Evaluation of the Texas Wellness Incentives and Navigation (WIN) Project
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 1,663
- 试验地点
- 1
- 主要终点
- Self-reported physical health related quality of life (HRQOL) using the Short Form-12 (SF-12)
研究概览
简要总结
The Wellness Incentives and Navigation (WIN) project is designed to help improve health self-management and reduce the incidence and consequences of chronic disease among non-elderly adult Medicaid Supplemental Security Income (SSI) beneficiaries. WIN targets SSI beneficiaries with behavioral health (mental health and substance abuse) diagnoses. Research demonstrates that these individuals are more likely to suffer chronic physical co-morbidities, experience debilitating chronic illnesses earlier in life and have elevated healthcare costs.
WIN uses person-centered wellness planning and navigation facilitated by trained, professional health Navigators, dedicated specifically to the WIN project, who use Motivational Interviewing (MI) techniques, and a personal wellness account. Participants with more serious mental illnesses will be offered additional support in the form of Wellness Recovery Action Planning (WRAP) to enable them to take full advantage of person-centered wellness planning.
详细描述
The Texas based Wellness Incentives and Navigation (WIN) project uses a continuum of evidence-based "whole person" interventions that take into account clinical, environmental, and social risk factors and co-morbidities. Unlike more traditional didactic approaches to health management, WIN addresses individual behavioral, social, and economic barriers to health and wellness, and promotes continued engagement in achieving, internalizing, and maintaining healthy behaviors.
The study is focused on non-dual eligible adult STAR+PLUS (a Texas Medicaid managed care program for people with chronic illnesses) members (ages 21-55) with a behavioral health disorder including serious mental illness (SMI - e.g., schizophrenia, bipolar disorder or major depressive disorder) or other behavioral health conditions (e.g., anxiety disorder or substance abuse). Key features of the program include the use of professional health navigators, working in collaboration with the three STAR+PLUS plans in the Harris Service Area (SA) (United-Evercare, Amerigroup, and Molina), the use of motivational interviewing (MI) techniques to help members develop and meet personal wellness goals, and a flexible wellness account for the participant to use in meeting his/her goals.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- None
入排标准
- 年龄范围
- 21 Years 至 55 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Be a resident of the Harris service area
- •Be a non-dual eligible member of STAR+PLUS;
- •Be 21 to 55 years of age; and
- •Have an SMI Diagnosis (schizophrenia, bi-polar disorder, major depressive disorder); or
- •Other behavioral health diagnoses (e.g., anxiety, depression, substance use disorder) coupled with a chronic health diagnosis (physical health condition).
排除标准
- •Intellectual or cognitive diagnoses indicative of severe cognitive impairment. These could include diagnoses such as 290.X (dementia) and 318-319 (moderate to severe mental retardation).
研究组 & 干预措施
Intervention
A person-centered wellness intervention that includes a patient-directed wellness account. Enrollees meet with a patient Navigator to develop a wellness plan. The enrollee can then use the flexible wellness account to make purchases that are consistent with the goals of the wellness plan. Health Navigators have monthly phone contact with enrollees and meet quarterly with them to discuss goals and spending with the express goal of improving self-management, use of preventive services, satisfaction with care, healthcare utilization and expenditures and quality of care.
干预措施: Patient-Directed Wellness Account (Behavioral)
Intervention
A person-centered wellness intervention that includes a patient-directed wellness account. Enrollees meet with a patient Navigator to develop a wellness plan. The enrollee can then use the flexible wellness account to make purchases that are consistent with the goals of the wellness plan. Health Navigators have monthly phone contact with enrollees and meet quarterly with them to discuss goals and spending with the express goal of improving self-management, use of preventive services, satisfaction with care, healthcare utilization and expenditures and quality of care.
干预措施: Health Navigator (Behavioral)
Control
Control group participants receive a monthly mailing requesting updated contact information. They can send this card via mail, or by calling the toll free number.
Comparison
These are STAR+PLUS enrollees who meet the same enrollment criteria as the intervention and control but reside outside of the Harris Service Area. The purpose of the comparison group is to follow them and their outcomes. This group will help us to better compare the outcomes we see with those enrolled in the WIN Project to a comparable group for whom we already house data.
结局指标
主要结局
Self-reported physical health related quality of life (HRQOL) using the Short Form-12 (SF-12)
时间窗: (Change) baseline, 12 months, 24 months and 36 months
The SF-12 has been validated across a number of chronic diseases and conditions. The survey consists of 12 questions measuring functional health and well-being. Patients answer questions related to daily functioning, difficulties in physical tasks, and disruptions in life due to mental illness (e.g. depression, anxiety). The overall score can be further classified into two summary scores for physical and mental health.
Self-reported mental health related quality of life (HRQOL) using the Short Form-12 (SF-12)
时间窗: (Change) baseline, 12 months, 24 months and 36 months
The SF-12 has been validated across a number of chronic diseases and conditions. The survey consists of 12 questions measuring functional health and well-being. Patients answer questions related to daily functioning, difficulties in physical tasks, and disruptions in life due to mental illness (e.g. depression, anxiety). The overall score can be further classified into two summary scores for physical and mental health.
次要结局
- Change in Total Healthcare expenditures as measured through Medicaid claims data((Change) baseline, 12 months, 24 months, 36 months, and 1 year after month 36)
- Changes in Inpatient Hospitalization expenditures as measured through Medicaid claims data((Change) baseline, 12 months, 24 months, 36 months, and 1 year after month 36)
- Changes in Outpatient expenditures as measured through Medicaid claims data((Change) baseline, 12 months, 24 months, 36 months, and 1 year after month 36)
- Changes in Emergency Department expenditures as measured through Medicaid claims data((Change) baseline, 12 months, 24 months, 36 months, and 1 year after month 36)