Group health coaching: strengths, challenges, and next steps.

PubMed

Armstrong, Colin; Wolever, Ruth Q; Manning, Linda; Elam, Roy; Moore, Margaret; Frates, Elizabeth Pegg; Duskey, Heidi; Anderson, Chelsea; Curtis, Rebecca L; Masemer, Susan; Lawson, Karen

2013-05-01

There is great need for cost effective approaches to increase patient engagement and improve health and well-being. Health and wellness coaching has recently demonstrated great promise, but the majority of studies to date have focused on individual coaching (ie, one coach with one client). Newer initiatives are bringing a group coaching model from corporate leadership development and educational settings into the healthcare arena. A group approach potentially increases cost-effective access to a larger number of clients and brings the possible additional benefit of group support. This article highlights some of the group coaching approaches currently being conducted across the United States. The group coaching interventions included in this overview are offered by a variety of academic and private sector institutions, use both telephonic and in-person coaching, and are facilitated by professionally trained health and wellness coaches as well as trained peer coaches. Strengths and challenges experienced in these efforts are summarized, as are recommendations to address those challenges. A working definition of "Group Health and Wellness Coaching" is proposed, and important next steps for research and for the training of group coaches are presented.

Group Health Coaching: Strengths, Challenges, and Next Steps

PubMed Central

Wolever, Ruth Q.; Manning, Linda; Elam, Roy; Moore, Margaret; Frates, Elizabeth Pegg; Duskey, Heidi; Anderson, Chelsea; Curtis, Rebecca L.; Masemer, Susan; Lawson, Karen

2013-01-01

There is great need for cost effective approaches to increase patient engagement and improve health and well-being. Health and wellness coaching has recently demonstrated great promise, but the majority of studies to date have focused on individual coaching (ie, one coach with one client). Newer initiatives are bringing a group coaching model from corporate leadership development and educational settings into the healthcare arena. A group approach potentially increases cost-effective access to a larger number of clients and brings the possible additional benefit of group support. This article highlights some of the group coaching approaches currently being conducted across the United States. The group coaching interventions included in this overview are offered by a variety of academic and private sector institutions, use both telephonic and in-person coaching, and are facilitated by professionally trained health and wellness coaches as well as trained peer coaches. Strengths and challenges experienced in these efforts are summarized, as are recommendations to address those challenges. A working definition of “Group Health and Wellness Coaching” is proposed, and important next steps for research and for the training of group coaches are presented. PMID:24416678

Improving awareness, accountability, and access through health coaching

PubMed Central

Liddy, Clare; Johnston, Sharon; Irving, Hannah; Nash, Kate; Ward, Natalie

2015-01-01

Abstract Objective To assess patients’ experiences with and perceptions of health coaching as part of their ongoing care. Design A qualitative research design using semistructured interviews that were recorded and transcribed verbatim. Setting Ottawa, Ont. Participants Eleven patients (> 18 years of age) enrolled in a health coaching pilot program who were at risk of or diagnosed with type 2 diabetes. Methods Patients’ perspectives were assessed with semistructured interviews. Interviews were conducted with 11 patients at the end of the pilot program, using a stratified sampling approach to ensure maximum variation. Main findings All patients found the overall experience with the health coaching program to be positive. Patients believed the health coaching program was effective in increasing awareness of how diabetes affected their bodies and health, in building accountability for their health-related actions, and in improving access to care and other health resources. Conclusion Patients perceive one-on-one health coaching as an acceptable intervention in their ongoing care. Patients enrolled in the health coaching pilot program believed that there was an improvement in access to care, health literacy, and accountability, all factors considered to be precursors to behavioural change. PMID:25932483

Costs for a health coaching intervention for chronic care management.

PubMed

Wagner, Todd H; Willard-Grace, Rachel; Chen, Ellen; Bodenheimer, Thomas; Thom, David H

2016-04-01

Health coaches can help patients gain knowledge, skills, and confidence to manage their chronic conditions. Coaches may be particularly valuable in resource-poor settings, but they are not typically reimbursed by insurance, raising questions about their budgetary impact. The Health Coaching in Primary Care (HCPC) study was a randomized controlled trial that showed health coaches were effective at helping low-income patients improve control of their type 2 diabetes, hypertension, and/or hyperlipidemia at 12 months compared with usual care. We estimated the cost of employing 3 health coaches and mapped these costs to participants. We tested whether the added costs of the coaches were offset by any savings in healthcare utilization within 1 year. Healthcare utilization data were obtained from 5 sources. Multivariate models assessed differences in costs at 1 year controlling for baseline characteristics. Coaches worked an average of 9 hours with each participant over the length of the study. On average, the health coach intervention cost $483 per participant per year. The average healthcare costs for the coaching group was $3207 compared with $3276 for the control group (P = .90). There was no evidence that the coaching intervention saved money at 1 year. Health coaches have been shown to improve clinical outcomes related to chronic disease management. We found that employing health coaches adds an additional cost of $483 per patient per year. The data do not suggest that health coaches pay for themselves by reducing healthcare utilization in the first year.

A Survey of Practicing Sleep Coaches.

PubMed

Ingram, David G; Mindell, Jodi A; Puzino, Kristina; Walters, Russel M

2018-01-01

Sleep coaches are individuals of various backgrounds who offer services to families struggling with behavioral childhood sleep problems. We conducted a survey of coaches to further elucidate scope of practice, practice patterns, geographic distribution, education, training, and beliefs regarding qualification requirements. A Web-based survey was completed by 142 individuals who identified as a sleep coach. Coaches were distributed across 17 countries and 5 continents. Overall, 65% of coaches served clients in countries beyond their home country. Within the United States, coaches were generally located in more affluent and well-educated zip codes near large metropolitan centers, 91% served clients beyond their home state, and 56% served clients internationally. Educational background varied across coaches (12% high school degree, 51% bachelor's degree, 32% master's degree, 2% doctoral degree, 1.5% JD degree). Few coaches (20%) were or had been licensed health care providers or carried malpractice insurance (38%). Coaches usually provided services for children < 4 months of age to about 6 years of age, and were much less likely to provide services for children with comorbid neurodevelopmental (32%) or significant medical disorders (19%). Coaches reported an average of 3 new and 6 total clients per week and working 20 hr per week on average. Most coaches (76%) felt that a formal sleep coach training program was the most important qualification for practice. These results highlight a diversity of background, training, and geographical distribution of sleep coaches, and may help inform discussions regarding guidelines for training and credentialing of sleep coaches.

The Coach Is in: Improving Nutritional Care in Nursing Homes

ERIC Educational Resources Information Center

Rahman, Anna N.; Simmons, Sandra F.; Applebaum, Robert; Lindabury, Kate; Schnelle, John F.

2012-01-01

Purpose: This article describes and evaluates a long distance coaching course aimed at improving nutritional care in nursing homes (NHs). The course was structured to provide more support than traditional training programs offer. Methods: In a series of 6 monthly teleconferences led by an expert in NH nutritional care, participating NH staff…

76 FR 52377 - Consolidated Energy, Inc., Diamond Home Services, Inc., Goran Capital Inc., Kingsley Coach, Inc...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-22

... SECURITIES AND EXCHANGE COMMISSION [File No. 500-1] Consolidated Energy, Inc., Diamond Home Services, Inc., Goran Capital Inc., Kingsley Coach, Inc. (The), Knockout Holdings, Inc., and Kuhlman Co... securities of Kingsley Coach, Inc. (The) because it has not filed any periodic reports since the period ended...

Evaluation of Telephone Health Coaching of German Health Insurants with Chronic Conditions

ERIC Educational Resources Information Center

Härter, Martin; Dwinger, Sarah; Seebauer, Laura; Simon, Daniela; Herbarth, Lutz; Siegmund-Schultze, Elisabeth; Temmert, Daniel; Bermejo, Isaac; Dirmaier, Jörg

2013-01-01

Objective: This study aimed to investigate how patients with chronic conditions evaluate telephone health coaching provided by their health insurance company. Methods: A retrospective survey was conducted among coaching participants ("n" = 834). Outcomes included the general evaluation of the coaching, the evaluation of process and…

Health coaching for glaucoma care: a pilot study using mixed methods

PubMed Central

Vin, Anita; Schneider, Suzanne; Muir, Kelly W; Rosdahl, Jullia A

2015-01-01

Introduction Adherence to glaucoma medications is essential for successful treatment of the disease but is complex and difficult for many of our patients. Health coaching has been used successfully in the treatment of other chronic diseases. This pilot study explores the use of health coaching for glaucoma care. Methods A mixed methods study design was used to assess the health coaching intervention for glaucoma patients. The health coaching intervention consisted of four to six health coaching sessions with a certified health coach via telephone. Quantitative measures included demographic and health information, adherence to glaucoma medications (using the visual analog adherence scale and medication event monitoring system), and an exit survey rating the experience. Qualitative measures included a precoaching health questionnaire, notes made by the coach during the intervention, and an exit interview with the subjects at the end of the study. Results Four glaucoma patients participated in the study; all derived benefits from the health coaching. Study subjects demonstrated increased glaucoma drop adherence in response to the coaching intervention, in both visual analog scale and medication event monitoring system. Study subjects’ qualitative feedback reflected a perceived improvement in both eye and general health self-care. The subjects stated that they would recommend health coaching to friends or family members. Conclusion Health coaching was helpful to the glaucoma patients in this study; it has the potential to improve glaucoma care and overall health. PMID:26604666

Behavioral changes following participation in a home health promotional program in King County, Washington.

PubMed Central

Leung, R; Koenig, J Q; Simcox, N; van Belle, G; Fenske, R; Gilbert, S G

1997-01-01

This study examined behavioral changes in households after participation in a home environmental assessment. Home assessment visits by a trained coach, which involved a walk-through in the home with the home residents, were conducted in 36 homes. The walk-through included a list of recommended behavioral changes that the residents could make to reduce their exposures to home pollutants in areas such as dust control, moisture problems, indoor air, hazardous household products, and hobbies. Recruited households were surveyed 3 months after the home assessment to evaluate their implementation of the recommendations. Following the home visits, 31 of 36 households reported making at least one behavioral change, and 41% of the recommendations made by the volunteer coaches were implemented. In conclusion, this study found that the majority of the households who participated in the home assessment reported implementing at least one recommendation. This home health promotional method was effective in influencing behavioral changes. PMID:9349831

Health coaching in primary care: a feasibility model for diabetes care.

PubMed

Liddy, Clare; Johnston, Sharon; Nash, Kate; Ward, Natalie; Irving, Hannah

2014-04-03

Health coaching is a new intervention offering a one-on-one focused self-management support program. This study implemented a health coaching pilot in primary care clinics in Eastern Ontario, Canada to evaluate the feasibility and acceptability of integrating health coaching into primary care for patients who were either at risk for or diagnosed with diabetes. We implemented health coaching in three primary care practices. Patients with diabetes were offered six months of support from their health coach, including an initial face-to-face meeting and follow-up by email, telephone, or face-to-face according to patient preference. Feasibility was assessed through provider focus groups and qualitative data analysis methods. All three sites were able to implement the program. A number of themes emerged from the focus groups, including the importance of physician buy-in, wide variation in understanding and implementing of the health coach role, the significant impact of different systems of team communication, and the significant effect of organizational structure and patient readiness on Health coaches' capacity to perform their role. It is feasible to implement health coaching as an integrated program within small primary care clinics in Canada without adding additional resources into the daily practice. Practices should review their organizational and communication processes to ensure optimal support for health coaches if considering implementing this intervention.

Health coaching in diabetes: empowering patients to self-manage.

PubMed

Wong-Rieger, Durhane; Rieger, Francis P

2013-02-01

To effectively manage diabetes mellitus, patients must adhere to treatment recommendations and healthy lifestyle behaviors, but research shows many patients do not do this. Education is effective when combined with self-management support but peer-support programs do not lead to lasting changes. Health coaching, or professional support, can be highly effective if it focuses on developing self-efficacy and skills such as goal-setting, problem-solving and managing cognitive and emotional barriers. This overview discusses the benefits of patient self-management for chronic conditions such as diabetes, core competencies for health coaching, theoretical bases and principles of health coaching interventions, delivery methods and the evidence that health coaching works for diabetes self-management. Copyright © 2013 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

The study of health coaching: the ithaca coaching project, research design, and future directions.

PubMed

Sforzo, Gary A

2013-05-01

Health coaching (HC) is a process holding tremendous potential as a complementary medical intervention to shape healthy behavior change and affect rates of chronic lifestyle diseases. Empirical knowledge of effectiveness for the HC process, however, is lacking. The purposes of this paper are to present the study protocol for the Ithaca Coaching Project while also addressing research design, methodological issues, and directions for HC research. This is one of the first large-scale, randomized control trials of HC for primary prevention examining impact on physical and emotional health status in an employee population. An additional intent for the project is to investigate self-determination theory as a theoretical framework for the coaching process. Participants (n=300) are recruited as part of a campus-wide wellness initiative and randomly assigned to one of three levels of client-centered HC or a control with standard wellness program care. Repeated measures analyses of covariance will be used to examine coaching effectiveness while path analyses will be used to examine relationships between coaching processes, self-determination variables, and health outcomes. There is a great need for well-designed HC studies that define coaching best practices, examine intervention effectiveness, provide cost:benefit analysis, and address scope of practice. This information will allow a clearer definition of HC to emerge and determination of if, and how, HC fits in modern-day healthcare. This is an exciting but critical time for HC research and for the practice of HC.

The Study of Health Coaching: The Ithaca Coaching Project, Research Design, and Future Directions

PubMed Central

2013-01-01

Health coaching (HC) is a process holding tremendous potential as a complementary medical intervention to shape healthy behavior change and affect rates of chronic lifestyle diseases. Empirical knowledge of effectiveness for the HC process, however, is lacking. The purposes of this paper are to present the study protocol for the Ithaca Coaching Project while also addressing research design, methodological issues, and directions for HC research. This is one of the first large-scale, randomized control trials of HC for primary prevention examining impact on physical and emotional health status in an employee population. An additional intent for the project is to investigate self-determination theory as a theoretical framework for the coaching process. Participants (n=300) are recruited as part of a campus-wide wellness initiative and randomly assigned to one of three levels of client-centered HC or a control with standard wellness program care. Repeated measures analyses of covariance will be used to examine coaching effectiveness while path analyses will be used to examine relationships between coaching processes, self-determination variables, and health outcomes. There is a great need for well-designed HC studies that define coaching best practices, examine intervention effectiveness, provide cost:benefit analysis, and address scope of practice. This information will allow a clearer definition of HC to emerge and determination of if, and how, HC fits in modern-day healthcare. This is an exciting but critical time for HC research and for the practice of HC. PMID:24416673

Health coaching in primary care: a feasibility model for diabetes care

PubMed Central

2014-01-01

Background Health coaching is a new intervention offering a one-on-one focused self-management support program. This study implemented a health coaching pilot in primary care clinics in Eastern Ontario, Canada to evaluate the feasibility and acceptability of integrating health coaching into primary care for patients who were either at risk for or diagnosed with diabetes. Methods We implemented health coaching in three primary care practices. Patients with diabetes were offered six months of support from their health coach, including an initial face-to-face meeting and follow-up by email, telephone, or face-to-face according to patient preference. Feasibility was assessed through provider focus groups and qualitative data analysis methods. Results All three sites were able to implement the program. A number of themes emerged from the focus groups, including the importance of physician buy-in, wide variation in understanding and implementing of the health coach role, the significant impact of different systems of team communication, and the significant effect of organizational structure and patient readiness on Health coaches’ capacity to perform their role. Conclusions It is feasible to implement health coaching as an integrated program within small primary care clinics in Canada without adding additional resources into the daily practice. Practices should review their organizational and communication processes to ensure optimal support for health coaches if considering implementing this intervention. PMID:24708783

Telephone Coaching to Enhance a Home-Based Physical Activity Program for Knee Osteoarthritis: A Randomized Clinical Trial.

PubMed

Bennell, Kim L; Campbell, Penny K; Egerton, Thorlene; Metcalf, Ben; Kasza, Jessica; Forbes, Andrew; Bills, Caroline; Gale, Janette; Harris, Anthony; Kolt, Gregory S; Bunker, Stephen J; Hunter, David J; Brand, Caroline A; Hinman, Rana S

2017-01-01

To investigate whether simultaneous telephone coaching improves the clinical effectiveness of a physiotherapist-prescribed home-based physical activity program for knee osteoarthritis (OA). A total of 168 inactive adults ages ≥50 years with knee pain on a numeric rating scale ≥4 (NRS; range 0-10) and knee OA were recruited from the community and randomly assigned to a physiotherapy (PT) and coaching group (n = 84) or PT-only (n = 84) group. All participants received five 30-minute consultations with a physiotherapist over 6 months for education, home exercise, and physical activity advice. PT+coaching participants also received 6-12 telephone coaching sessions by clinicians trained in behavioral-change support for exercise and physical activity. Primary outcomes were pain (NRS) and physical function (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC; score range 0-68]) at 6 months. Secondary outcomes were these same measures at 12 and 18 months, as well as physical activity, exercise adherence, other pain and function measures, and quality of life. Analyses were intent-to-treat with multiple imputation for missing data. A total of 142 (85%), 136 (81%), and 128 (76%) participants completed 6-, 12-, and 18-month measurements, respectively. The change in NRS pain (mean difference 0.4 unit [95% confidence interval (95% CI) -0.4, 1.3]) and in WOMAC function (1.8 [95% CI -1.9, 5.5]) did not differ between groups at 6 months, with both groups showing clinically relevant improvements. Some secondary outcomes related to physical activity and exercise behavior favored PT+coaching at 6 months but generally not at 12 or 18 months. There were no between-group differences in most other outcomes. The addition of simultaneous telephone coaching did not augment the pain and function benefits of a physiotherapist-prescribed home-based physical activity program. © 2016, American College of Rheumatology.

mHealth in the Wild: Using Novel Data to Examine the Reach, Use, and Impact of PTSD Coach.

PubMed

Owen, Jason E; Jaworski, Beth K; Kuhn, Eric; Makin-Byrd, Kerry N; Ramsey, Kelly M; Hoffman, Julia E

2015-01-01

A majority of Americans (58%) now use smartphones, making it possible for mobile mental health apps to reach large numbers of those who are living with untreated, or under-treated, mental health symptoms. Although early trials suggest positive effects for mobile health (mHealth) interventions, little is known about the potential public health impact of mobile mental health apps. The purpose of this study was to characterize reach, use, and impact of "PTSD Coach", a free, broadly disseminated mental health app for managing posttraumatic stress disorder (PTSD) symptoms. Using a mixed-methods approach, aggregate mobile analytics data from 153,834 downloads of PTSD Coach were analyzed in conjunction with 156 user reviews. Over 60% of users engaged with PTSD Coach on multiple occasions (mean=6.3 sessions). User reviews reflected gratitude for the availability of the app and being able to use the app specifically during moments of need. PTSD Coach users reported relatively high levels of trauma symptoms (mean PTSD Checklist Score=57.2, SD=15.7). For users who chose to use a symptom management tool, distress declined significantly for both first-time users (mean=1.6 points, SD=2.6 on the 10-point distress thermometer) and return-visit users (mean=2.0, SD=2.3). Analysis of app session data identified common points of attrition, with only 80% of first-time users reaching the app's home screen and 37% accessing one of the app's primary content areas. These findings suggest that PTSD Coach has achieved substantial and sustained reach in the population, is being used as intended, and has been favorably received. PTSD Coach is a unique platform for the delivery of mobile mental health education and treatment, and continuing evaluation and improvement of the app could further strengthen its public health impact.

A Qualitative Study of How Health Coaches Support Patients in Making Health-Related Decisions and Behavioral Changes

PubMed Central

Thom, David H.; Wolf, Jessica; Gardner, Heather; DeVore, Denise; Lin, Michael; Ma, Andy; Ibarra-Castro, Ana; Saba, George

2016-01-01

PURPOSE Although health coaches are a growing resource for supporting patients in making health decisions, we know very little about the experience of health. We undertook a qualitative study of how health coaches support patients in making decisions and implementing changes to improve their health. METHODS We conducted 6 focus groups (3 in Spanish and 3 in English) with 25 patients and 5 friends or family members, followed by individual interviews with 42 patients, 17 family members, 17 health coaches, and 20 clinicians. Audio recordings were transcribed and analyzed by at least 2 members of the study team in ATLAS.ti using principles of grounded theory to identify themes and the relationship between them. RESULTS We identified 7 major themes that were related to each other in the final conceptual model. Similarities between health coaches and patients and the time health coaches spent with patients helped establish the health coach–patient relationship. The coach-patient relationship allowed for, and was further strengthened by, 4 themes of key coaching activities: education, personal support, practical support, and acting as a bridge between patients and clinicians. CONCLUSIONS We identified a conceptual model that supports the development of a strong relationship, which in turn provides the basis for effective coaching. These results can be used to design health coach training curricula and to support health coaches in practice. PMID:28376437

The impacts of using community health volunteers to coach medication safety behaviors among rural elders with chronic illnesses.

