for patients with high rates of hospitalization and/or emergency department visits
- •Unable to consent due to an unstable condition or serious emotional or neurologic condition
- •Admitted or anticipated to be admitted to the hospital from the ED
Outcomes
Primary Outcomes
Number of emergency department visits
Time Frame: 6 month period after enrollment
Self-reported measure collected via follow-up phone surveys at 1, 3, and 6 months.
Secondary Outcomes
- Number of primary care visits(6 month period after enrollment)
- Physical health and mental health (Validated measure - SF-12v2)(Baseline, 1 month, 3 months, and 6 months after enrollment)
- Medication adherence (Validated measure - Morisky Medication Adherence Scale, MMAS-8)(Baseline, 1 month, 3 months, and 6 months after enrollment)
- Patient activation (Validated measure - Patient Activation Measure, PAM)(Baseline, 1 month, 3 months, and 6 months after enrollment)
- Type and frequency of health coach contact(6 months after enrollment)
- Percent of action plan goals achieved (Health coach documentation notes)(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)(6 months after enrollment)