Health Coach Program to Improve Chronic Disease Outcomes Following an Emergency Department Visit
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 295
- 试验地点
- 2
- 主要终点
- Number of emergency department visits
研究概览
简要总结
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.
详细描述
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.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •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.
排除标准
- •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
研究组 & 干预措施
Health Coaching
Patients randomized to the experimental arm receive six months of post-ED health coaching from the Alameda County Health Coach Program (ACHCP) in addition to usual care in the emergency department at enrollment.
干预措施: Health Coaching (Behavioral)
Usual Care
Patients randomized to the control arm receive usual care in the emergency department at enrollment.
结局指标
主要结局
Number of emergency department visits
时间窗: 6 month period after enrollment
Self-reported measure collected via follow-up phone surveys at 1, 3, and 6 months.
次要结局
- 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)
研究者
Harrison J. Alter
Associate Chair for Research, Department of Emergency Medicine, Highland Hospital
Alameda County Medical Center