PubMed

Wang, Chi-Jane; Fetzer, Susan J; Yang, Yi-Ching; Wang, Jing-Jy

2013-01-01

It is a challenge for rural health professionals to promote medication safety among older adults taking multiple medications. A volunteer coaching program to promote medication safety among rural elders with chronic illnesses was designed and evaluated. A community-based interventional study randomly assigned 62 rural elders with at least two chronic illnesses to routine care plus volunteer coaching or routine care alone. The volunteer coaching group received a medication safety program, including a coach and reminders by well-trained volunteers, as well as three home visits and five telephone calls over a two-month period. All the subjects received routine medication safety instructions for their chronic illnesses. The program was evaluated using pre- and post-tests of knowledge, attitude and behaviors with regard to medication safety. Results show the volunteer coaching group improved their knowledge of medication safety, but there was no change in attitude after the two-month study period. Moreover, the group demonstrated three improved medication safety behaviors compared to the routine care group. The volunteer coaching program and instructions with pictorial aids can provide a reference for community health professionals who wish to improve the medication safety of chronically ill elders. Copyright © 2013 Mosby, Inc. All rights reserved.

Delivery of Health Coaching by Medical Assistants in Primary Care.

PubMed

Djuric, Zora; Segar, Michelle; Orizondo, Carissa; Mann, Jeffrey; Faison, Maya; Peddireddy, Nithin; Paletta, Matthew; Locke, Amy

2017-01-01

Health coaching is potentially a practical method to assist patients in achieving and maintaining healthy lifestyles. In health coaching, the coach partners with the patient, helping patients discover their own strengths, challenges, and solutions. Two medical assistants were provided with brief training. The 12-week program consisted of telephone coaching with in-person visits at the beginning and end of the program. Coaching targeted improvements in diet, physical activity, and/or sleep habits using a self-care planning form. A total of 82 subjects enrolled in the program, 72% completed 8 weeks and 49% completed 12 weeks. Subjects who completed assessments at 12 weeks had significant weight loss despite the fact that weight loss was not a study goal. There also were improvements in diet and physical activity. Subject who completed the study were highly satisfied with the program and felt that health coaching should be available in all family medicine clinics. The main barrier providers voiced was remembering to refer patients. The medical providers indicated high satisfaction with the study and valued having coaching available for their patients. Medical assistants can be trained to assist patients with lifestyle changes that are associated with improved health and weight control. © Copyright 2017 by the American Board of Family Medicine.

Delivery of Health Coaching by Medical Assistants in Primary Care

PubMed Central

Djuric, Zora; Segar, Michelle; Orizondo, Carissa; Mann, Jeffrey; Faison, Maya; Peddireddy, Nithin; Paletta, Matthew; Locke, Amy

2017-01-01

Background Health coaching is potentially a practical method to assist patients in achieving and maintaining healthy lifestyles. In health coaching, the coach partners with the patient, helping patients discover their own strengths, challenges, and solutions. Methods Two medical assistants were provided with brief training. The 12-week program consisted of telephone coaching with in-person visits at the beginning and end of the program. Coaching targeted improvements in diet, physical activity, and/or sleep habits using a self-care planning form. Results A total of 82 subjects enrolled in the program, 72% completed 8 weeks and 49% completed 12 weeks. Subjects who completed assessments at 12 weeks had significant weight loss despite the fact that weight loss was not a study goal. There also were improvements in diet and physical activity. Subject who completed the study were highly satisfied with the program and felt that health coaching should be available in all family medicine clinics. The main barrier providers voiced was remembering to refer patients. The medical providers indicated high satisfaction with the study and valued having coaching available for their patients. Conclusions Medical assistants can be trained to assist patients with lifestyle changes that are associated with improved health and weight control. PMID:28484068

Is health coaching effective in changing the health status and behaviour of prisoners?-a systematic review protocol.

PubMed

Almondes, Nadja; Downie, Denise; Cinar, Ayse B; Richards, Derek; Freeman, Ruth

2017-07-03

This is a protocol for a systematic review of the impact of health coaching on changing the health behaviour of offenders. Prisoners are more likely to suffer from health-related issues when compared to the general population. Health coaching has been shown to influence health outcomes of patients with chronic conditions. This review, therefore, aims to assess the effectiveness of health coaching interventions on the health of adolescent and adult offenders in custodial institutions. We plan to conduct a systematic review of the current literature on health coaching interventions delivered in the prison setting. We will include randomised controlled trials and observational studies that compare health coaching to the usual care or other alternative interventions. The ideal interventions will be delivered either by health professionals or peer coaches, and the outcomes extracted in the data collection will be disease-specific, clients' life and self-management skills, behavioural and psychosocial outcomes. If appropriate, a meta-analysis of the data collected will be carried out on the last stage of the review. This systematic review will identify and gather evidence on the impact of health coaching interventions delivered in the prison setting and can function as a supporting material for health professionals, prison staff, the healthcare system, and public health departments when considering delivering health coaching. PROSPERO CRD42016053237 .

Does Health Coaching Grow Capacity in Cancer Survivors? A Systematic Review.

PubMed

Barakat, Suzette; Boehmer, Kasey; Abdelrahim, Marwan; Ahn, Sangwoo; Al-Khateeb, Abdulrahman A; Villalobos, Neri Álvarez; Prokop, Larry; Erwin, Patricia J; Fleming, Kirsten; Serrano, Valentina; Spencer-Bonilla, Gabriela; Murad, Mohammad Hassan

2018-02-01

Interventions that grow patient capacity to do the work of health care and life are needed to support the health of cancer survivors. Health coaching may grow capacity. This systematic review of health coaching interventions explored coaching's ability to grow capacity of cancer survivors. The authors included randomized trials or quasi-experimental studies comparing coaching to alternative interventions, and adhered to PRISMA reporting guidelines. Data were analyzed using the Theory of Patient Capacity (BREWS: Capacity is affected by factors that influence ability to reframe Biography ["B"], mobilize or recruit Resources ["R"], interact with the Environment of care ["E"], accomplish Work ["W"]), and function Socially ["S"]). The authors reviewed 2210 references and selected 12 studies (6 randomized trials and 6 pre-post). These studies included 1038 cancer survivors, mean age 57.2 years, with various type of cancers: breast, colorectal, prostate, and lung. Health coaching was associated with improved quality of life, mood, and physical activity but not self-efficacy. Classified by potential to support growth in patient capacity, 67% of included studies reported statistically significant outcomes that support "B" (quality of life, acceptance, spirituality), 75% "R" (decreased fatigue, pain), 67% "W" (increased physical activity), and 33% "S" (social deprivation index). None addressed changing the patient's environment of care. In cancer survivors, health coaching improved quality of life and supported patient capacity by several mechanisms, suggesting an important role for "Capacity Coaching." Future interventions that improve self-efficacy and patients' environments of care are needed. Capacity Coaching may improve health and quality of life of cancer survivors.

mHealth in the Wild: Using Novel Data to Examine the Reach, Use, and Impact of PTSD Coach

PubMed Central

Jaworski, Beth K; Kuhn, Eric; Makin-Byrd, Kerry N; Ramsey, Kelly M; Hoffman, Julia E

2015-01-01

Background A majority of Americans (58%) now use smartphones, making it possible for mobile mental health apps to reach large numbers of those who are living with untreated, or under-treated, mental health symptoms. Although early trials suggest positive effects for mobile health (mHealth) interventions, little is known about the potential public health impact of mobile mental health apps. Objective The purpose of this study was to characterize reach, use, and impact of “PTSD Coach”, a free, broadly disseminated mental health app for managing posttraumatic stress disorder (PTSD) symptoms. Methods Using a mixed-methods approach, aggregate mobile analytics data from 153,834 downloads of PTSD Coach were analyzed in conjunction with 156 user reviews. Results Over 60% of users engaged with PTSD Coach on multiple occasions (mean=6.3 sessions). User reviews reflected gratitude for the availability of the app and being able to use the app specifically during moments of need. PTSD Coach users reported relatively high levels of trauma symptoms (mean PTSD Checklist Score=57.2, SD=15.7). For users who chose to use a symptom management tool, distress declined significantly for both first-time users (mean=1.6 points, SD=2.6 on the 10-point distress thermometer) and return-visit users (mean=2.0, SD=2.3). Analysis of app session data identified common points of attrition, with only 80% of first-time users reaching the app’s home screen and 37% accessing one of the app’s primary content areas. Conclusions These findings suggest that PTSD Coach has achieved substantial and sustained reach in the population, is being used as intended, and has been favorably received. PTSD Coach is a unique platform for the delivery of mobile mental health education and treatment, and continuing evaluation and improvement of the app could further strengthen its public health impact. PMID:26543913

The impact of Telephonic Health Coaching on Health Outcomes in a High-risk Population.

PubMed

Lawson, Karen L; Jonk, Yvonne; O'Connor, Heidi; Riise, Kirsten Sundgaard; Eisenberg, David M; Kreitzer, Mary Jo

2013-05-01

Health coaching is a client-centric process to increase motivation and self-efficacy that supports sustainable lifestyle behavior changes and active management of health conditions. This study describes an intervention offered as a benefit to health plan members and examines health and behavioral outcomes of participants. High-risk health plan enrollees were invited to participate in a telephonic health coaching intervention addressing the whole person and focusing on motivating health behavior changes. Outcomes of self-reported lifestyle behaviors, perceived health, stress levels, quality of life, readiness to make changes, and patient activation levels were reported at baseline and upon program completion. Retrospectively, these data were extracted from administrative and health coaching records of participants during the first 2 full years of the program. Less than 7% of the 114 615 potential candidates self-selected to actively participate in health coaching, those with the highest chronic disease load being the most likely to participate. Of 6940 active participants, 1082 fully completed health inventories, with 570 completing Patient Activation Measure (PAM). The conditions most often represented in the active participants were depression, congestive heart failure, diabetes, hyperlipidemia, hypertension, osteoporosis, asthma, and low back pain. In 6 months or less, 89% of participants met at least one goal. Significant improvements occurred in stress levels, healthy eating, exercise levels, and physical and emotional health, as well as in readiness to make change and PAM scores. The types of client-selected goals most often met were physical activity, eating habits, stress management, emotional health, sleep, and pain management, resulting in improved overall quality of life regardless of condition. Positive shifts in activation levels and readiness to change suggest that health coaching is an intervention deserving of future prospective research studies to

The feasibility of a telephone coaching program on heart failure home management for family caregivers

PubMed Central

Piamjariyakul, Ubolrat; Smith, Carol E.; Russell, Christy; Werkowitch, Marilyn; Elyachar, Andrea

2012-01-01

Objectives To test the feasibility of delivery and evaluate the helpfulness of a coaching heart failure (HF) home management program for family caregivers. Background The few available studies on providing instruction for family caregivers are limited in content for managing HF home care and guidance for program implementation. Method This pilot study employed a mixed methods design. The measures of caregiver burden, confidence, and preparedness were compared at baseline and 3 months post-intervention. Descriptive statistics were used to summarize program costs and demographic data. Content analysis research methods were used to evaluate program feasibility and helpfulness. Results Caregiver (n=10) burden scores were significantly reduced and raw scores of confidence and preparedness for HF home management improved 3 months after the intervention. Content analyses of nurse and caregiver post-intervention data found caregivers rated the program as helpful and described how they initiated HF management skills based on the program. Conclusion The program was feasible to implement. These results suggest the coaching program should be further tested with a larger sample size to evaluate its efficacy. PMID:23116654

Coaching mental health peer advocates for rural LGBTQ people.

PubMed

Willging, Cathleen E; Israel, Tania; Ley, David; Trott, Elise M; DeMaria, Catherine; Joplin, Aaron; Smiley, Verida

Lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) people are affected by mental health disparities, especially in rural communities. We trained peer advocates in rural areas in the fundamentals of mental health, outreach, education, and support for this population. The peer advocates were coached by licensed mental health professionals. We evaluated this process through iterative qualitative analysis of semi-structured interviews and written logs from coaches and advocates. The six major themes comprising the results centered on (1) coaching support, (2) peer advocate skills and preparation, (3) working with help seekers, (4) negotiating diversity, (5) logistical challenges in rural contexts, and (6) systemic challenges. We concluded that peer advocacy for LGBTQ people with mental distress offers an affirmative, community-based strategy to assist the underserved. To be successful, however, peer advocates will likely require ongoing training, coaching, and infrastructural support to negotiate contextual factors that can influence provision of community resources and support to LGBTQ people within rural communities.

Coaching mental health peer advocates for rural LGBTQ people

PubMed Central

Willging, Cathleen E.; Israel, Tania; Ley, David; Trott, Elise M.; DeMaria, Catherine; Joplin, Aaron; Smiley, Verida

2016-01-01

Lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) people are affected by mental health disparities, especially in rural communities. We trained peer advocates in rural areas in the fundamentals of mental health, outreach, education, and support for this population. The peer advocates were coached by licensed mental health professionals. We evaluated this process through iterative qualitative analysis of semi-structured interviews and written logs from coaches and advocates. The six major themes comprising the results centered on (1) coaching support, (2) peer advocate skills and preparation, (3) working with help seekers, (4) negotiating diversity, (5) logistical challenges in rural contexts, and (6) systemic challenges. We concluded that peer advocacy for LGBTQ people with mental distress offers an affirmative, community-based strategy to assist the underserved. To be successful, however, peer advocates will likely require ongoing training, coaching, and infrastructural support to negotiate contextual factors that can influence provision of community resources and support to LGBTQ people within rural communities. PMID:27458498

Improving awareness, accountability, and access through health coaching: qualitative study of patients' perspectives.

PubMed

Liddy, Clare; Johnston, Sharon; Irving, Hannah; Nash, Kate; Ward, Natalie

2015-03-01

To assess patients' experiences with and perceptions of health coaching as part of their ongoing care. A qualitative research design using semistructured interviews that were recorded and transcribed verbatim.Setting Ottawa, Ont. Eleven patients (> 18 years of age) enrolled in a health coaching pilot program who were at risk of or diagnosed with type 2 diabetes. Patients' perspectives were assessed with semistructured interviews. Interviews were conducted with 11 patients at the end of the pilot program, using a stratified sampling approach to ensure maximum variation. All patients found the overall experience with the health coaching program to be positive. Patients believed the health coaching program was effective in increasing awareness of how diabetes affected their bodies and health, in building accountability for their health-related actions, and in improving access to care and other health resources. Patients perceive one-on-one health coaching as an acceptable intervention in their ongoing care. Patients enrolled in the health coaching pilot program believed that there was an improvement in access to care, health literacy, and accountability,all factors considered to be precursors to behavioural change.

Training meals on wheels volunteers as health literacy coaches for older adults.

PubMed

Rubin, Donald L; Freimuth, Vicki S; Johnson, Sharon D; Kaley, Terry; Parmer, John

2014-05-01

Homebound older adults constitute a "hardly reached" population with respect to health communication. Older adults also typically suffer from health literacy challenges, which put them at increased risk of adverse health outcomes. Suboptimal interactions with providers are one such challenge. Interventions to improve interactive health literacy focus on training consumers/patients in question preparation and asking. Meals on Wheels volunteers are uniquely suited to coach their clients in such interaction strategies. Seventy-three Meals on Wheels volunteers participated in workshops to train as health literacy coaches. The 3- to 4-hour workshops included units on communicating with older adults, on the nature of health literacy, and on the process of interactive health literacy coaching. Participants viewed and discussed videos that modeled the targeted communication behaviors for older adult patients interacting with physicians. They role-played the coaching process. After 9 months, coaches participated in a "booster" session that included videos of ideal coaching practices. Evaluation questionnaires revealed that participants had favorable reactions to the workshops with respect to utility and interest. They especially appreciated learning communication skills and seeing realistic videos. A measure of knowledge about the workshop material revealed a significant increment at posttest. Fidelity of coaching practices with respect to workshop curriculum was confirmed. This training in interactive health literacy for community-based lay volunteers constitutes one way to implement the National Action Plan to Improve Health Literacy for one "hardly reached" population. An online tool kit containing all workshop materials is available.

Danish Health Professionals' Experiences of Being Coached: A Pilot Study

ERIC Educational Resources Information Center

Ammentorp, Jette; Jensen, Hanne Irene; Uhrenfeldt, Lisbeth

2013-01-01

Introduction: In recent years, coaching, as a supplement to professional development, has received increased attention, especially in nursing. Still, only little is known about how health professionals experience participating in coaching sessions. The purpose of this pilot study was to describe and analyze health professionals' experiences from…

Efficacy of Adjunct In-Home Coaching to Improve Outcomes in Parent-Child Interaction Therapy

ERIC Educational Resources Information Center

Timmer, Susan G.; Zebell, Nancy M.; Culver, Michelle A.; Urquiza, Anthony J.

2010-01-01

Objectives: The purpose of this study is to test whether increasing the exposure to coaching by adding an in-home component to clinic-delivered Parent-Child Interaction Therapy (PCIT) will increase the speed of parenting skill acquisition and show greater improvements in children's behaviors and parental stress. Methods: Seventy-three parent-child…

Coaching patients On Achieving Cardiovascular Health (COACH): a multicenter randomized trial in patients with coronary heart disease.

PubMed

Vale, Margarite J; Jelinek, Michael V; Best, James D; Dart, Anthony M; Grigg, Leeanne E; Hare, David L; Ho, Betty P; Newman, Robert W; McNeil, John J

Disease management programs in which drugs are prescribed by dietitians or nurses have been shown to improve the coronary risk factor profile in patients with coronary heart disease. However, those disease management programs in which drugs are not prescribed by allied health professionals have not improved coronary risk factor status. The objective of the Coaching patients On Achieving Cardiovascular Health (COACH) study was to determine whether dietitians or nurses who did not prescribe medications could coach patients with coronary heart disease to work with their physicians to achieve the target levels for their total cholesterol (TC) and other risk factors. Multicenter randomized controlled trial in which 792 patients from 6 university teaching hospitals underwent a stratified randomization by cardiac diagnosis within each hospital: 398 were assigned to usual care plus The COACH Program and 394 to usual care alone. Patients in The COACH Program group received regular personal coaching via telephone and mailings to achieve the target levels for their particular coronary risk factors. There was one coach per hospital. The primary outcome was the change in TC (DeltaTC) from baseline (in hospital) to 6 months after randomization. Secondary outcomes included measurement of a wide range of physical, nutritional, and psychological factors. The analysis was performed by intention to treat. The COACH Program achieved a significantly greater DeltaTC than usual care alone: the mean DeltaTC was 21 mg/dL (0.54 mmol/L) (95% confidence interval [CI], 16-25 mg/dL [0.42-0.65 mmol/L]) in The COACH Program vs 7 mg/dL (0.18 mmol/L) (95% CI, 3-11 mg/dL [0.07-0.29 mmol/L]) in the usual care group (P<.0001). Thus, the reduction in TC from baseline to 6 months after randomization was 14 mg/dL (0.36 mmol/L) (95% CI, 8-20 mg/dL [0.20-0.52 mmol/L]) greater in The COACH Program group than in the usual care group. Coaching produced substantial improvements in most of the other coronary

Evaluating the Effect of a Diabetes Health Coach in Individuals with Type 2 Diabetes.

PubMed

Sherifali, Diana; Viscardi, Virginia; Bai, Johnny-Wei; Ali, R Muhammad Usman

2016-02-01

Diabetes health coaching has not been adequately assessed in individuals with type 2 diabetes. The objective of this review was to synthesize the evidence of health coaching for individuals with diabetes to determine the effects of coaching on diabetes control, specifically on glycated hemoglobin (A1C) levels. The EMBASE, MEDLINE, CINAHL, PsychINFO and Cochrane Central Register of Controlled Trials databases were searched from inception to January 2015. Reference lists from important publications were also reviewed. At least 2 evaluators independently screened and extracted data from eligible studies. A total of 8 trials met the selection criteria, which included 724 adult participants; 353 participants were randomized to a diabetes health coaching intervention, and 371 were randomized to usual care. The pooled effect of diabetes health coaching overall was a statistically significant reduction of A1C levels by 0.32 (95% CI, -0.50 to -0.15). Longer diabetes health coaching exposure (>6 months) resulted in a 0.57% reduction in A1C levels (95% CI, -0.76 to -0.38), compared to shorter diabetes health coaching exposure (≤6 months) (-0.23%; 95% CI, -0.37 to -0.09). Across all studies, diabetes health coaching consisted of goal setting, knowledge acquisition, individualized care and frequent follow up. Diabetes health coaching has an emerging role in healthcare that facilitates self-care, behaviour change and offers frequent follow up and support. This review finds that health coaching for those with diabetes is an effective intervention for improving glycemic control, which may be of greater benefit when offered in addition to existing diabetes care. Copyright © 2015 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

A pilot study of health and wellness coaching for fibromyalgia.

PubMed

Hackshaw, Kevin V; Plans-Pujolras, Marcal; Rodriguez-Saona, Luis E; Moore, Margaret A; Jackson, Erika K; Sforzo, Gary A; Buffington, C A Tony

2016-11-08

The purpose of this study was to test the hypothesis that a health and wellness coaching (HWC)-based intervention for fibromyalgia (FM) would result in sustained improvements in health and quality of life, and reductions in health care utilization. Nine female subjects meeting American College of Rheumatology criteria for a diagnosis of primary FM were studied. The HWC protocol had two components, which were delivered telephonically over a twelve-month period. First, each patient met individually with a coach during the 12 month study at the patient's preference of schedule and frequency (Range:22-32 × 45-min sessions). Coaches were health professionals trained in health and wellness coaching tasks, knowledge, and skills. Second, each patient participated in bimonthly (first six months) and monthly (second six months) group classes on self-coaching strategies during the 12 month study. Prior to the intervention, and after 6 months and 12 months of coaching, the Revised Fibromyalgia Impact Questionnaire (FIQR) was used to measure health and quality of life, and the Brief Pain Inventory-Short Form (BPI) was used to measure pain intensity and interference with function. Total and rheumatology-related health encounters were documented using electronic medical records. Data were analyzed using repeated measures ANOVA. All nine patients finished the HWC protocol. FIQR scores improved by 35 % (P = 0.001). BPI scores decreased by 32 % overall (P = 0.006), 31 % for severity (P = 0.02), and 44 % for interference (P = 0.006). Health care utilization declined by 86 % (P = 0.006) for total and 78 % (P < 0.0001) for rheumatology-related encounters. The HWC program added to standard FM therapy produced clinically significant improvements in quality of life measures (FIQR), pain (BPI), and marked reductions in health care utilization. Such improvements do not typically occur spontaneously in FM patients, suggesting that HWC deserves further

Health Coaching in Severe COPD After a Hospitalization: A Qualitative Analysis of a Large Randomized Study.

PubMed

Benzo, Roberto P; Kirsch, Janae L; Hathaway, Julie C; McEvoy, Charlene E; Vickers, Kristin S

2017-11-01

We recently demonstrated in a randomized study the feasibility and effectiveness of telephone-based health coaching using motivational interviewing on decreasing hospital readmissions and improving quality of life at 6 and 12 months after hospital discharge. In this qualitative study, we sought to explore the health-coaching intervention as seen from the perspective of the participants who received the intervention and the coaches who delivered it. Semistructured participant interviews ( n = 24) and a focus group of all health coaches ( n = 3) who participated in this study were conducted. Interviews and focus group were recorded and transcribed verbatim. Transcripts were analyzed using coding and categorizing techniques and thematic analysis. Mixed-method triangulation was used to merge quantitative and qualitative data. Content analysis revealed 4 predominant themes of the coaching intervention: health-coaching relationship, higher participant confidence and reassurance (most related to improvement in physical quality of life), improved health-care system access (most related to decreased hospital readmissions), and increased awareness of COPD symptoms (most related to improvement in emotional quality of life). The strongest theme was the relationship with the health coach, including coach style and motivational interviewing approach. Health coaches' focus group also noted the importance of the coaching relationship as the most significant theme. This study provided themes to further inform the delivery and implementation of health-coaching interventions in patients with COPD after hospital discharge. Health coaching forged partnerships and created a platform for patient engagement, which was confirmed by both participants and health coaches. Copyright © 2017 by Daedalus Enterprises.

Are coaches' health promotion activities beneficial for sport participants? A multilevel analysis.

PubMed

Van Hoye, Aurélie; Heuzé, Jean-Philippe; Van den Broucke, Stephan; Sarrazin, Philippe

2016-12-01

As major actors in sports activities, sports coaches can play a significant role in health education and contribute to the psychological well-being of young people. However, not all participants in sports activities experience sports positively, which reduces the potential benefits for health. The present study investigates if coaches' efforts to promote health increase young athletes' enjoyment, self-esteem and perceived health in daily life and decrease sport dropout. To control for the variability between teams and between clubs, multilevel modeling was applied. A sample of 342 young football players completed questionnaires assessing their perceptions of coaches' Health Promotion (HP) activities, enjoyment of sports, dropout intentions, self-esteem and perceived health in daily life. HP general score was positively related to enjoyment and perceived health as well as negatively dropout intentions. Players perceiving their coaches as promoting fair and play (Respect for oneself and others) scored higher on their perceptions of enjoyment in sport, self-esteem and self-reported health, and lower on dropout intentions. Moreover, players recognizing their coaches as encouraging their healthy lifestyle also reported higher perceptions of sport enjoyment, whereas player's perceived coaches' activities on substance use were associated with lower participants' enjoyment. These results support the importance of developing HP in sports clubs. Especially, promoting respect of oneself and others seems to be the more beneficial to sport participants. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

National Training and Education Standards for Health and Wellness Coaching: The Path to National Certification

PubMed Central

Wolever, Ruth Q.; Lawson, Karen; Moore, Margaret

2015-01-01

The purpose of this article is twofold: (1) to announce the findings of the job task analysis as well as national training and education standards for health and wellness coaching (HWC) that have been developed by the large-scale, collaborative efforts of the National Consortium for Credentialing Health and Wellness Coaches (NCCHWC) and (2) to invite commentary from the public. The rapid proliferation of individuals and organizations using the terms of health and/or wellness coaches and the propagation of private industry and academic coach training and education programs endeavoring to prepare these coaches has created an urgent and pressing need for national standards for use of the term health and wellness coach, as well as minimal requirements for training, education, and certification. Professionalizing the field with national standards brings a clear and consistent definition of health and wellness coaching and accepted practice standards that are uniform across the field. In addition, clear standards allow for uniform curricular criteria to ensure a minimal benchmark for education, training, and skills and knowledge evaluation of professional health and wellness coaches. PMID:25984418

Coaches' and Players' Perceptions of Health Promotion Activities in Sport Clubs

ERIC Educational Resources Information Center

Van Hoye, Aurélie; Heuzé, Jean-Philippe; Meganck, Jeroen; Seghers, Jan; Sarrazin, Philippe

2018-01-01

Objectives: To better understand the role sports club coaches can play in health promotion (HP), as well as factors supporting this task, this study compared coaches' and players' perception of coaches' HP activities and tested whether coaches' basic need satisfaction predicted coaches' HP activities mediated by self-determined motivation to…

Unobtrusive monitoring of divided attention in a cognitive health coaching intervention for the elderly.

PubMed

McKanna, James A; Pavel, Misha; Jimison, Holly

2010-11-13

Assessment of cognitive functionality is an important aspect of care for elders. Unfortunately, few tools exist to measure divided attention, the ability to allocate attention to different aspects of tasks. An accurate determination of divided attention would allow inference of generalized cognitive decline, as well as providing a quantifiable indicator of an important component of driving skill. We propose a new method for determining relative divided attention ability through unobtrusive monitoring of computer use. Specifically, we measure performance on a dual-task cognitive computer exercise as part of a health coaching intervention. This metric indicates whether the user has the ability to pay attention to both tasks at once, or is primarily attending to one task at a time (sacrificing optimal performance). The monitoring of divided attention in a home environment is a key component of both the early detection of cognitive problems and for assessing the efficacy of coaching interventions.

Complexity and Health Coaching: Synergies in Nursing

PubMed Central

Mitchell, Gail J.; Wong, Winnie; Rush, Danica

2013-01-01

Health care professionals are increasingly aware that persons are complex and live in relation with other complex human communities and broader systems. Complex beings and systems are living and evolving in nonlinear ways through a process of mutual influence. Traditional standardized approaches in chronic disease management do not address these non-linear linkages and the meaning and changes that impact day-to-day life and caring for self and family. The RN health coach role described in this paper addresses the complexities and ambiguities for persons living with chronic illness in order to provide person-centered care and support that are unique and responsive to the context of persons' lives. Informed by complexity thinking and relational inquiry, the RN health coach is an emergent innovation of creative action with community and groups that support persons as they shape their health and patterns of living. PMID:24102025

Can life coaching improve health outcomes?--A systematic review of intervention studies.

PubMed

Ammentorp, Jette; Uhrenfeldt, Lisbeth; Angel, Flemming; Ehrensvärd, Martin; Carlsen, Ebbe B; Kofoed, Poul-Erik

2013-10-22

In recent years, coaching has received special attention as a method to improve healthy lifestyle behaviours. The fact that coaching has found its way into healthcare and may provide new ways of engaging the patients and making them accountable for their health, justifies the need for an overview of the evidence regarding coaching interventions used in patient care, the effect of the interventions, and the quality of the studies published. However, in order to provide a clear definition of the coaching interventions selected for this review, we have found it necessary to distinguish between health coaching and life coaching. In this review, we will only focus on the latter method and on that basis assess the health related outcomes of life coaching. Intervention studies using quantitative or qualitative methods to evaluate the outcome of the life coach interventions were identified through systematic literature searches in PubMed, Embase, Psycinfo, and CINAHL. The quality of the methodology was independently assessed by three of the authors using a criteria list. A total of 4359 citations were identified in the electronic search and five studies were included; two of them were randomized controlled trials and met all quality criteria. The two studies investigating objective health outcomes (HbA1c) showed mixed but promising results, especially concerning the patient group that usually does not benefit from intensified interventions. Because of the very limited number of solid studies, this review can only present tendencies for patient outcomes and a preliminary description of an effective life coaching intervention.The coaching method used in these studies aims to improve self-efficacy and self-empowerment. This may explain why the studies including disadvantaged patients showed the most convincing results. The findings also indicate that some patients benefit from being met with an alternative approach and a different type of communication than they are used to

Virtual Training and Coaching of Health Behavior: Example from Mindfulness Meditation Training

PubMed Central

Hudlicka, Eva

2014-01-01

Objective Computer-based virtual coaches are increasingly being explored for patient education, counseling, and health behavior training and coaching. The objective of this research was to develop and evaluate a Virtual Mindfulness Coach for training and coaching in mindfulness meditation. Method The coach was implemented as an embodied conversational character, providing mindfulness training and coaching via mixed initiative, text-based, natural language dialogue with the student, and emphasizing affect-adaptive interaction. (The term ‘mixed initiative dialog’ refers to a human-machine dialogue where either can initiate a conversation or a change in the conversation topic.) Results Findings from a pilot evaluation study indicate that the coach-based training is more effective in helping students establish a regular practice than self-administered training using written and audio materials. The coached group also appeared to be in more advanced stages of change in terms of the transtheoretical model, and have a higher sense of self-efficacy regarding establishment of a regular mindfulness practice. Conclusion These results suggest that virtual coach-based training of mindfulness is both feasible, and potentially more effective, than a self-administered program. Of particular interest is the identification of the specific coach features that contribute to its effectiveness. Practice Implications Virtual coaches could provide easily-accessible and cost-effective customized training for a range of health behaviors. The affect-adaptive aspect of these coaches is particularly relevant for helping patients establish long-term behavior changes. PMID:23809167

Virtual training and coaching of health behavior: example from mindfulness meditation training.

PubMed

Hudlicka, Eva

2013-08-01

Computer-based virtual coaches are increasingly being explored for patient education, counseling, and health behavior training and coaching. The objective of this research was to develop and evaluate a Virtual Mindfulness Coach for training and coaching in mindfulness meditation. The coach was implemented as an embodied conversational character, providing mindfulness training and coaching via mixed initiative, text-based, natural language dialog with the student, and emphasizing affect-adaptive interaction. (The term 'mixed initiative dialog' refers to a human-machine dialog where either can initiate a conversation or a change in the conversation topic.) Findings from a pilot evaluation study indicate that the coach-based training is more effective in helping students establish a regular practice than self-administered training using written and audio materials. The coached group also appeared to be in more advanced stages of change in terms of the transtheoretical model, and have a higher sense of self-efficacy regarding establishment of a regular mindfulness practice. These results suggest that virtual coach-based training of mindfulness is both feasible, and potentially more effective, than a self-administered program. Of particular interest is the identification of the specific coach features that contribute to its effectiveness. Virtual coaches could provide easily accessible and cost-effective customized training for a range of health behaviors. The affect-adaptive aspect of these coaches is particularly relevant for helping patients establish long-term behavior changes. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Introducing the health coach at a primary care practice: a pilot study (part 2).

PubMed

Lanese, Bethany Sneed; Dey, Asoke; Srivastava, Prashant; Figler, Robert

2011-01-01

It is well known that the cost of healthcare in the United States is a poor value proposition. One of the primary goals of the healthcare reform act is to reduce cost while improving healthcare quality. The authors believe that adding a health coach helps to achieve this goal. In part I, the authors discuss the role of a health coach in the healthcare field. They present the findings from a pilot study at a primary care practice managing diabetes of patients using a health coach. The findings from the study suggest that adding a health coach helps in cost savings as well as improved health for the patients.

Managing the health of the elite athlete: a new integrated performance health management and coaching model.

PubMed

Dijkstra, H Paul; Pollock, N; Chakraverty, R; Alonso, J M

2014-04-01

Elite athletes endeavour to train and compete even when ill or injured. Their motivation may be intrinsic or due to coach and team pressures. The sports medicine physician plays an important role to risk-manage the health of the competing athlete in partnership with the coach and other members of the support team. The sports medicine physician needs to strike the right ethical and operational balance between health management and optimising performance. It is necessary to revisit the popular delivery model of sports medicine and science services to elite athletes based on the current reductionist multispecialist system lacking in practice an integrated approach and effective communication. Athlete and coach in isolation or with a member of the multidisciplinary support team, often not qualified or experienced to do so, decide on the utilisation of services and how to apply the recommendations. We propose a new Integrated Performance Health Management and Coaching model based on the UK Athletics experience in preparation for the London Olympic and Paralympic Games. The Medical and Coaching Teams are managed by qualified and experienced individuals operating in synergy towards a common performance goal, accountable to a Performance Director and ultimately to the Board of Directors. We describe the systems, processes and implementation strategies to assist the athlete, coach and support teams to continuously monitor and manage athlete health and performance. These systems facilitate a balanced approach to training and competing decisions, especially while the athlete is ill or injured. They take into account the best medical advice and athlete preference. This Integrated Performance Health Management and Coaching model underpinned the Track and Field Gold Medal performances at the London Olympic and Paralympic Games.

Managing the health of the elite athlete: a new integrated performance health management and coaching model

PubMed Central

Dijkstra, H Paul; Pollock, N; Chakraverty, R; Alonso, J M

2014-01-01

Elite athletes endeavour to train and compete even when ill or injured. Their motivation may be intrinsic or due to coach and team pressures. The sports medicine physician plays an important role to risk-manage the health of the competing athlete in partnership with the coach and other members of the support team. The sports medicine physician needs to strike the right ethical and operational balance between health management and optimising performance. It is necessary to revisit the popular delivery model of sports medicine and science services to elite athletes based on the current reductionist multispecialist system lacking in practice an integrated approach and effective communication. Athlete and coach in isolation or with a member of the multidisciplinary support team, often not qualified or experienced to do so, decide on the utilisation of services and how to apply the recommendations. We propose a new Integrated Performance Health Management and Coaching model based on the UK Athletics experience in preparation for the London Olympic and Paralympic Games. The Medical and Coaching Teams are managed by qualified and experienced individuals operating in synergy towards a common performance goal, accountable to a Performance Director and ultimately to the Board of Directors. We describe the systems, processes and implementation strategies to assist the athlete, coach and support teams to continuously monitor and manage athlete health and performance. These systems facilitate a balanced approach to training and competing decisions, especially while the athlete is ill or injured. They take into account the best medical advice and athlete preference. This Integrated Performance Health Management and Coaching model underpinned the Track and Field Gold Medal performances at the London Olympic and Paralympic Games. PMID:24620040

Health coaching to improve healthy lifestyle behaviors: an integrative review.

PubMed

Olsen, Jeanette M; Nesbitt, Bonnie J

2010-01-01

Chronic diseases account for 70% of U.S. deaths. Health coaching may help patients adopt healthy lifestyle behaviors that prevent and control diseases. This integrative review analyzed health coaching studies for evidence of effectiveness and to identify key program features. Multiple electronic databases were utilized, yielding a final sample of 15 documents. The search was limited to peer-reviewed research articles published between 1999 and 2008. Studies were further analyzed if they (1) specifically cited coaching as a program intervention, and (2) applied the intervention to research. Articles describing various quantitative and qualitative methodologies were critically analyzed using a systematic method. Data were synthesized using a matrix format according to purpose, method, intervention, findings, critique, and quality rating. All 15 studies utilized nonprobability sampling, 7 (47%) with randomized intervention and control groups. Significant improvements in one or more of the behaviors of nutrition, physical activity, weight management, or medication adherence were identified in six (40%) of the studies. Common features of effective programs were goal setting (73%), motivational interviewing (27%), and collaboration with health care providers (20%). Health coaching studies with well-specified methodologies and more rigorous designs are needed to strengthen findings; however, this behavioral change intervention suggests promise.

The Early Childhood Coaching Handbook

ERIC Educational Resources Information Center

Rush, Dathan D.; Shelden, M'Lisa L.

2011-01-01

Evidence-based and highly effective, "coaching" helps early childhood practitioners support other professionals and families as they enhance existing knowledge, develop new skills, and promote healthy development of young children. This hands-on guide shows professionals how to conduct skillful coaching in any setting--home, school, or community.…

Employee weight management through health coaching.

PubMed

Merrill, R M; Aldana, S G; Bowden, D E

2010-01-01

This study will evaluate the effectiveness of an interactive health coaching intervention at lowering weight. The study involved 5405 overweight or obese employees aged 18-85, who entered the program sometime during 2001-2008. Average body mass index (BMI) significantly decreased from 32.1 at baseline to 31.4 at 3 months, 31.0 at 6 months, and 30.6 at 12 months. Decreasing BMI was more pronounced in older age groups and among women, those using weight loss medication, those with higher BMI, and those with higher motivation and confidence to make behavior changes. When the effects of these variables on the decreasing trend in BMI were simultaneously estimated, only baseline classifications of BMI, health status, and confidence remained significant. Change in BMI through 12 months was -0.7% for those with normal weight, -2.0% for overweight, -3.6% for obese, and -7.1% for morbidly obese individuals at baseline. Among morbidly obese individuals, decrease in BMI through 12 months was -7.6% for those with "high" confidence to lose weight at baseline vs -4.4% for those with low confidence. Better health status at baseline was also related to more pronounced weight loss. Interactive health coaching significantly lowered BMI among participants through 3, 6, and 12 months of follow-up.

Effectiveness of coaching for enhancing the health of menopausal Japanese women.

PubMed

Fujimoto, Kaoru

2017-01-01

We conducted and evaluated a coaching intervention aimed at encouraging menopausal women's engagement in goal-oriented actions, self-efficacy enhancement, menopausal symptom alleviation, and quality of life improvement. The study was a randomized controlled trial comprising women aged 40-60 who were not receiving hormone therapy. The intervention group received leaflets and three monthly coaching sessions. Instruments included the Simplified Menopausal Index, Medical Outcome Study 36-Item Short Form Health Survey, and goal achievement scale. Participants were measured preintervention, immediately postintervention, and three months postintervention. A 3-month coaching intervention to enhance menopausal women's health increased their self-efficacy. This effect was not maintained 3 months postintervention.

Evaluating the Treatment Fidelity of Parents Who Conduct In-Home Functional Communication Training with Coaching via Telehealth

ERIC Educational Resources Information Center

Suess, Alyssa N.; Romani, Patrick W.; Wacker, David P.; Dyson, Shannon M.; Kuhle, Jennifer L.; Lee, John F.; Lindgren, Scott D.; Kopelman, Todd G.; Pelzel, Kelly E.; Waldron, Debra B.

2014-01-01

We conducted a retrospective, descriptive evaluation of the fidelity with which parents of three children with autism spectrum disorders conducted functional communication training (FCT) in their homes. All training was provided to the parents via telehealth by a behavior consultant in a tertiary-level hospital setting. FCT trials coached by the…

Linking High Risk Postpartum Women with a Technology Enabled Health Coaching Program to Reduce Diabetes Risk and Improve Wellbeing: Program Description, Case Studies, and Recommendations for Community Health Coaching Programs

PubMed Central

Thomas, Melanie; Delgadillo-Duenas, Adriana T.; Leong, Karen; Najmabadi, Adriana; Harleman, Elizabeth; Rios, Christina; Quan, Judy; Soria, Catalina; Handley, Margaret A.

2016-01-01

Background. Low-income minority women with prior gestational diabetes mellitus (pGDM) or high BMIs have increased risk for chronic illnesses postpartum. Although the Diabetes Prevention Program (DPP) provides an evidence-based model for reducing diabetes risk, few community-based interventions have adapted this program for pGDM women. Methods. STAR MAMA is an ongoing randomized control trial (RCT) evaluating a hybrid HIT/Health Coaching DPP-based 20-week postpartum program for diabetes prevention compared with education from written materials at baseline. Eligibility includes women 18–39 years old, ≥32 weeks pregnant, and GDM or BMI > 25. Clinic- and community-based recruitment in San Francisco and Sonoma Counties targets 180 women. Sociodemographic and health coaching data from a preliminary sample are presented. Results. Most of the 86 women included to date (88%) have GDM, 80% were identified as Hispanic/Latina, 78% have migrant status, and most are Spanish-speaking. Women receiving the intervention indicate high engagement, with 86% answering 1+ calls. Health coaching callbacks last an average of 9 minutes with range of topics discussed. Case studies presented convey a range of emotional, instrumental, and health literacy-related supports offered by health coaches. Discussion. The DPP-adapted HIT/health coaching model highlights the possibility and challenge of delivering DPP content to postpartum women in community settings. This trial is registered with ClinicalTrials.gov NCT02240420. PMID:27830157

Linking High Risk Postpartum Women with a Technology Enabled Health Coaching Program to Reduce Diabetes Risk and Improve Wellbeing: Program Description, Case Studies, and Recommendations for Community Health Coaching Programs.

PubMed

Athavale, Priyanka; Thomas, Melanie; Delgadillo-Duenas, Adriana T; Leong, Karen; Najmabadi, Adriana; Harleman, Elizabeth; Rios, Christina; Quan, Judy; Soria, Catalina; Handley, Margaret A

2016-01-01

Background . Low-income minority women with prior gestational diabetes mellitus (pGDM) or high BMIs have increased risk for chronic illnesses postpartum. Although the Diabetes Prevention Program (DPP) provides an evidence-based model for reducing diabetes risk, few community-based interventions have adapted this program for pGDM women. Methods . STAR MAMA is an ongoing randomized control trial (RCT) evaluating a hybrid HIT/Health Coaching DPP-based 20-week postpartum program for diabetes prevention compared with education from written materials at baseline. Eligibility includes women 18-39 years old, ≥32 weeks pregnant, and GDM or BMI > 25. Clinic- and community-based recruitment in San Francisco and Sonoma Counties targets 180 women. Sociodemographic and health coaching data from a preliminary sample are presented. Results . Most of the 86 women included to date (88%) have GDM, 80% were identified as Hispanic/Latina, 78% have migrant status, and most are Spanish-speaking. Women receiving the intervention indicate high engagement, with 86% answering 1+ calls. Health coaching callbacks last an average of 9 minutes with range of topics discussed. Case studies presented convey a range of emotional, instrumental, and health literacy-related supports offered by health coaches. Discussion . The DPP-adapted HIT/health coaching model highlights the possibility and challenge of delivering DPP content to postpartum women in community settings. This trial is registered with ClinicalTrials.gov NCT02240420.

Australian rural football club leaders as mental health advocates: an investigation of the impact of the Coach the Coach project

PubMed Central

2010-01-01

Background Mental ill health, especially depression, is recognised as an important health concern, potentially with greater impact in rural communities. This paper reports on a project, Coach the Coach, in which Australian rural football clubs were the setting and football coaches the leaders in providing greater mental health awareness and capacity to support early help seeking behaviour among young males experiencing mental health difficulties, especially depression. Coaches and other football club leaders were provided with Mental Health First Aid (MHFA) training. Method Pre-post measures of the ability of those club leaders undertaking mental health training to recognise depression and schizophrenia and of their knowledge of evidence supported treatment options, and confidence in responding to mental health difficulties were obtained using a questionnaire. This was supplemented by focus group interviews. Pre-post questionnaire data from players in participating football clubs was used to investigate attitudes to depression, treatment options and ability to recognise depression from a clinical scenario. Key project stakeholders were also interviewed. Results Club leaders (n = 36) who were trained in MHFA and club players (n = 275) who were not trained, participated in this evaluation. More than 50% of club leaders who undertook the training showed increased capacity to recognise mental illness and 66% reported increased confidence to respond to mental health difficulties in others. They reported that this training built upon their existing skills, fulfilled their perceived social responsibilities and empowered them. Indirect benefit to club players from this approach seemed limited as minimal changes in attitudes were reported by players. Key stakeholders regarded the project as valuable. Conclusions Rural football clubs appear to be appropriate social structures to promote rural mental health awareness. Club leaders, including many coaches, benefit from MHFA

Advancing Health Promotion in Dentistry: Articulating an Integrative Approach to Coaching Oral Health Behavior Change in the Dental Setting

PubMed Central

Howard, Anita R.

2015-01-01

Oral health is managed based on objective measures such as the presence and severity of dental caries and periodontal disease. In recent years, oral health researchers and practitioners have shown increasing interest in a widened array of physical, psychological, and social factors found to influence patients’ oral health. In this article, we introduce a behavior change coaching approach that can be used to enhance psychosocial diagnosis and client-centered delivery of health-promoting interventions. Briefly, this health coaching approach is based on an interactive assessment (both physical and psychological), a non-judgmental exploration of patients’ knowledge, attitudes, and beliefs, a mapping of patient behaviors that may contribute to disease progression, gauging patient motivation, and tailoring health communication to encourage health-promoting behavior change. Developed in a clinical setting, this coaching model is supported by interdisciplinary theory, research, and practice on health behavior change. We suggest that, with supervision, this coaching process may be learned. PMID:26457237

A Systematic Review of the Literature on Health and Wellness Coaching: Defining a Key Behavioral intervention in Healthcare

PubMed Central

Simmons, Leigh Ann; Sforzo, Gary A.; Dill, Diana; Kaye, Miranda; Bechard, Elizabeth M.; Southard, Mary Elaine; Kennedy, Mary; Vosloo, Justine; Yang, Nancy

2013-01-01

Primary Objective: Review the operational definitions of health and wellness coaching as published in the peer-reviewed medical literature. Background: As global rates of preventable chronic diseases have reached epidemic proportions, there has been an increased focus on strategies to improve health behaviors and associated outcomes. One such strategy, health and wellness coaching, has been inconsistently defined and shown mixed results. Methods: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)—guided systematic review of the medical literature on health and wellness coaching allowed for compilation of data on specific features of the coaching interventions and background and training of coaches. Results: Eight hundred abstracts were initially identified through PubMed, with 284 full-text articles ultimately included. The majority (76%) were empirical articles. The literature operationalized health and wellness coaching as a process that is fully or partially patient-centered (86% of articles), included patient-determined goals (71%), incorporated self-discovery and active learning processes (63%) (vs more passive receipt of advice), encouraged accountability for behaviors (86%), and provided some type of education to patients along with using coaching processes (91%). Additionally, 78% of articles indicated that the coaching occurs in the context of a consistent, ongoing relationship with a human coach who is trained in specific behavior change, communication, and motivational skills. Conclusions: Despite disparities in how health and wellness coaching have been operationalized previously, this systematic review observes an emerging consensus in what is referred to as health and wellness coaching; namely, a patient-centered process that is based upon behavior change theory and is delivered by health professionals with diverse backgrounds. The actual coaching process entails goal-setting determined by the patient, encourages self

Health Coaching to Optimize Well-Being among Returning Veterans with Suicide Risk

DTIC Science & Technology

2017-10-01

AWARD NUMBER: W81XWH-16-1-0630 TITLE: Health Coaching to Optimize Well-Being among Returning Veterans with Suicide Risk PRINCIPAL INVESTIGATOR...Lauren M. Denneson, PhD CONTRACTING ORGANIZATION: Oregon Health & Science University Portland, OR 97239 REPORT DATE: October 2017 TYPE OF...COVERED (From - To) 15 Sept 2016 - 14 Sept 2017 4. TITLE AND SUBTITLE Health Coaching to Optimize Well-Being among Returning Veterans with Suicide Risk

Health coaching interventions for persons with chronic conditions: a systematic review and meta-analysis protocol.

PubMed

Boehmer, Kasey R; Barakat, Suzette; Ahn, Sangwoo; Prokop, Larry J; Erwin, Patricia J; Murad, M Hassan

2016-09-01

Chronic conditions are increasingly more common and negatively impact quality of life, disability, morbidity, and mortality. Health coaching has emerged as a possible intervention to help individuals with chronic conditions adopt health supportive behaviors that improve both quality of life and health outcomes. We planned a systematic review and meta-analysis of the contemporary health coaching literature published in the last decade to evaluate the effect of health coaching on clinically important, disease-specific, functional, and behavioral outcomes. We will include randomized controlled trials or quasi-experimental studies that compared health coaching to alternative interventions or usual care. To enable adoption of effective interventions, we aim to explore how the effect of intervention is modified by the intervention components, delivering personnel (i.e., health professionals vs trained lay or peer persons), dose, frequency, and setting. Analysis of intervention outcomes will be reported and classified using an existing theoretical framework, the Theory of Patient Capacity, to identify the areas of patients' capacity to access and use healthcare and enact self-care where coaching may be an effective intervention. This systematic review and meta-analysis will identify and synthesize evidence to inform the practice of health coaching by providing evidence on components and characteristics of the intervention essential for success in individuals with chronic health conditions. PROSPERO CRD42016039730.

Medical students as health coaches: Implementation of a student-initiated Lifestyle Medicine curriculum.

PubMed

Polak, Rani; Finkelstein, Adi; Axelrod, Tom; Dacey, Marie; Cohen, Matan; Muscato, Dennis; Shariv, Avi; Constantini, Naama W; Brezis, Mayer

2017-11-10

By 2020, the World Health Organization predicts that two-thirds of all diseases worldwide will be the result of lifestyle choices. Physicians often do not counsel patients about healthy behaviors, and lack of training has been identified as one of the barriers. Between 2010 and 2014, Hebrew University developed and implemented a 58-h Lifestyle Medicine curriculum spanning five of the 6 years of medical school. Content includes nutrition, exercise, smoking cessation, and behavior change, as well as health coaching practice with friends/relatives (preclinical years) and patients (clinical years). This report describes this development and diffusion process, and it also presents findings related to the level of acceptance of this student-initiated Lifestyle Medicine (LM) curriculum. Students completed an online semi-structured questionnaire after the first coaching session (coaching questionnaire) and the last coaching session (follow-up questionnaire). Nine hundred and twenty-three students completed the coaching questionnaire (296 practices were with patients, 627 with friends /relatives); and 784 students completed the follow-up questionnaire (208 practices were with patients, 576 with friends /relatives). They reported overall that health coaching domains included smoking cessation (263 students), nutrition (79), and exercise (117); 464 students reported on combined topics. Students consistently described a high acceptance of the curriculum and their active role in coaching. Further, most students reported that they were eager to address their own health behaviors. We described the development and acceptance of a student-initiated comprehensive LM curriculum. Students perceived LM as an important component of physicians' professional role and were ready to explore it both as coaches and in their personal lives. Thus, medical school deans might consider developing similar initiatives in order to position medical schools as key players within a preventive strategy

The Essential Components of Coach Training for Mental Health Professionals: A Delphi Study

ERIC Educational Resources Information Center

Moriarity, Marlene Therese

2010-01-01

Purpose. The purpose of this study was to discover how coach training experts define coaching and what they would identify to be the essential components of a coach training program for mental health professionals. Methods. A panel of nine experts, through an iterative Delphi process of responding to three rounds of questionnaires, provided…

Qualitative Evaluation of the Coach Training within a Community Paramedicine Care Transitions Intervention.

PubMed

Lau, Hunter Singh; Hollander, Matthew M; Cushman, Jeremy T; DuGoff, Eva H; Jones, Courtney M C; Kind, Amy J H; Lohmeier, Michael T; Coleman, Eric A; Shah, Manish N

2018-02-12

The Care Transitions Intervention (CTI) has potential to improve the emergency department (ED)-to-home transition for older adults. Community paramedics may function as the CTI coaches; however, this requires the appropriate knowledge, skills, and attitudes, which they do not receive in traditional emergency medical services (EMS) education. This study aimed to define community paramedics' perceptions regarding their training needs to serve as CTI coaches supporting the ED-to-home transition. This study forms part of an ongoing randomized controlled trial evaluating a community paramedic-implemented CTI to enhance the ED-to-home transition. The community paramedics' training covered the following domains: the CTI program, geriatrics, effective coaching, ED discharge processes, and community paramedicine. Sixteen months after starting the study, we conducted audio-recorded semi-structured interviews with community paramedics at both study sites. After transcribing the interviews, team members independently coded the transcripts. Ensuing group analysis sessions led to the development of final codes and identifying common themes. Finally, we conducted member checking to confirm our interpretations of the interview data. We interviewed all 8 participating community paramedics. Participants consisted solely of non-Hispanic whites, included 5 women, and had a mean age of 43. Participants had extensive backgrounds in healthcare, primarily as EMS providers, but minimal experience with community paramedicine. All reported some prior geriatrics training. Four themes emerged from the interviews: (1) paramedics with positive attitudes and willingness to acquire the needed knowledge and skills will succeed as CTI coaches; (2) active rather than passive learning is preferred by paramedics; (3) the existing training could benefit from adjustments such as added content on mental health, dementia, and substance abuse issues, as well as content on coaching subjects with a range of

Wellness coaching and health-related quality of life: a case-control difference-in-differences analysis.

PubMed

Menon, Jyothi; Paulet, Mindy; Thomas, Joseph

2012-10-01

Association between wellness coaching and changes in health-related quality of life over 1 year and 2 years was assessed. Difference-in-differences analysis of covariance assessed association between coaching and change in 8-item short-form health survey (SF-8) summary scores. Ordered logistic models assessed coaching and change in SF-8 individual domain scores. This was a case-control study. Participants in at least one coaching program were more likely to have increases in social functioning after 1 year and less likely to have increases in role physical after 2 years. Participants in nutrition coaching had more positive change in mental component summary scores after 1 year. Participants in stress management had more negative change in mental component summary scores after 1 year and after 2 years and had more negative change in physical component summary scores after 2 years. Findings were mixed regarding association between coaching and change in health-related quality of life.

Nursing home queues and home health users.

PubMed

Swan, J H; Benjamin, A E

1993-01-01

Home health market growth suggests the need for models explaining home health utilization. We have previously explained state-level Medicare home health visits with reference to nursing home markets. Here we introduce a model whereby state-level Medicare home health use is a function of nursing home queues and other demand and supply factors. Medicare home health users per state population is negatively related to nursing home bed stock, positively to Medicaid eligibility levels and to Medicaid nursing home recipients per population, as well as to various other demand and supply measures. This explanation of home health users explains previously-reported findings for home health visits. The findings support the argument that home health use is explained by factors affecting lengths of nursing home queues.

Gifts in Health Crisis: The Use of Health Coaching to Create Opportunity for a More Meaningful Life.

PubMed

Nutt, Theresa

2018-02-01

The purpose of this article is to explore health coaching as an effective intervention in times of health crisis for patients, families, and health-care staff. The pause that a health crisis creates in the activities of normal life allows for deeper questions about a person's life to emerge. Health coaching provides a safe space for clients to engage with these life questions while facilitating a connection with their sense of personal empowerment and innate inner wisdom. The result is a more meaningful and resilient life despite the outcome of the health crisis.

What Happens After Health Coaching? Observational Study 1 Year Following a Randomized Controlled Trial

PubMed Central

Sharma, Anjana E.; Willard-Grace, Rachel; Hessler, Danielle; Bodenheimer, Thomas; Thom, David H.

2016-01-01

PURPOSE Health coaching is effective for chronic disease self-management in the primary care safety-net setting, but little is known about the persistence of its benefits. We conducted an observational study evaluating the maintenance of improved cardiovascular risk factors following a health coaching intervention. METHODS We performed a naturalistic follow-up to the Health Coaching in Primary Care Study, a 12-month randomized controlled trial (RCT) comparing health coaching to usual care for patients with uncontrolled diabetes, hypertension, or hyperlipidemia. Participants were followed up 24 months from RCT baseline. The primary outcome was the proportion at goal for at least 1 measure (hemoglobin A1c, systolic blood pressure, or LDL cholesterol) that had been above goal at enrollment; secondary outcomes included each individual clinical goal. Chi-square tests and paired t-tests compared dichotomous and continuous measures. RESULTS 290 of 441 participants (65.8%) participated at both 12 and 24 months. The proportion of patients in the coaching arm of the RCT who achieved the primary outcome dropped only slightly from 47.1% at 12 to 45.9% at 24 months (P = .80). The proportion at goal for hemoglobin A1c dropped from 53.4% to 36.2% (P = .03). All other clinical metrics had small, nonsignificant changes between 12 and 24 months. CONCLUSIONS Results support the conclusion that most improved clinical outcomes persisted 1 year after the completion of the health coaching intervention. PMID:27184989

What Happens After Health Coaching? Observational Study 1 Year Following a Randomized Controlled Trial.

PubMed

Sharma, Anjana E; Willard-Grace, Rachel; Hessler, Danielle; Bodenheimer, Thomas; Thom, David H

2016-05-01

Health coaching is effective for chronic disease self-management in the primary care safety-net setting, but little is known about the persistence of its benefits. We conducted an observational study evaluating the maintenance of improved cardiovascular risk factors following a health coaching intervention. We performed a naturalistic follow-up to the Health Coaching in Primary Care Study, a 12-month randomized controlled trial (RCT) comparing health coaching to usual care for patients with uncontrolled diabetes, hypertension, or hyperlipidemia. Participants were followed up 24 months from RCT baseline. The primary outcome was the proportion at goal for at least 1 measure (hemoglobin A1c, systolic blood pressure, or LDL cholesterol) that had been above goal at enrollment; secondary outcomes included each individual clinical goal. Chi-square tests and paired t-tests compared dichotomous and continuous measures. 290 of 441 participants (65.8%) participated at both 12 and 24 months. The proportion of patients in the coaching arm of the RCT who achieved the primary outcome dropped only slightly from 47.1% at 12 to 45.9% at 24 months (P = .80). The proportion at goal for hemoglobin A1c dropped from 53.4% to 36.2% (P = .03). All other clinical metrics had small, nonsignificant changes between 12 and 24 months. Results support the conclusion that most improved clinical outcomes persisted 1 year after the completion of the health coaching intervention. © 2016 Annals of Family Medicine, Inc.

Personalized Health Planning With Integrative Health Coaching to Reduce Obesity Risk Among Women Gaining Excess Weight During Pregnancy

PubMed Central

Yang, Nancy Y.; Wroth, Shelley; Parham, Catherine; Strait, Melva

2013-01-01

Health coaching is an emerging behavioral intervention to improve outcomes in chronic disease management and prevention; however, no studies have investigated its utility in postpartum women who have gained excess weight during pregnancy. A 32-year-old primigravida woman who was overweight at conception and gained 23 lbs more than Institute of Medicine recommendations for her pre-pregnancy body mass index participated in a 6-month personalized health planning with integrative health coaching (PHPIHC) intervention. The intervention included a baseline health risk assessment review with a healthcare provider and eight biweekly, 30-minute telephonic health coaching sessions. The participant demonstrated improvement in physical activity, energy expenditure, knowledge, and confidence to engage in healthpromoting behaviors. Although the participant did not reach the target weight by completion of the health coaching sessions, follow up 8 months later indicated she achieved the target goal (within 5% of prepregnancy weight). This case report suggests that PHP-IHC can support postpartum women in returning to pre-pregnancy weight after gaining excess gestational weight. Future research and clinical trials are needed to determine the best timing, length, and medium (online, in-person, telephonic) of PHP-IHC for postpartum women. PMID:24278848

Do we know how to design effective health coaching interventions: a systematic review of the state of the literature.

PubMed

Hill, Briony; Richardson, Ben; Skouteris, Helen

2015-01-01

To systematically review health coaching interventions regarding effectiveness of health coaching for specific outcomes, optimal intervention approaches, and identification of specific techniques associated with effectiveness. Articles were sourced from CINAHL, Global Health, PsycINFO, Academic Search Complete, Health Source, Psychology and Behavioral Sciences Collection, and Medline. Randomized controlled trials were included if the study (1) employed health coaching according to a predefined criterion; (2) clearly reported the use of health coaching; or (3) incorporated the use of coaching. Aims, participants, approach, behavior change techniques (BCTs), and findings pertaining to each study were summarized. BCTs were classified according to the CALO-RE taxonomy. Data were synthesized by cross-tabulation of BCTs with study outcomes. Fifteen of 16 eligible studies reported a positive intervention effect in at least one outcome. Nine studies (56%) did not define health coaching; the number of intervention sessions provided ranged from 2 to 48; and in three studies, one or more intervention details were unclear. It was hence difficult to synthesize the studies to adequately address our research questions. Health coaching is a promising strategy for health improvements; however, future research should ensure clarity in reporting intervention details, clearer definitions of health coaching/theoretical bases, consistency in reporting BCTs, and the inclusion of process variables as outcome measures.

Health Coaching and Chronic Obstructive Pulmonary Disease Rehospitalization. A Randomized Study.

PubMed

Benzo, Roberto; Vickers, Kristin; Novotny, Paul J; Tucker, Sharon; Hoult, Johanna; Neuenfeldt, Pamela; Connett, John; Lorig, Kate; McEvoy, Charlene

2016-09-15

Hospital readmission for chronic obstructive pulmonary disease (COPD) has attracted attention owing to the burden to patients and the health care system. There is a knowledge gap on approaches to reducing COPD readmissions. To determine the effect of comprehensive health coaching on the rate of COPD readmissions. A total of 215 patients hospitalized for a COPD exacerbation were randomized at hospital discharge to receive either (1) motivational interviewing-based health coaching plus a written action plan for exacerbations (the use of antibiotics and oral steroids) and brief exercise advice or (2) usual care. We evaluated the rate of COPD-related hospitalizations during 1 year of follow-up. The absolute risk reductions of COPD-related rehospitalization in the health coaching group were 7.5% (P = 0.01), 11.0% (P = 0.02), 11.6% (P = 0.03), 11.4% (P = 0.05), and 5.4% (P = 0.24) at 1, 3, 6, 9, and 12 months, respectively, compared with the control group. The odds ratios for COPD hospitalization in the intervention arm compared with the control arm were 0.09 (95% confidence interval [CI], 0.01-0.77) at 1 month postdischarge, 0.37 (95% CI, 0.15-0.91) at 3 months postdischarge, 0.43 (95% CI, 0.20-0.94) at 6 months postdischarge, and 0.60 (95% CI, 0.30-1.20) at 1 year postdischarge. The missing value rate for the primary outcome was 0.4% (one patient). Disease-specific quality of life improved significantly in the health coaching group compared with the control group at 6 and 12 months, based on the Chronic Respiratory Disease Questionnaire emotional score (emotion and mastery domains) and physical score (dyspnea and fatigue domains) (P < 0.05). There were no differences between groups in measured physical activity at any time point. Health coaching may represent a feasible and possibly effective intervention designed to reduce COPD readmissions. Clinical trial registered with www.clinicaltrials.gov (NCT01058486).

The survive and thrive program: encouraging coaching, mentoring, and peer learning among new local health officials.

PubMed

Henry, Vonna; Sarpy, Sue Ann; Green, Rachel; Kaplan, Seth; Bonzon, Ramon

2010-01-01

There is a need for programs tailored to train the approximately 300 new local health officials (LHOs) who emerge each year with the knowledge and skills needed to build, maintain, and enhance public health capacity and infrastructure. The Survive and Thrive program incorporates a curriculum that is designed to address the challenges faced by a new LHO. The Survive and Thrive program seeks to address these issues by leveraging the expertise of the current generation of local public health leadership by incorporating experienced LHOs as coaches. Coaching, mentoring, and peer assistance by seasoned LHOs is critical to these new learning opportunities. This article highlights aspects of the coaching component of Survive and Thrive program. Actual examples of its relevance to the professional growth and development of new LHOs and the coaches themselves are presented. The article also describes the novel approach of including coaches in evaluating program effectiveness. The Survive and Thrive program's coaching component can serve as a template for other public health leadership programs and related workforce development initiatives as well as a model to help facilitate lifelong learning of LHOs.

Recovery Coaches and Substance Exposed Births: An Experiment in Child Welfare

ERIC Educational Resources Information Center

Ryan, Joseph P.; Choi, Sam; Hong, Jun Sung; Hernandez, Pedro; Larrison, Christopher R.

2008-01-01

Objectives: Substance exposed infants present a major challenge to child welfare and public health systems. Prenatal substance exposure and continued substance abuse in the home are associated with a wide range of adverse social, emotional, and developmental outcomes. The objective of the current study is to evaluate the use of recovery coaches in…

"I Don't See Myself as a Medical Assistant Anymore": Learning to Become a Health Coach, in Our Own Voices

ERIC Educational Resources Information Center

Willard-Grace, Rachel; Najmabadi, Adriana; Araujo, Christina; Canizalez, Dalia; DeVore, Denise

2013-01-01

Health coaching may improve the health of patients with chronic conditions, and the model is growing in popularity. However, little is known about the experience of becoming a Health Coach. We explored our experiences as medical assistants moving into new roles as health coaches, a trainer of health coaches, and their supporting team. A focus…

Health promotion activities of sports clubs and coaches, and health and health behaviours in youth participating in sports clubs: the Health Promoting Sports Club study.

PubMed

Kokko, Sami; Selänne, Harri; Alanko, Lauri; Heinonen, Olli J; Korpelainen, Raija; Savonen, Kai; Vasankari, Tommi; Kannas, Lasse; Kujala, Urho M; Aira, Tuula; Villberg, Jari; Parkkari, Jari

2015-01-01

Sports clubs form a potential setting for health promotion, but the research is limited. The aim of the Health Promoting Sports Club (HPSC) study was to elucidate the current health promotion activities of youth sports clubs and coaches, and to investigate the health behaviours and health status of youth participating in sports clubs compared to non-participants. The study design employs cross-sectional multilevel and multimethod research with aspirations to a prospective cohort study in the next phase. The setting-based variables at sports clubs and coaching levels, and health behaviour variables at the individual level, are investigated using surveys; and total levels of physical activity are assessed using objective accelerometer measurements. Health status variables will be measured by preparticipation screening. The health promotion activity of sports clubs (n=154) is evaluated by club officials (n=313) and coaches (n=281). Coaches and young athletes aged 14-16 (n=759) years evaluate the coaches' health promotion activity. The survey of the adolescents' health behaviours consist of two data sets-the first is on their health behaviours and the second is on musculoskeletal complaints and injuries. Data are collected via sports clubs (759 participants) and schools 1650 (665 participants and 983 non-participants). 591 (418 athletes and 173 non-athletes) youth, have already participated in preparticipation screening. Screening consists of detailed personal medical history, electrocardiography, flow-volume spirometry, basic laboratory analyses and health status screening, including posture, muscle balance, and static and dynamic postural control tests, conducted by sports and exercise medicine specialists. The HPSC study is carried out conforming with the declaration of Helsinki. Ethical approval was received from the Ethics Committee of Health Care District of Central Finland. The HPSC study is close-to-practice, which generates foundations for development work

A Proactive Innovation for Health Care Transformation: Health and Wellness Nurse Coaching.

PubMed

Erickson, Helen Lorraine; Erickson, Margaret Elizabeth; Southard, Mary Elaine; Brekke, Mary E; Sandor, M Kay; Natschke, Mary

2016-03-01

A cohort of holistic nurses, recognizing opportunities inherent in health care transformation, organized and worked together from 2009 to 2012. The goal was to hold space for holistic nursing by developing a health and wellness coaching role and certification program for holistic nurses. The intent was to ensure that holistic nurses could work to the fullest of their ability within the evolving health care system, and others could discover the merit of holistic nursing as they explored the possibilities of nurse coaching. Challenges emerged that required the cohort plan strategies that would hold the space for nursing while also moving toward the intended goal. As they worked, this cohort demonstrated leadership skills, knowledge, values, and attitudes of holistic nursing that provide an example for others who follow in the wake of health care transformation. The American Holistic Credentialing Corporation's perspective of the events that unfolded and of the related decisions made by the coalition provides a record of the evolution of holistic nursing. © The Author(s) 2015.

A randomized trial of air cleaners and a health coach to improve indoor air quality for inner-city children with asthma and secondhand smoke exposure.

PubMed

Butz, Arlene M; Matsui, Elizabeth C; Breysse, Patrick; Curtin-Brosnan, Jean; Eggleston, Peyton; Diette, Gregory; Williams, D'Ann; Yuan, Jie; Bernert, John T; Rand, Cynthia

2011-08-01

To test an air cleaner and health coach intervention to reduce secondhand smoke exposure compared with air cleaners alone or no air cleaners in reducing particulate matter (PM), air nicotine, and urine cotinine concentrations and increasing symptom-free days in children with asthma residing with a smoker. Randomized controlled trial, with randomization embedded in study database. The Johns Hopkins Hospital Children's Center and homes of children. Children with asthma, residing with a smoker, randomly assigned to interventions consisting of air cleaners only (n = 41), air cleaners plus a health coach (n = 41), or delayed air cleaner (control) (n = 44). Changes in PM, air nicotine, and urine cotinine concentrations and symptom-free days during the 6-month study. The overall follow-up rate was high (91.3%). Changes in mean fine and coarse PM (PM(2.5) and PM(2.5-10)) concentrations (baseline to 6 months) were significantly lower in both air cleaner groups compared with the control group (mean differences for PM(2.5) concentrations: control, 3.5 μg/m(3); air cleaner only, -19.9 μg/m(3); and air cleaner plus health coach, -16.1 μg/m(3); P = .003; and PM(2.5-10) concentrations: control, 2.4 μg/m(3); air cleaner only, -8.7 μg/m(3); and air cleaner plus health coach, -10.6 μg/m(3); P = .02). No differences were noted in air nicotine or urine cotinine concentrations. The health coach provided no additional reduction in PM concentrations. Symptom-free days were significantly increased [corrected] in both air cleaner groups compared with the control group (P = .03). Although the use of air cleaners can result in a significant reduction in indoor PM concentrations and a significant increase in symptom-free days, it is not enough to prevent exposure to secondhand smoke.

Improvements in Health Behaviors, Eating Self-Efficacy, and Goal-Setting Skills Following Participation in Wellness Coaching.

PubMed

Clark, Matthew M; Bradley, Karleah L; Jenkins, Sarah M; Mettler, Emily A; Larson, Brent G; Preston, Heather R; Liesinger, Juliette T; Werneburg, Brooke L; Hagen, Philip T; Harris, Ann M; Riley, Beth A; Olsen, Kerry D; Vickers Douglas, Kristin S

2016-07-01

Purpose . This project examined potential changes in health behaviors following wellness coaching. Design . In a single cohort study design, wellness coaching participants were recruited in 2011, data were collected through July 2012, and were analyzed through December 2013. Items in the study questionnaire used requested information about 11 health behaviors, self-efficacy for eating, and goal-setting skills. Setting . Worksite wellness center. Participants . One-hundred employee wellness center members with an average age of 42 years; 90% were female and most were overweight or obese. Intervention . Twelve weeks of in-person, one-on-one wellness coaching. Method . Participants completed study questionnaires when they started wellness coaching (baseline), after 12 weeks of wellness coaching, and at a 3-month follow-up. Results . From baseline to week 12, these 100 wellness coaching participants improved their self-reported health behaviors (11 domains, 0- to 10-point scale) from an average of 6.4 to 7.7 (p < .001), eating self-efficacy from an average of 112 to 142 (on a 0- to 180-point scale; p < .001), and goal-setting skills from an average of 49 to 55 (on a 16- to 80-point scale; p < .001). Conclusion . These results suggest that participants improved their current health behaviors and learned skills for continued healthy living. Future studies that use randomized controlled trials are needed to establish causality for wellness coaching.

Health Coaching and Chronic Obstructive Pulmonary Disease Rehospitalization. A Randomized Study

PubMed Central

Vickers, Kristin; Novotny, Paul J.; Tucker, Sharon; Hoult, Johanna; Neuenfeldt, Pamela; Connett, John; Lorig, Kate; McEvoy, Charlene

2016-01-01

Rationale: Hospital readmission for chronic obstructive pulmonary disease (COPD) has attracted attention owing to the burden to patients and the health care system. There is a knowledge gap on approaches to reducing COPD readmissions. Objectives: To determine the effect of comprehensive health coaching on the rate of COPD readmissions. Methods: A total of 215 patients hospitalized for a COPD exacerbation were randomized at hospital discharge to receive either (1) motivational interviewing–based health coaching plus a written action plan for exacerbations (the use of antibiotics and oral steroids) and brief exercise advice or (2) usual care. Measurements and Main Results: We evaluated the rate of COPD-related hospitalizations during 1 year of follow-up. The absolute risk reductions of COPD-related rehospitalization in the health coaching group were 7.5% (P = 0.01), 11.0% (P = 0.02), 11.6% (P = 0.03), 11.4% (P = 0.05), and 5.4% (P = 0.24) at 1, 3, 6, 9, and 12 months, respectively, compared with the control group. The odds ratios for COPD hospitalization in the intervention arm compared with the control arm were 0.09 (95% confidence interval [CI], 0.01–0.77) at 1 month postdischarge, 0.37 (95% CI, 0.15–0.91) at 3 months postdischarge, 0.43 (95% CI, 0.20–0.94) at 6 months postdischarge, and 0.60 (95% CI, 0.30–1.20) at 1 year postdischarge. The missing value rate for the primary outcome was 0.4% (one patient). Disease-specific quality of life improved significantly in the health coaching group compared with the control group at 6 and 12 months, based on the Chronic Respiratory Disease Questionnaire emotional score (emotion and mastery domains) and physical score (dyspnea and fatigue domains) (P < 0.05). There were no differences between groups in measured physical activity at any time point. Conclusions: Health coaching may represent a feasible and possibly effective intervention designed to reduce COPD readmissions. Clinical trial

Transforming Farm Health and Safety: The Case for Business Coaching.

PubMed

Blackman, Anna; Franklin, Richard C; Rossetto, Allison; Gray, David E

2015-01-01

In the U.S. and Australia, agriculture is consistently ranked as one of the most hazardous industries. The cost of injuries and deaths on Australian farms is significant, estimated to be between AU$0.5 billion and AU$1.2 billion per year. Death and injury in agriculture also place a significant financial and social burden on the family and friends of the injured, the community, and the health system. This article proposes that if farmers were to employ coaching in their businesses, they would benefit from advances in safety practices, resulting in associated improvements in overall farm productivity and a reduction in injury costs to the wider community. A coaching model is presented to demonstrate what an effective coaching process would need to include. An agenda for future research areas is also provided.

Impact of peer delivered wellness coaching.

PubMed

Swarbrick, Margaret; Gill, Kenneth J; Pratt, Carlos W

2016-09-01

People receiving publicly funded behavioral health services for severe mental disorders have shorter lifespans and significantly impaired health-related quality of life compared to the general population. The aim of this article was to explore how peer wellness coaching (PWC), a manualized approach to pursue specific physical wellness goals, impacted goal attainment and overall health related quality of life. Deidentified archival program evaluation data were examined to explore whether peer delivered wellness coaching had an impact on 33 service recipients with regard to goal attainment and health-related quality of life. Participants were served by 1 of 12 wellness coach trainees from a transformation transfer initiative grant who had been trained in the manualized approach. Coaching participants and their coaches reported significant progress toward the attainment of individually chosen goals, 2 to 4 weeks after establishing their goals. After 8 to 10 weeks of peer delivered wellness coaching, improvements were evident in the self-report of physical health, general health, and perceived health. These improvements were sustained 90 days later. PWC is potentially a promising practice for helping people choose and pursue individual goals and facilitating positive health and wellness changes. Rigorous controlled research with larger samples is needed to evaluate the benefits of peer delivered wellness coaching. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

mHealth Technology and Nurse Health Coaching to Improve Health in Diabetes: Protocol for a Randomized Controlled Trial.

PubMed

Miyamoto, Sheridan; Dharmar, Madan; Fazio, Sarina; Tang-Feldman, Yajarayma; Young, Heather M

2018-02-15

Chronic diseases, including diabetes mellitus, are the leading cause of mortality and disability in the United States. Current solutions focus primarily on diagnosis and pharmacological treatment, yet there is increasing evidence that patient-centered models of care are more successful in improving and addressing chronic disease outcomes. The objective of this clinical trial is to evaluate the impact of a mobile health (mHealth) enabled nurse health coaching intervention on self-efficacy among adults with type-2 diabetes mellitus. A randomized controlled trial was conducted at an academic health system in Northern California. A total of 300 participants with type-2 diabetes were scheduled to be enrolled through three primary care clinics. Participants were randomized to either usual care or intervention. All participants received training on use of the health system patient portal. Participants in the intervention arm received six scheduled health-coaching telephone calls with a registered nurse and were provided with an activity tracker and mobile application that integrated data into the electronic health record (EHR) to track their daily activity and health behavior decisions. All participants completed a baseline survey and follow-up surveys at 3 and 9 months. Primary and secondary outcomes include diabetes self-efficacy, hemoglobin A 1c (HbA 1c ), and quality of life measures. Data collection for this trial, funded by the Patient-Centered Outcomes Research Institute, will be completed by December 2017. Results from the trial will be available mid-2018. This protocol details a patient-centered intervention using nurse health coaching, mHealth technologies, and integration of patient-generated data into the EHR. The aim of the intervention is to enhance self-efficacy and health outcomes by providing participants with a mechanism to track daily activity by offering coaching support to set reasonable and attainable health goals, and by creating a complete feedback

A case series of an off-the-shelf online health resource with integrated nurse coaching to support self-management in COPD.

PubMed

Early, Frances; Young, Jane S; Robinshaw, Elizabeth; Mi, Emma Z; Mi, Ella Z; Fuld, Jonathan P

2017-01-01

COPD has significant psychosocial impact. Self-management support improves quality of life, but programs are not universally available. IT-based self-management interventions can provide home-based support, but have mixed results. We conducted a case series of an off-the-shelf Internet-based health-promotion program, The Preventive Plan (TPP), coupled with nurse-coach support, which aimed to increase patient activation and provide self-management benefits. A total of 19 COPD patients were recruited, and 14 completed 3-month follow-up in two groups: groups 1 and 2 with more and less advanced COPD, respectively. Change in patient activation was determined with paired t -tests and Wilcoxon signed-rank tests. Benefits and user experience were explored in semistructured interviews, analyzed thematically. Only group 1 improved significantly in activation, from a lower baseline than group 2; group 1 also improved significantly in mastery and anxiety. Both groups felt significantly more informed about COPD and reported physical functioning improvements. Group 1 reported improvements in mood and confidence. Overall, group 2 reported fewer benefits than group 1. Both groups valued nurse-coach support; for group 1, it was more important than TPP in building confidence to self-manage. The design of TPP and lack of motivation to use IT were barriers to use, but disease severity and poor IT skills were not. Our findings demonstrate the feasibility of combining nurse-coach support aligned to an Internet-based health resource, TPP, in COPD and provide learning about the challenges of such an approach and the importance of the nurse-coach role.

Structured Coaching Programs to Develop Staff.

PubMed

Dyess, Susan MacLeod; Sherman, Rose; Opalinski, Andra; Eggenberger, Terry

2017-08-01

Health care environments are complex and chaotic, therein challenging patients and professionals to attain satisfaction, well-being, and exceptional outcomes. These chaotic environments increase the stress and burnout of professionals and reduce the likelihood of optimizing success in many dimensions. Coaching is evolving as a professional skill that may influence the optimization of the health care environment. This article reflects on three coaching programs: Gallup Strengths-Based Coaching, Dartmouth Microsystem Coaching, and Health and Wellness Nurse Coaching. Each approach is presented, processes and outcomes are considered, and implications for educators are offered. Continuing education departments may recognize various coaching approaches as opportunities to support staff professionals achieve not only the triple aim, but also the quadruple aim. J Contin Educ Nurs. 2017;48(8):373-378. Copyright 2017, SLACK Incorporated.

Participant experiences in a smartphone-based health coaching intervention for type 2 diabetes: A qualitative inquiry.

PubMed

Pludwinski, Sarah; Ahmad, Farah; Wayne, Noah; Ritvo, Paul

2016-04-01

We investigated the experience of individuals diagnosed with type 2 diabetes mellitus (T2DM) who participated in an intervention in which the key elements were the provision of a smartphone and self-monitoring software. The interviews focused on use of a smartphone and the effects on motivation for health behavior change. This was a qualitative evaluation of participants in a larger T2DM self-management randomized controlled trial (RCT) conducted at the Black Creek Community Health Centre (BCCHC) in Toronto, Canada (ClinicalTrials.gov Identifier: NCT02036892). The study is based on semi-structured interviews (n = 11) that were audio taped and analyzed with a thematic analytic approach. The RCT compared the effectiveness of six months of smartphone-based self-monitoring and health coaching with a control group who received health coaching without internet or smartphone-based assistance. Qualitative data analyses resulted in derivation of four major themes that describe participant experience: (a) 'smartphone and software', describes smartphone use in relation to health behavior change; (b) 'health coach' describes how client/health coach relationships were assisted by smartphone use; (c) 'overall experience' describes perceptions of the overall intervention; and (d) 'frustrations in managing chronic conditions' describes difficulties with the complexities of T2DM management from a patient perspective. Findings suggest that interventions with T2DM assisted by smartphone software and health coaches actively engage individuals in improved hemoglobin A1c (HbA1c) control. © The Author(s) 2015.

Direct and Mediated Relationships Between Participation in a Telephonic Health Coaching Program and Health Behavior, Life Satisfaction, and Optimism.

PubMed

Sears, Lindsay E; Coberley, Carter R; Pope, James E

2016-07-01

The aim of this study was to examine the direct and mediated effects of a telephonic health coaching program on changes to healthy behaviors, life satisfaction, and optimism. This longitudinal correlational study of 4881 individuals investigated simple and mediated relationships between participation in a telephonic health risk coaching program and outcomes from three annual Well-being Assessments. Program participation was directly related to improvements in healthy behaviors, life satisfaction and optimism, and indirect effects of coaching on these variables concurrently and over a one-year time lag were also supported. Given previous research that improvements to life satisfaction, optimism, and health behaviors are valuable for individuals, employers, and communities, a clearer understanding of intervention approaches that may impact these outcomes simultaneously can drive greater program effectiveness and value on investment.

Telephone-Based Coaching.

PubMed

Boccio, Mindy; Sanna, Rashel S; Adams, Sara R; Goler, Nancy C; Brown, Susan D; Neugebauer, Romain S; Ferrara, Assiamira; Wiley, Deanne M; Bellamy, David J; Schmittdiel, Julie A

2017-03-01

Many Americans continue to smoke, increasing their risk of disease and premature death. Both telephone-based counseling and in-person tobacco cessation classes may improve access for smokers seeking convenient support to quit. Little research has assessed whether such programs are effective in real-world clinical populations. Retrospective cohort study comparing wellness coaching participants with two groups of controls. Kaiser Permanente Northern California, a large integrated health care delivery system. Two hundred forty-one patients who participated in telephonic tobacco cessation coaching from January 1, 2011, to March 31, 2012, and two control groups: propensity-score-matched controls, and controls who participated in a tobacco cessation class during the same period. Wellness coaching participants received an average of two motivational interviewing-based coaching sessions that engaged the patient, evoked their reason to consider quitting, and helped them establish a quit plan. Self-reported quitting of tobacco and fills of tobacco cessation medications within 12 months of follow-up. Logistic regressions adjusting for age, gender, race/ethnicity, and primary language. After adjusting for confounders, tobacco quit rates were higher among coaching participants vs. matched controls (31% vs. 23%, p < .001) and comparable to those of class attendees (31% vs. 29%, p = .28). Coaching participants and class attendees filled tobacco-cessation prescriptions at a higher rate (47% for both) than matched controls (6%, p < .001). Telephonic wellness coaching was as effective as in-person classes and was associated with higher rates of quitting compared to no treatment. The telephonic modality may increase convenience and scalability for health care systems looking to reduce tobacco use and improve health.

Coach to cope: feasibility of a life coaching program for young adults with cystic fibrosis.

PubMed

Knudsen, Karin Bæk; Pressler, Tacjana; Mortensen, Laust Hvas; Jarden, Mary; Boisen, Kirsten Arntz; Skov, Marianne; Quittner, Alexandra L; Katzenstein, Terese Lea

2017-01-01

Over the last two decades, lifespan has increased significantly for people living with cystic fibrosis (CF). However, several studies have demonstrated that many young adults with CF report mental health problems and poor adherence to their prescribed treatments, challenging their long-term physical health. Treatment guidelines recommend interventions to improve adherence and self-management. The aim of this study was to test the feasibility of a life coaching intervention for young adults with CF. A randomized, controlled feasibility study was conducted at the CF Center at Copenhagen University Hospital, Rigshospitalet. Participants were young adults with CF, aged 18-30 years without severe intellectual impairments. Participants were randomized to either life coaching or standard care. The intervention consisted of up to 10 individual, face-to-face or telephone coaching sessions over a period of 1 year. Primary outcomes were recruitment success, acceptability, adherence to the intervention, and retention rates. Secondary outcome measures included health-related quality of life, adherence to treatment, self-efficacy, pulmonary function, body mass index, and blood glucose values. Among the 85 eligible patients approached, 40 (47%) were enrolled and randomized to the intervention or control group; two patients subsequently withdrew consent. Retention rates after 5 and 10 coaching sessions were 67% and 50%, respectively. Reasons for stopping the intervention included lack of time, poor health, perceiving coaching as not helpful, lack of motivation, and no need for further coaching. Coaching was primarily face-to-face (68%). No significant differences were found between the groups on any of the secondary outcomes. Both telephone and face-to-face coaching were convenient for participants, with 50% receiving the maximum offered coaching sessions. However, the dropout rate early in the intervention was a concern. In future studies, eligible participants should be screened

Weight-Related Goal Setting in a Telephone-Based Preventive Health-Coaching Program: Demonstration of Effectiveness.

PubMed

O'Hara, Blythe J; Gale, Joanne; McGill, Bronwyn; Bauman, Adrian; Hebden, Lana; Allman-Farinelli, Margaret; Maxwell, Michelle; Phongsavan, Philayrath

2017-11-01

This study investigated whether participants in a 6-month telephone-based coaching program, who set physical activity, nutrition, and weight loss goals had better outcomes in these domains. Quasi-experimental design. The Australian Get Healthy Information and Coaching Service (GHS), a free population-wide telephone health-coaching service that includes goal setting as a key component of its coaching program. Consenting GHS coaching participants who had completed coaching between February 2009 and December 2012 (n = 4108). At baseline, participants select a goal for the coaching program, and sociodemographic variables are collected. Self-reported weight, height, waist circumference, physical activity, and nutrition-related behaviors are assessed at baseline and 6 months. Descriptive analysis was performed on key sociodemographic variables, and the relationship between goal type and change in health outcomes was assessed using a series of linear mixed models that modeled change from baseline to 6 months. Participants who set goals in relation to weight management and physical activity achieved better results in these areas than those who set alternate goals, losing more than those who set alternate goals (1.5 kg and 0.9 cm in waist circumference) and increasing walking per week (40 minutes), respectively. There was no difference in food-related outcomes for those that set nutrition-related goals. Goal setting for weight management and increasing physical activity in the overweight and obese population, undertaken in a telephone-based coaching program, can be effective.

Peer Coaching Through mHealth Targeting Physical Activity in People With Parkinson Disease: Feasibility Study

PubMed Central

Latham, Nancy K; Quintiliani, Lisa M

2018-01-01

Background Long-term engagement in exercise and physical activity mitigates the progression of disability and increases quality of life in people with Parkinson disease (PD). Despite this, the vast majority of individuals with PD are sedentary. There is a critical need for a feasible, safe, acceptable, and effective method to assist those with PD to engage in active lifestyles. Peer coaching through mobile health (mHealth) may be a viable approach. Objective The purpose of this study was to develop a PD-specific peer coach training program and a remote peer-mentored walking program using mHealth technology with the goal of increasing physical activity in persons with PD. We set out to examine the feasibility, safety, and acceptability of the programs along with preliminary evidence of individual-level changes in walking activity, self-efficacy, and disability in the peer mentees. Methods A peer coach training program and a remote peer-mentored walking program using mHealth was developed and tested in 10 individuals with PD. We matched physically active persons with PD (peer coaches) with sedentary persons with PD (peer mentees), resulting in 5 dyads. Using both Web-based and in-person delivery methods, we trained the peer coaches in basic knowledge of PD, exercise, active listening, and motivational interviewing. Peer coaches and mentees wore FitBit Zip activity trackers and participated in daily walking over 8 weeks. Peer dyads interacted daily via the FitBit friends mobile app and weekly via telephone calls. Feasibility was determined by examining recruitment, participation, and retention rates. Safety was assessed by monitoring adverse events during the study period. Acceptability was assessed via satisfaction surveys. Individual-level changes in physical activity were examined relative to clinically important differences. Results Four out of the 5 peer pairs used the FitBit activity tracker and friends function without difficulty. A total of 4 of the 5 pairs

The effects on team emotions and team effectiveness of coaching in interprofessional health and social care teams.

PubMed

Dimas, Isabel Dórdio; Renato Lourenço, Paulo; Rebelo, Teresa

2016-07-01

The purpose of this study was to examine the effects of coaching behaviours provided by peers and by the leader on the emotions experienced by interprofessional health and social care teams and on members' satisfaction with the team, as well as on team performance. Data were obtained from a survey among 344 employees working in 52 interprofessional health and social care teams from nine Portuguese organizations. The results show that leader coaching and peer coaching have a positive effect on the level of team members' satisfaction with the team and on positive emotions, and a negative effect on negative emotions. Furthermore, coaching provided by peers presents a positive effect on team performance as assessed by the leader of the team. Our findings put forward the importance of engaging in coaching behaviours to promote quality of the team experience, as well as the achievement of team performance objectives. Further studies should explore how coaching behaviours impact the patient, whose well-being is the ultimate objective of a team in the health and social care system, namely in terms of the patient's perception of quality care or patient outcomes.

Telephone-Based Coaching: A Comparison of Tobacco Cessation Programs in an Integrated Health Care System

PubMed Central

Boccio, Mindy; Sanna, Rashel S.; Adams, Sara R.; Goler, Nancy C.; Brown, Susan D.; Neugebauer, Romain S.; Ferrara, Assiamira; Wiley, Deanne M.; Bellamy, David J.; Schmittdiel, Julie A.

2016-01-01

Purpose Many Americans continue to smoke, increasing their risk of disease and premature death. Both telephone-based counseling and in-person tobacco cessation classes may improve access for smokers seeking convenient support to quit. Little research has assessed whether such programs are effective in real-world clinical populations. Design Retrospective cohort study comparing wellness coaching participants with two groups of controls. Setting Kaiser Permanente, Northern California (KPNC), a large integrated health care delivery system. Subjects 241 patients who participated in telephonic tobacco cessation coaching from 1/1/2011–3/31/2012, and two control groups: propensity-score matched controls, and controls who participated in a tobacco cessation class during the same period. Wellness coaching participants received an average of two motivational interviewing based coaching sessions that engage the patient, evoke their reason to consider quitting and help them establish a quit plan. Measures Self-reported quitting of tobacco and fills of tobacco cessation medications within 12 months of follow-up. Analysis Logistic regressions adjusting for age, gender, race/ethnicity, and primary language. Results After adjusting for confounders, tobacco quit rates were higher among coaching participants vs. matched controls (31% vs. 23%, P<0.001) and comparable to class attendees (31% vs. 29%, P=0.28). Coaching participants and class attendees filled tobacco-cessation prescriptions at a higher rate (47% for both) than matched controls (6%, P<0.001). Conclusions Telephonic wellness coaching was as effective as in-person classes and was associated with higher rates of quitting compared to no treatment. The telephonic modality may increase convenience and scalability for health care systems looking to reduce tobacco use and improve health. PMID:26559720

Health promotion activities of sports clubs and coaches, and health and health behaviours in youth participating in sports clubs: the Health Promoting Sports Club study

PubMed Central

Kokko, Sami; Selänne, Harri; Alanko, Lauri; Heinonen, Olli J; Korpelainen, Raija; Savonen, Kai; Vasankari, Tommi; Kannas, Lasse; Kujala, Urho M; Aira, Tuula; Villberg, Jari; Parkkari, Jari

2015-01-01

Introduction Sports clubs form a potential setting for health promotion, but the research is limited. The aim of the Health Promoting Sports Club (HPSC) study was to elucidate the current health promotion activities of youth sports clubs and coaches, and to investigate the health behaviours and health status of youth participating in sports clubs compared to non-participants. Methods and analysis The study design employs cross-sectional multilevel and multimethod research with aspirations to a prospective cohort study in the next phase. The setting-based variables at sports clubs and coaching levels, and health behaviour variables at the individual level, are investigated using surveys; and total levels of physical activity are assessed using objective accelerometer measurements. Health status variables will be measured by preparticipation screening. The health promotion activity of sports clubs (n=154) is evaluated by club officials (n=313) and coaches (n=281). Coaches and young athletes aged 14–16 (n=759) years evaluate the coaches’ health promotion activity. The survey of the adolescents’ health behaviours consist of two data sets—the first is on their health behaviours and the second is on musculoskeletal complaints and injuries. Data are collected via sports clubs (759 participants) and schools 1650 (665 participants and 983 non-participants). 591 (418 athletes and 173 non-athletes) youth, have already participated in preparticipation screening. Screening consists of detailed personal medical history, electrocardiography, flow-volume spirometry, basic laboratory analyses and health status screening, including posture, muscle balance, and static and dynamic postural control tests, conducted by sports and exercise medicine specialists. Ethics and dissemination The HPSC study is carried out conforming with the declaration of Helsinki. Ethical approval was received from the Ethics Committee of Health Care District of Central Finland. The HPSC study is

Assessing Needs and Feasibility of Diabetes Self-management Coaching at Faith-Based Organizations for Indo-Guyanese Immigrants.

PubMed

Hosler, Akiko S; Solanki, Malini N; Savadatti, Sanghamitra

2015-06-01

The purpose of this study is to explore barriers and needs related to diabetes care and the feasibility of diabetes self-management (DSM) "coaching" at faith-based organizations (FBOs) for the Indo-Guyanese community in Schenectady, New York. Participants were recruited though flyers and mass mailings, and in-depth interviews were conducted at their homes by a team of culturally matched interviewers using a semi-structured questionnaire. Characteristics of participants were compared with existing population-based data to confirm their representativeness. Responses were transcribed, coded, and summarized, and findings are presented along with selective quotations. Key dimensions of feasibility were scored and charted for visualization. Findings revealed barriers regarding diet-related knowledge and skills, access to structured DSM education, hyperglycemia control, and environmental support for physical activity. Participants responded positively to receiving free DSM coaching at their FBOs. All participants preferred a qualified health care professional such as certified diabetes educator as their coach and wanted coaching in all aspects of DSM; however, food preparation/diet was the most frequently requested specific topic. Participants uniformly disliked contact with the coach through e-mails and text messages but liked receiving periodic telephone calls at home by the coach. Overall, DSM coaching at FBOs rated high on the key dimensions of feasibility, namely, affordability, accessibility, acceptability, cultural relevance, and safety. This study sheds light on the feasibility of an FBO-based DSM intervention for the Indo-Guyanese. It offers insights into developing culturally appropriate DSM intervention format and strategy. © 2015 The Author(s).

Peer Coaching Through mHealth Targeting Physical Activity in People With Parkinson Disease: Feasibility Study.

PubMed

Colón-Semenza, Cristina; Latham, Nancy K; Quintiliani, Lisa M; Ellis, Terry D

2018-02-15

Long-term engagement in exercise and physical activity mitigates the progression of disability and increases quality of life in people with Parkinson disease (PD). Despite this, the vast majority of individuals with PD are sedentary. There is a critical need for a feasible, safe, acceptable, and effective method to assist those with PD to engage in active lifestyles. Peer coaching through mobile health (mHealth) may be a viable approach. The purpose of this study was to develop a PD-specific peer coach training program and a remote peer-mentored walking program using mHealth technology with the goal of increasing physical activity in persons with PD. We set out to examine the feasibility, safety, and acceptability of the programs along with preliminary evidence of individual-level changes in walking activity, self-efficacy, and disability in the peer mentees. A peer coach training program and a remote peer-mentored walking program using mHealth was developed and tested in 10 individuals with PD. We matched physically active persons with PD (peer coaches) with sedentary persons with PD (peer mentees), resulting in 5 dyads. Using both Web-based and in-person delivery methods, we trained the peer coaches in basic knowledge of PD, exercise, active listening, and motivational interviewing. Peer coaches and mentees wore FitBit Zip activity trackers and participated in daily walking over 8 weeks. Peer dyads interacted daily via the FitBit friends mobile app and weekly via telephone calls. Feasibility was determined by examining recruitment, participation, and retention rates. Safety was assessed by monitoring adverse events during the study period. Acceptability was assessed via satisfaction surveys. Individual-level changes in physical activity were examined relative to clinically important differences. Four out of the 5 peer pairs used the FitBit activity tracker and friends function without difficulty. A total of 4 of the 5 pairs completed the 8 weekly phone

Multidisciplinary perspectives: Application of the Consolidated Framework for Implementation Research to evaluate a health coaching initiative.

PubMed

Brook, Judy; McGraw, Caroline

2018-05-01

Long-term conditions are a leading cause of mortality and morbidity. Their management is founded on a combination of approaches involving government policy, better integration between health and care systems, and individual responsibility for self-care. Health coaching has emerged as an approach to encouraging individual responsibility and enhancing the self-management of long-term conditions. This paper focuses on the evaluation of a workforce initiative in a diverse and socially deprived community. The initiative sought both to improve integration between health and care services for people with long-term conditions, and equip practitioners with health coaching skills. The aim of the study was to contribute an empirical understanding of what practitioners perceive to be the contextual factors that impact on the adoption of health coaching in community settings. These factors were conceptualised using the Consolidated Framework for Implementation Research (CFIR). A stratified purposive sample of 22 health and care practitioners took part in semi-structured telephone interviews. Data were analysed using the CFIR as an analytical framework. The perceptions of trainees mapped onto the major domains of the CFIR: characteristics of the intervention, outer setting, inner setting, characteristics of individuals involved and process of implementation. Individual patient expectations, comorbidities and social context were central to the extent to which practitioners and patients engaged with health coaching. Structural constraints within provider services and the wider NHS were also reported as discouraging initiatives that focused on long-term rewards rather than short-term wins. The authors recommend further research is undertaken both to understand the role of health coaching in disadvantaged communities and ensure the service user voice is heard. © 2018 John Wiley & Sons Ltd.

The effectiveness of peer health coaching in improving glycemic control among low-income patients with diabetes: protocol for a randomized controlled trial.

PubMed

Ghorob, Amireh; Vivas, Maria Mercedes; De Vore, Diana; Ngo, Victoria; Bodenheimer, Thomas; Chen, Ellen; Thom, David H

2011-04-01

Although self-management support improves diabetes outcomes, it is not consistently provided in health care settings strained for time and resources. One proposed solution to personnel and funding shortages is to utilize peer coaches, patients trained to provide diabetes education and support to other patients. Coaches share similar experiences about living with diabetes and are able to reach patients within and beyond the health care setting. Given the limited body of evidence that demonstrates peer coaching significantly improves chronic disease care, this present study examines the impact of peer coaching delivered in a primary care setting on diabetes outcomes. The aim of this multicenter, randomized control trial is to evaluate the effectiveness of utilizing peer coaches to improve clinical outcomes and self-management skills in low-income patients with poorly controlled diabetes. A total of 400 patients from six primary health centers based in San Francisco that serve primarily low-income populations will be randomized to receive peer coaching (n = 200) or usual care (n = 200) over 6 months. Patients in the peer coach group receive coaching from patients with diabetes who are trained and mentored as peer coaches. The primary outcome is change in HbA1c. Secondary outcomes include change in: systolic blood pressure, body mass index (BMI), LDL cholesterol, diabetes self-care activities, medication adherence, diabetes-related quality of life, diabetes self-efficacy, and depression. Clinical values (HbA1c, LDL cholesterol and blood pressure) and self-reported diabetes self-efficacy and self-care activities are measured at baseline and after 6 months for patients and coaches. Peer coaches are also assessed at 12 months. Patients with diabetes, who are trained as peer health coaches, are uniquely poised to provide diabetes self management support and education to patients. This study is designed to investigate the impact of peer health coaching in patients with

Using motivational interviewing: through evidence-based health coaching.

PubMed

Huffman, Melinda

2014-10-01

To enhance compliance and achieve better outcomes, providers must actively engage their patients and caregivers in different ways than in the past. One strategy that has gained national attention is motivational interviewing through evidence-based health coaching. A closer look at this exciting new clinical skill reveals what it is, how it works, why it is so successful, and why our traditional patient approach has fallen short.

Home health care

MedlinePlus

... Skilled nursing - home health; Skilled nursing - home care; Physical therapy - at home; Occupational therapy - at home; Discharge - ... and any medicines that you may be taking. Physical and occupational therapists can make sure your home ...

Athletic coaches as violence prevention advocates.

PubMed

Jaime, Maria Catrina D; McCauley, Heather L; Tancredi, Daniel J; Nettiksimmons, Jasmine; Decker, Michele R; Silverman, Jay G; O'Connor, Brian; Stetkevich, Nicholas; Miller, Elizabeth

2015-04-01

Adolescent relationship abuse (ARA) is a significant public health problem. Coaching Boys Into Men (CBIM) is an evidence-based ARA prevention program that trains coaches to deliver violence prevention messages to male athletes. Assessing acceptability and impact of CBIM on coaches may inform prevention efforts that involve these important adults in health promotion among youth. As part of a two-armed cluster-randomized controlled trial of CBIM in 16 high schools in Northern California, coaches completed baseline and postseason surveys (n = 176) to assess their attitudes and confidence delivering the program. Coaches in the intervention arm also participated in interviews (n = 36) that explored program acceptability, feasibility, and impact. Relative to controls, intervention coaches showed increases in confidence intervening when witnessing abusive behaviors among their athletes, greater bystander intervention, and greater frequency of violence-related discussions with athletes and other coaches. Coaches reported the program was easy to implement and valuable for their athletes. Findings illustrate the value of exploring attitudinal and behavioral changes among ARA prevention implementers, and suggest that coaches can gain confidence and enact behaviors to discourage ARA among male athletes. Coaches found the program to be feasible and valuable, which suggests potential for long-term uptake and sustainability. © The Author(s) 2014.

Long-term effectiveness of telephone-based health coaching for heart failure patients: A post-only randomised controlled trial.

PubMed

Tiede, Michel; Dwinger, Sarah; Herbarth, Lutz; Härter, Martin; Dirmaier, Jörg

2017-09-01

Introduction The * Equal contributors. health-status of heart failure patients can be improved to some extent by disease self-management. One method of developing such skills is telephone-based health coaching. However, the effects of telephone-based health coaching remain inconclusive. The aim of this study was to evaluate the effects of telephone-based health coaching for people with heart failure. Methods A total sample of 7186 patients with various chronic diseases was randomly assigned to either the coaching or the control group. Then 184 patients with heart failure were selected by International Classification of Diseases (ICD)-10 code for subgroup analysis. Data were collected at 24 and 48 months after the beginning of the coaching. The primary outcome was change in quality of life. Secondary outcomes were changes in depression and anxiety, health-related control beliefs, control preference, health risk behaviour and health-related behaviours. Statistical analyses included a per-protocol evaluation, employing analysis of variance and analysis of covariance (ANCOVA) as well as Mann-Whitney U tests. Results Participants' average age was 73 years (standard deviation (SD) = 9) and the majority were women (52.8%). In ANCOVA analyses there were no significant differences between groups for the change in quality of life (QoL) . However, the coaching group reported a significantly higher level of physical activity ( p = 0.03), lower intake of non-prescribed drugs ( p = 0.04) and lower levels of stress ( p = 0.02) than the control group. Mann-Whitney U tests showed a different external locus of control ( p = 0.014), and higher reduction in unhealthy nutrition ( p = 0.019), physical inactivity ( p = 0.004) and stress ( p = 0.028). Discussion Our results suggest that telephone-based health coaching has no effect on QoL, anxiety and depression of heart failure patients, but helps in improving certain risk behaviours and changes the locus

The Happy Life Club™ study protocol: a cluster randomised controlled trial of a type 2 diabetes health coach intervention.

PubMed

Browning, Colette; Chapman, Anna; Cowlishaw, Sean; Li, Zhixin; Thomas, Shane A; Yang, Hui; Zhang, Tuohong

2011-02-09

The Happy Life Club™ is an intervention that utilises health coaches trained in behavioural change and motivational interviewing techniques to assist with the management of type 2 diabetes mellitus (T2DM) in primary care settings in China. Health coaches will support participants to improve modifiable risk factors and adhere to effective self-management treatments associated with T2DM. A cluster randomised controlled trial involving 22 Community Health Centres (CHCs) in Fengtai District of Beijing, China. CHCs will be randomised into a control or intervention group, facilitating recruitment of at least 1320 individual participants with T2DM into the study. Participants in the intervention group will receive a combination of both telephone and face-to-face health coaching over 18 months, in addition to usual care received by the control group. Health coaching will be performed by CHC doctors and nurses certified in coach-assisted chronic disease management. Outcomes will be assessed at baseline and again at 6, 12 and 18 months by means of a clinical health check and self-administered questionnaire. The primary outcome measure is HbA1c level. Secondary outcomes include metabolic, physiological and psychological variables. This cluster RCT has been developed to suit the Chinese health care system and will contribute to the evidence base for the management of patients with T2DM. With a strong focus on self-management and health coach support, the study has the potential to be adapted to other chronic diseases, as well as other regions of China. Current Controlled Trials ISRCTN01010526.

Towards a Psychology of Coaching: The Impact of Coaching on Metacognition, Mental Health and Goal Attainment.

ERIC Educational Resources Information Center

Grant, Anthony M.

A theoretical framework for a psychology of coaching was developed. First, the literature on cognitive approaches to coaching, behavioral approaches to coaching, and combinations of the cognitive and behavioral approaches was reviewed. Next, two studies examined the development and validation of a new measure of private self-consciousness called…

Coaching vs Psychotherapy in health and Wellness: Overlap, Dissimilarities, and the Potential for Collaboration

PubMed Central

Livingstone, John B.

2013-01-01

Health coaches and psychotherapists both work with the art and science of facilitating change in their patients and clients. While the evolving field of health coaching and the established disciplines of clinical or counseling psychology share major areas of overlap, there are also significant distinctions between the two fields. This article outlines those similarities and dissimilarities with the intention of fostering a cooperative and mutually enriching stance between the two helping professions for the benefit of the respective professionals and the countless clients and patients they serve. PMID:24416682

Coaching the Coach: A Program for Development of Faculty Portfolio Coaches.

PubMed

Kopechek, Jack; Bardales, Cheryl; Lash, A Todd; Walker, Curtis; Pfeil, Sheryl; Ledford, Cynthia H

2017-01-01

Faculty coaching is recognized as an essential element for effective use of portfolios in undergraduate medical education, yet best practices for training these coaches are uncertain. New portfolio coaches participated in a multifaceted training program that included orienting modules, a 7.5-hr training workshop featuring analysis of reflective writing, an Observed Structured Teaching Exercise (OSTE), and subsequent longitudinal coaches' meetings for timely task training. Four desired coaching skills were emphasized in the initial training: creating a safe environment, explicitly using performance data, asking questions that elicit reflection, and guiding the student to develop future goals and plans. We collected and analyzed several outcomes: (a) coaches' self-assessment at key intervals, (b) open-ended written responses to three coaching vignettes, (c) video recordings of the OSTE, and (d) subsequent student evaluation of the coach. In an attempt to capture learning from the workshop, both the responses to written vignettes and the video-recorded encounters were coded for presence or absence of the four desired skills. Our portfolio and coaching program was instituted as part of a major undergraduate medical education reform. A new cohort of 25 coaches is enrolled with each matriculating student class, and each coach is assigned to work individually with 8-10 students, forming a coaching relationship that continues over 4 years. Coaches are compensated at 5% full-time equivalent. On coach self-assessment, the majority of coaches reported significant improvement in their perceived ability to assess a student's level of reflection, enhance reflection, use performance data, and guide a student to develop goals and plans. After two semesters, coach perception of improved abilities persisted. Students rated coaches as excellent (82%), reporting that coaches created safe environments (99%), promoted insight (92%), and aided in goal setting (97%). Written responses to

The influence of worksite and employee variables on employee engagement in telephonic health coaching programs: a retrospective multivariate analysis.

PubMed

Grossmeier, Jessica

2013-01-01

This study assessed 11 determinants of health coaching program participation. A cross-sectional study design used secondary data to assess the role of six employee-level and five worksite-level variables on telephone-based coaching enrollment, active participation, and completion. Data was provided by a national provider of worksite health promotion program services for employers. A random sample of 34,291 employees from 52 companies was selected for inclusion in the study. Survey-based measures included age, gender, job type, health risk status, tobacco risk, social support, financial incentives, comprehensive communications, senior leadership support, cultural support, and comprehensive program design. Gender-stratified multivariate logistic regression models were applied using backwards elimination procedures to yield parsimonious prediction models for each of the dependent variables. Employees were more likely to enroll in coaching programs if they were older, female, and in poorer health, and if they were at worksites with fewer environmental supports for health, clear financial incentives for participation in coaching, more comprehensive communications, and more comprehensive programs. Once employees were enrolled, program completion was greater among those who were older, did not use tobacco, worked at a company with strong communications, and had fewer environmental supports for health. Both worksite-level and employee-level factors have significant influences on health coaching engagement, and there are gender differences in the strength of these predictors.

Coaches Coaching Coaches

ERIC Educational Resources Information Center

Burkins, Jan Miller; Ritchie, Scott

2007-01-01

Researchers have argued that "job-embedded" professional learning is the most valuable model for teachers (Joyce & Showers, 2002). But there is little or no corresponding literature regarding job-embedded professional learning for literacy coaches. In this paper, the authors offer an example of one such model, the Coach-to-Coach…

The Antecedents of Coaches' Interpersonal Behaviors: The Role of the Coaching Context, Coaches' Psychological Needs, and Coaches' Motivation.

PubMed

Rocchi, Meredith; Pelletier, Luc G

2017-10-01

This study explored how the coaching context influences coaches' psychological needs, motivation, and reported interpersonal behaviors, using self-determination theory. In Study 1, 56 coaches identified how contextual factors influence their coaching experience. Coaches identified administration, athlete motivation, colleagues, parents, professional development, time, and work-life as having the largest impact on them. In Study 2, 424 coaches reported on their perceptions of the factors identified in Study 1 and their psychological needs, motivation, and interpersonal behaviors. Structural equation modeling analyses suggested perceptions of the coaching context supported or thwarted their psychological needs, which positively or negatively predicted their autonomous and controlled motivation. Coaches' autonomous motivation predicted their reported supportive interpersonal behaviors and controlled motivation predicted thwarting behaviors. Overall, the results provided additional support for understanding how the coaching context, coaches' psychological needs, and their motivation for coaching relate to their coaching behaviors.

Antecedents of perceived coach interpersonal behaviors: the coaching environment and coach psychological well- and ill-being.

PubMed

Stebbings, Juliette; Taylor, Ian M; Spray, Christopher M; Ntoumanis, Nikos

2012-08-01

Embedded in the self-determination theory (Deci & Ryan, 2000) framework, we obtained self-report data from 418 paid and voluntary coaches from a variety of sports and competitive levels with the aim of exploring potential antecedents of coaches' perceived autonomy supportive and controlling behaviors. Controlling for socially desirable responses, structural equation modeling revealed that greater job security and opportunities for professional development, and lower work-life conflict were associated with psychological need satisfaction, which, in turn, was related to an adaptive process of psychological well-being and perceived autonomy support toward athletes. In contrast, higher work-life conflict and fewer opportunities for development were associated with a distinct maladaptive process of thwarted psychological needs, psychological ill-being, and perceived controlling interpersonal behavior. The results highlight how the coaching context may impact upon coaches' psychological health and their interpersonal behavior toward athletes. Moreover, evidence is provided for the independence of adaptive and maladaptive processes within the self-determination theory paradigm.

Impact of Managers' Coaching Conversations on Staff Knowledge Use and Performance in Long-Term Care Settings.

PubMed

Cummings, Greta G; Hewko, Sarah J; Wang, Mengzhe; Wong, Carol A; Laschinger, Heather K Spence; Estabrooks, Carole A

2018-02-01

Extended lifespans and complex resident care needs have amplified resource demands on nursing homes. Nurse managers play an important role in staff job satisfaction, research use, and resident outcomes. Coaching skills, developed through leadership skill-building, have been shown to be of value in nursing. To test a theoretical model of nursing home staff perceptions of their work context, their managers' use of coaching conversations, and their use of instrumental, conceptual and persuasive research. Using a two-group crossover design, 33 managers employed in seven Canadian nursing homes were invited to attend a 2-day coaching development workshop. Survey data were collected from managers and staff at three time points; we analyzed staff data (n = 333), collected after managers had completed the workshop. We used structural equation modeling to test our theoretical model of contextual characteristics as causal variables, managers' characteristics, and coaching behaviors as mediating variables and staff use of research, job satisfaction, and burnout as outcome variables. The theoretical model fit the data well (χ 2 = 58, df = 43, p = .06) indicating no significant differences between data and model-implied matrices. Resonant leadership (a relational approach to influencing change) had the strongest significant relationship with manager support, which in turn influenced frequency of coaching conversations. Coaching conversations had a positive, non-significant relationship with staff persuasive use of research, which in turn significantly increased instrumental research use. Importantly, coaching conversations were significantly, negatively related to job satisfaction. Our findings add to growing research exploring the role of context and leadership in influencing job satisfaction and use of research by healthcare practitioners. One-on-one coaching conversations may be difficult for staff not used to participating in such conversations. Resonant leadership, as

Enabling Occupational Performance of Children through Coaching Parents: Three Case Reports

ERIC Educational Resources Information Center

Graham, Fiona; Rodger, Sylvia; Ziviani, Jenny

2010-01-01

This study explores the use of occupational performance coaching (OPC) with three parent-child dyads using descriptive case study methodology. OPC is a parent-directed intervention in which parents are coached to improve their own or their children's performance in home and community contexts. In this study, parent and child performance was…

Effect of telephone health coaching (Birmingham OwnHealth) on hospital use and associated costs: cohort study with matched controls.

PubMed

Steventon, Adam; Tunkel, Sarah; Blunt, Ian; Bardsley, Martin

2013-08-06

To test the effect of a telephone health coaching service (Birmingham OwnHealth) on hospital use and associated costs. Analysis of person level administrative data. Difference-in-difference analysis was done relative to matched controls. Community based intervention operating in a large English city with industry. 2698 patients recruited from local general practices before 2009 with heart failure, coronary heart disease, diabetes, or chronic obstructive pulmonary disease; and a history of inpatient or outpatient hospital use. These individuals were matched on a 1:1 basis to control patients from similar areas of England with respect to demographics, diagnoses of health conditions, previous hospital use, and a predictive risk score. Telephone health coaching involved a personalised care plan and a series of outbound calls usually scheduled monthly. Median length of time enrolled on the service was 25.5 months. Control participants received usual healthcare in their areas, which did not include telephone health coaching. Number of emergency hospital admissions per head over 12 months after enrolment. Secondary metrics calculated over 12 months were: hospital bed days, elective hospital admissions, outpatient attendances, and secondary care costs. In relation to diagnoses of health conditions and other baseline variables, matched controls and intervention patients were similar before the date of enrolment. After this point, emergency admissions increased more quickly among intervention participants than matched controls (difference 0.05 admissions per head, 95% confidence interval 0.00 to 0.09, P=0.046). Outpatient attendances also increased more quickly in the intervention group (difference 0.37 attendances per head, 0.16 to 0.58, P<0.001), as did secondary care costs (difference £175 per head, £22 to £328, P=0.025). Checks showed that we were unlikely to have missed reductions in emergency admissions because of unobserved differences between intervention and

Reading Coaching Discourse: Exploring Coaching Processes

ERIC Educational Resources Information Center

Heineke, Sally Frances

2009-01-01

This study investigates the discourse of elementary school reading coaches and teachers during coaching interactions in four Alabama schools. Coach/teacher dyads recorded naturally occurring coaching dialogue over periods of 3 to 6 weeks. Each participant shared her views on coaching and commented on the recorded discourse during post-interviews…

Effect of a Home-Based Exercise Intervention of Wearable Technology and Telephone Coaching on Walking Performance in Peripheral Artery Disease: The HONOR Randomized Clinical Trial.

PubMed

McDermott, Mary M; Spring, Bonnie; Berger, Jeffrey S; Treat-Jacobson, Diane; Conte, Michael S; Creager, Mark A; Criqui, Michael H; Ferrucci, Luigi; Gornik, Heather L; Guralnik, Jack M; Hahn, Elizabeth A; Henke, Peter; Kibbe, Melina R; Kohlman-Trighoff, Debra; Li, Lingyu; Lloyd-Jones, Donald; McCarthy, Walter; Polonsky, Tamar S; Skelly, Christopher; Tian, Lu; Zhao, Lihui; Zhang, Dongxue; Rejeski, W Jack

2018-04-24

Clinical practice guidelines support home-based exercise for patients with peripheral artery disease (PAD), but no randomized trials have tested whether an exercise intervention without periodic medical center visits improves walking performance. To determine whether a home-based exercise intervention consisting of a wearable activity monitor and telephone coaching improves walking ability over 9 months in patients with PAD. Randomized clinical trial conducted at 3 US medical centers. Patients with PAD were randomized between June 18, 2015, and April 4, 2017, to home-based exercise vs usual care for 9 months. Final follow-up was on December 5, 2017. The exercise intervention group (n = 99) received 4 weekly medical center visits during the first month followed by 8 months of a wearable activity monitor and telephone coaching. The usual care group (n = 101) received no onsite sessions, active exercise, or coaching intervention. The primary outcome was change in 6-minute walk distance at 9-month follow-up (minimal clinically important difference [MCID], 20 m). Secondary outcomes included 9-month change in subcomponents of the Walking Impairment Questionnaire (WIQ) (0-100 score; 100, best), SF-36 physical functioning score, Patient-Reported Outcomes Measurement Information System (PROMIS) mobility questionnaire (higher = better; MCID, 2 points), PROMIS satisfaction with social roles questionnaire, PROMIS pain interference questionnaire (lower = better; MCID range, 3.5-4.5 points), and objectively measured physical activity. Among 200 randomized participants (mean [SD] age, 70.2 [10.4] years; 105 [52.5%] women), 182 (91%) completed 9-month follow-up. The mean change from baseline to 9-month follow-up in the 6-minute walk distance was 5.5 m in the intervention group vs 14.4 m in the usual care group (difference, -8.9 m; 95% CI, -26.0 to 8.2 m; P = .31). The exercise intervention worsened the PROMIS pain interference score, mean change from baseline

MyCoach: In Situ User Evaluation of a Virtual and Physical Coach for Running

NASA Astrophysics Data System (ADS)

Biemans, Margit; Haaker, Timber; Szwajcer, Ellen

Running is an enjoyable exercise for many people today. Trainers help people to reach running goals. However, today’s busy and nomadic people are not always able to attend running classes. A combination of a virtual and physical coach should be useful. A virtual coach (MyCoach) was designed to provide this support. MyCoach consists of a mobile phone (real time) and a web application, with a focus on improving health and well-being. A randomised controlled trial was performed to evaluate MyCoach. The results indicate that the runners value the tangible aspects on monitoring and capturing their exercise and analysing progress. The system could be improved by incorporating running schedules provided by the physical trainer and by improving its usability. Extensions of the system should focus on the real-time aspects of information sharing and “physical” coaching at a distance.

Experience with Health Coach-Mediated Physician Referral in an Employed Insured Population

PubMed Central

Rao, Sowmya R.; Rogers, Robert S.; Mailhot, Johanna R.; Galvin, Robert

2010-01-01

BACKGROUND Given increasing interest in helping consumers choose high-performing (higher quality, lower cost) physicians, one approach chosen by several large employers is to provide assistance in the form of a telephonic “health coach” — a registered nurse who assists with identifying appropriate and available providers. OBJECTIVE To evaluate the health coach’s influence on provider choice and the quality of the user experience in the early introduction of this service. DESIGN Cross-sectional survey of 3490 employees and covered dependents of a large national firm that offered health coach services to all employees and covered dependents. The survey began in September 2007 with proportionate stratified sampling of 1750 employees and covered dependents who used the services between October 2007 and February 2008, and 1740 non-users. PARTICIPANTS Insured adults (ages 21–64) employed by a large national firm or covered dependents of employees. MEASUREMENTS Awareness of the service, reason for using service, visits to providers recommended by service, use of health advice provided by service, user satisfaction. MAIN RESULTS The primary reason for using the service was to obtain provider referrals (73%). Fifty-two percent of users sought a specialist referral, 33% a PCP referral and 9% a hospital referral. Eighty-nine percent of users seeking a provider referral were referred in-network; 81% of those referred visited the referred provider. Measures of satisfaction with both the service and the care delivered by recommended providers were over 70%. CONCLUSIONS Customers largely follow the provider recommendation of the health coach. Users express general satisfaction with existing health coach services, but differences in performance between vendors highlight the need for the services to be well implemented. Electronic supplementary material The online version of this article (doi:10.1007/s11606-010-1428-4) contains supplementary material, which is available

Identification of Patients With Diabetes Who Benefit Most From a Health Coaching Program in Chronic Disease Management, Sydney, Australia, 2013.

PubMed

Delaney, Grace; Newlyn, Neroli; Pamplona, Elline; Hocking, Samantha L; Glastras, Sarah J; McGrath, Rachel T; Fulcher, Gregory R

2017-03-02

Chronic disease management programs (CDMPs) that include health coaching can facilitate and coordinate diabetes management. The aim of this study was to assess changes in patients' general knowledge of diabetes, self-reported health status, diabetes distress, body mass index (BMI), and glycemic control after enrollment in a face-to-face CDMP group health coaching session (with telephone follow-up) compared with participation in telephone-only health coaching, during a 12-month period. Patients with diabetes were enrolled in a health coaching program at Royal North Shore Hospital, Sydney, Australia, in 2013. Questionnaires were administered at baseline and at 3, 6, and 12 months, and the results were compared with baseline. Glycemic control, measured with glycated hemoglobin A 1c (HbA 1c ) and BMI, were measured at baseline and 12 months. Overall, 238 patients attended a face-to-face CDMP session with telephone follow-up (n = 178) or participated in telephone-only health coaching (n = 60). We found no change in BMI in either group; however, HbA 1c levels in patients with baseline above the current recommended target (>7%) decreased significantly from 8.5% (standard deviation [SD], 1.0%) to 7.9% (SD, 1.0%) (P = .03). Patients with the lowest self-reported health status at baseline improved from 4.4 (SD, 0.5) to 3.7 (SD, 0.9) (P = .001). Diabetes knowledge improved in all patients (24.4 [SD, 2.4] to 25.2 [SD, 2.4]; P < .001), and diabetes distress decreased among those with the highest levels of distress at baseline (3.0 [SD, 0.4] vs 3.8 [SD, 0.6]; P = .003). Diabetes health coaching programs can improve glycemic control and reduce diabetes distress in patients with high levels of these at baseline.

Impact of coaching certification on coaching attitudes.

PubMed

Graham, R H; Carron, A V

1983-09-01

The purpose of the present investigation was to examine the impact of coaching certification upon coaching attitudes toward important social psychological correlates of involvement in sport. Specifically, 249 coaches with 0, 1, 2, 3, 4 and 5 levels of certification in the National Coaching Certification Program for Hockey were compared on attitudes toward important social psychological correlates of athletic involvement. As a consequence of anomalies in the sample, the six levels of certification were collapsed to form a factorial design comprising 2 levels of certification (coaches with 0.1 and 2 levels versus coaches with 3, 4, and 5 levels) and 2 levels of competition (house league versus competitive league coaches). The results revealed that coaches with greater certification were older and more experienced. Also, coaches in competitive leagues were more experienced, attached more importance to setting realistic objectives and playing well, but less importance to providing a recreational experience for players than house league coaches. Also, with increasing certification, coaches in competitive leagues attached increased importance to beating an opponent and having a winning team while house league coaches showed a decrease. Finally, the emphasis planed upon providing equal ice time for all players remained low over the two levels of certification in the competitive league coaches; it showed a decrease with greater certification in the house league coaches.

Coaching Patients Saves Lives and Money.

PubMed

Byrnes, Joshua; Elliott, Thomas; Vale, Margarite J; Jelinek, Michael V; Scuffham, Paul

2018-04-01

The Coaching On Achieving Cardiovascular Health (COACH) Program has been proven to improve biomedical and lifestyle cardiovascular disease (CVD) risk factors. The objective of this study was to evaluate the long-term impact of The COACH Program on overall survival, hospital utilization, and costs from the perspective of a private health insurer (payor), in patients with CVD. A prospective parallel-group case-control study design with controls randomly matched to patients based on propensity score. There were 512 participants with CVD engaged in a structured disease management program of 6 months duration (The COACH Program) who were matched to 512 patients with CVD who were allocated to the control group. The independent variables that estimated the propensity score were preprogram hospital admissions, age, and sex. The primary outcome was overall survival with secondary outcomes, including hospital utilization and cost incurred by the private health insurer. Mean follow-up was 6.35 years. Difference in overall survival between the 2 groups was estimated using a Cox proportional hazard ratio (HR) with difference in total cost estimated using a generalized linear model. The COACH Program achieved a significant reduction in overall mortality (HR 0.70; 95% confidence interval [CI], 0.53-0.93; P = .014). There was an apparent dose-response effect: those who received up to 3 coaching sessions had no decrease in mortality (HR 1.02; 95% CI, 0.69-1.49; P = .926); those who received 4 or more coaching sessions had a substantial decrease in mortality (HR 0.58; 95% CI, 0.42-0.81; P = .001). Total cost to the health insurer was substantially lower in the intervention group ($12,707 per person lower; P = .078). The reduction in total cost was significantly greater in those who received 4 or more sessions ($19,418 per person; P = .006) and in males ($18,947 per person; P = .029). Those enrolled in The COACH program achieved a statistically significant decrease in overall

Misalignment between Medicare Policies and Depression Care in Home Health Care: Home health provider perspectives

PubMed Central

Bao, Yuhua; Eggman, Ashley; Richardson, Joshua; Bruce, Martha

2013-01-01

Objective Depression affects one in four older adults receiving home health care. Medicare policies are influential in shaping home health practice. This study aims to identify Medicare policy areas that are aligned or misaligned with depression care quality improvement in home health care. Methods Qualitative study based on semi-structured interviews with nurses and administrators from five home health agencies in five states (n=20). Digitally recorded interviews were transcribed and analyzed using the grounded theory method. A multi-disciplinary team iteratively developed a codebook from interview data to identify themes. Results Several important Medicare policies are largely misaligned with depression care quality improvement in home health care: Medicare eligibility requirements for patients to remain homebound and to demonstrate a need for skilled care restrict nurses’ abilities to follow up with depressed patients for sufficient length of time; the lack of explicit recognition of nursing time and quality of care in the home health Prospective Payment System (PPS) provides misaligned incentives for depression care; incorporation of a two-item depression screening tool in Medicare-mandated comprehensive patient assessment raised clinician awareness of depression; however, inclusion of the tool at Start-of-Care only but not any other follow-up points limits its potential in assisting nurses with depression care management; under-development of clinical decision support for depression care in vendor-developed electronic health records constitutes an important barrier to depression quality improvement in home health care. Conclusions Several influential Medicare policies and regulations for home health practice may be misaligned with evidence-based depression care for home health patients. PMID:24632686

A Mobile Phone-Based Health Coaching Intervention for Weight Loss and Blood Pressure Reduction in a National Payer Population: A Retrospective Study

PubMed Central

Magana, Candy; Caballero Barajas, Karla

2017-01-01

Background The prevalence of obesity and associated metabolic conditions continue to be challenging and costly to address for health care systems; 71% of American adults were overweight, with 35% of men and 40% of women diagnosed with obesity in 2014. Digital health coaching is an innovative approach to decreasing the barriers of cost and accessibility of receiving health coaching for the prevention and management of chronic disease in overweight or obese individuals. Objective To evaluate the early impact of a mobile phone-based health coaching service on weight loss and blood pressure management in a commercially insured population. Methods This was a retrospective study using existing registry data from a pilot commercial collaboration between Vida Health and a large national insurance provider, which enrolled adult members who were overweight (body mass index >25 kg/m2) and able to engage in a mobile phone-based coaching intervention. Participants received 4 months of intensive health coaching via live video, phone, and text message through the Vida Health app. Participants were also provided with a wireless scale, pedometer, and blood pressure cuff. Of the 1012 enrolled, 763 (75.40%) participants had an initial weight upon enrollment and final weight between 3 and 5 months from enrollment; they served as our intervention group. There were 73 participants out of the 1012 (7.21%) who had weight data 4 months prior to and after Vida coaching, who served as the matched-pair control group. Results Participants in the intervention group lost an average of 3.23% total body weight (TBW) at 4 months of coaching and 28.6% (218/763) intervention participants achieved a clinically significant weight loss of 5% or more of TBW, with an average of 9.46% weight loss in this cohort. In the matched-pair control group, participants gained on average 1.81% TBW in 4 months without Vida coaching and lost, on average, 2.47% TBW after 4 months of Vida coaching, demonstrating a

Peer coaching and mentoring: a new model of educational intervention for safe patient handling in health care.

PubMed

Alamgir, Hasanat; Drebit, Sharla; Li, Helen Guiyun; Kidd, Catherine; Tam, Helen; Fast, Catherine

2011-08-01

To reduce the risk of patient handling-related musculoskeletal injury, overhead ceiling lifts have been installed in health care facilities. To increase ceiling lift usage for a variety of patient handling tasks, a peer coaching and mentoring program was implemented among the direct care staff in the long-term care subsector in British Columbia, Canada. They received a 4-day training program on body mechanics, ergonomics, patient-handling techniques, ceiling lift usage, in addition to coaching skills. A questionnaire was administered among staff before and after the intervention to evaluate the program's effectiveness. There were 403 and 200 respondents to the pre-intervention and post-intervention questionnaires. In general, staff perceived the peer-coaching program to be effective. The number of staff who reported to be using ceiling lifts "often and always" went higher from 64.5% to 80.5% (<0.001) after coaching program implementation. Furthermore, staff reported that they were using the ceiling lifts for more types of tasks post-intervention. Staff reported that the peer coaching program has increased their safety awareness at work and confidence in using the ceiling lifts. The findings suggest that this educational model can increase the uptake of mechanical interventions for occupational health and safety initiatives. It appears that the training led to a greater awareness of the availability of or increased perceptions of the number of ceiling lifts, presumably through coaches advocating their use. Copyright © 2011 Wiley-Liss, Inc.

The Future of Home Health Care

PubMed Central

Landers, Steven; Madigan, Elizabeth; Leff, Bruce; Rosati, Robert J.; McCann, Barbara A.; Hornbake, Rodney; MacMillan, Richard; Jones, Kate; Bowles, Kathryn; Dowding, Dawn; Lee, Teresa; Moorhead, Tracey; Rodriguez, Sally; Breese, Erica

2016-01-01

The Future of Home Health project sought to support transformation of home health and home-based care to meet the needs of patients in the evolving U.S. health care system. Interviews with key thought leaders and stakeholders resulted in key themes about the future of home health care. By synthesizing this qualitative research, a literature review, case studies, and the themes from a 2014 Institute of Medicine and National Research Council workshop on “The Future of Home Health Care,” the authors articulate a vision for home-based care and recommend a bold framework for the Medicare-certified home health agency of the future. The authors also identify challenges and recommendations for achievement of this framework. PMID:27746670

A socialization intervention in remote health coaching for older adults in the home.

PubMed

Jimison, Holly B; Klein, Krystal A; Marcoe, Jennifer L

2013-01-01

Previous studies have shown that social ties enhance both physical and mental health, and that social isolation has been linked to increased cognitive decline. As part of our cognitive training platform, we created a socialization intervention to address these issues. The intervention is designed to improve social contact time of older adults with remote family members and friends using a variety of technologies, including Web cameras, Skype software, email and phone. We used usability testing, surveys, interviews and system usage monitoring to develop design guidance for socialization protocols that were appropriate for older adults living independently in their homes. Our early results with this intervention show increased number of social contacts, total communication time (we measure email, phone, and Skype usage) and significant participant satisfaction with the intervention.

A Socialization Intervention in Remote Health Coaching for Older Adults in the Home*

PubMed Central

Jimison, Holly B.; Klein, Krystal A.; Marcoe, Jennifer L.

2014-01-01

Previous studies have shown that social ties enhance both physical and mental health, and that social isolation has been linked to increased cognitive decline. As part of our cognitive training platform, we created a socialization intervention to address these issues. The intervention is designed to improve social contact time of older adults with remote family members and friends using a variety of technologies, including Web cameras, Skype software, email and phone. We used usability testing, surveys, interviews and system usage monitoring to develop design guidance for socialization protocols that were appropriate for older adults living independently in their homes. Our early results with this intervention show increased number of social contacts, total communication time (we measure email, phone, and Skype usage) and significant participant satisfaction with the intervention. PMID:24111362

Do 'school coaches' make a difference in school-based mental health promotion? Results from a large focus group study.

PubMed

Corrieri, Sandro; Conrad, Ines; Riedel-Heller, Steffi G

2014-12-01

Mental disorders in children and adolescents are common and have serious consequences. Schools present a key opportunity to promote mental health and implement prevention measures. Four school coaches in five German schools were enlisted to engage students, teachers and parents in building a sustainably healthy school and classroom climate. Altogether, 58 focus groups with students (N=244), parents (N=54) and teachers (N=62) were conducted longitudinally. Topics included: (1) the development of the school and classroom climate, (2) the role of mental health in the regular curriculum, and (3) the role of school coaches in influencing these aspects. Over time, school coaches became trusted reference persons for an increasing number of school system members. They were able to positively influence the school and classroom climate by increasing the awareness of students, teachers and parents of mental health in daily routines. Nevertheless, topics like bullying and student inclusion remained an issue at follow-up. Overall, the school coach intervention is a good model for establishing the topic of mental health in everyday school life and increasing its importance. Future efforts will focus on building self-supporting structures and networks in order to make these efforts sustainable.

Virtual coach technology for supporting self-care.

PubMed

Ding, Dan; Liu, Hsin-Yi; Cooper, Rosemarie; Cooper, Rory A; Smailagic, Asim; Siewiorek, Dan

2010-02-01

"Virtual Coach" refers to a coaching program or device aiming to guide users through tasks for the purpose of prompting positive behavior or assisting with learning new skills. This article reviews virtual coach interventions with the purpose of guiding rehabilitation professionals to comprehend more effectively the essential components of such interventions, the underlying technologies and their integration, and example applications. A design space of virtual coach interventions including self-monitoring, context awareness, interface modality, and coaching strategies were identified and discussed to address when, how, and what coaching messages to deliver in an automated and intelligent way. Example applications that address various health-related issues also are provided to illustrate how a virtual coach intervention is developed and evaluated. Finally, the article provides some insight into addressing key challenges and opportunities in designing and implementing virtual coach interventions. It is expected that more virtual coach interventions will be developed in the field of rehabilitation to support self-care and prevent secondary conditions in individuals with disabilities.

Teacher consultation and coaching within mental health practice: classroom and child effects in urban elementary schools.

PubMed

Cappella, Elise; Hamre, Bridget K; Kim, Ha Yeon; Henry, David B; Frazier, Stacy L; Atkins, Marc S; Schoenwald, Sonja K

2012-08-01

To examine effects of a teacher consultation and coaching program delivered by school and community mental health professionals on change in observed classroom interactions and child functioning across one school year. Thirty-six classrooms within 5 urban elementary schools (87% Latino, 11% Black) were randomly assigned to intervention (training + consultation/coaching) and control (training only) conditions. Classroom and child outcomes (n = 364; 43% girls) were assessed in the fall and spring. Random effects regression models showed main effects of intervention on teacher-student relationship closeness, academic self-concept, and peer victimization. Results of multiple regression models showed levels of observed teacher emotional support in the fall moderated intervention impact on emotional support at the end of the school year. Results suggest teacher consultation and coaching can be integrated within existing mental health activities in urban schools and impact classroom effectiveness and child adaptation across multiple domains. © 2012 American Psychological Association

Financing of pediatric home health care. Committee on Child Health Financing, Section on Home Care, American Academy of Pediatrics.

PubMed

2006-08-01

In certain situations, home health care has been shown to be a cost-effective alternative to inpatient hospital care. National health expenditures reveal that pediatric home health costs totaled $5.3 billion in 2000. Medicaid is the major payer for pediatric home health care (77%), followed by other public sources (22%). Private health insurance and families each paid less than 1% of pediatric home health expenses. The most important factors affecting access to home health care are the inadequate supply of clinicians and ancillary personnel, shortages of home health nurses with pediatric expertise, inadequate payment, and restrictive insurance and managed care policies. Many children must stay in the NICU, PICU, and other pediatric wards and intermediate care areas at a much higher cost because of inadequate pediatric home health care services. The main financing problem pertaining to Medicaid is low payment to home health agencies at rates that are insufficient to provide beneficiaries access to home health services. Although home care services may be a covered benefit under private health plans, most do not cover private-duty nursing (83%), home health aides (45%), or home physical, occupational, or speech therapy (33%) and/or impose visit or monetary limits or caps. To advocate for improvements in financing of pediatric home health care, the American Academy of Pediatrics has developed several recommendations for public policy makers, federal and state Medicaid offices, private insurers, managed care plans, Title V officials, and home health care professionals. These recommendations will improve licensing, payment, coverage, and research related to pediatric home health services.

FastStats: Home Health Care

MedlinePlus

... Submit What's this? Submit Button NCHS Home Home Health Care Recommend on Facebook Tweet Share Compartir Data are ... Data Alzheimer’s disease Characteristics and Use of Home Health Care by Men and Women Aged 65 and Over [ ...

Managing Home Health Care (For Parents)

MedlinePlus

... Videos for Educators Search English Español Managing Home Health Care KidsHealth / For Parents / Managing Home Health Care What's ... español La atención médica en el hogar Intensive Health Care at Home Kids can need intensive health care ...

Advancing a new evidence-based professional in health care: job task analysis for health and wellness coaches.

PubMed

Wolever, Ruth Q; Jordan, Meg; Lawson, Karen; Moore, Margaret

2016-06-27

The pressing need to manage burgeoning chronic disease has led to the emergence of job roles such as health and wellness coaches (HWCs). As use of this title has increased dramatically, so has the need to ensure consistency, quality and safety for health and wellness coaching (HWC) provided in both practice and research. Clear and uniform role definitions and competencies are required to ensure appropriate scope of practice, to allow best practices to emerge, and to support the implementation of well-designed, large scale studies to accumulate a rigorous evidence base. Since the nascent field is replete with heterogeneity in terms of role delineations and competencies, a collaborative volunteer non-profit organization, the National Consortium for Credentialing Health and Wellness Coaches (NCCHWC), has been built over the past six years to support professionalization of the field. In 2014, a professionally led Job Task Analysis (JTA) was conducted with 15 carefully selected subject matter experts (SMEs) with diverse education and professional backgrounds who were practicing HWC in a wide variety of settings. After establishing a thorough list of specific tasks employed during HWC, the expert panel discussed the knowledge and skills necessary to competently perform the tasks. Subsequently, a large validation survey assessed the relative importance and frequency of each identified job task in conducting HWC. The JTA identified 21 job tasks as essential to HWC. In the subsequent validation survey, 4026 practicing health and wellness coaches were invited to rate each of the 21 job tasks in terms of their importance and frequency. A response rate of 25.6 % provided a diverse sample (n = 1031) in terms of background, and represented a wide variety of training programs from academia, industry, the private sector and associations. Per best practices, the subset of practicing HWCs (n = 885) provided importance and frequency ratings to be used to calculate task and

Is telephone health coaching a useful population health strategy for supporting older people with multimorbidity? An evaluation of reach, effectiveness and cost-effectiveness using a 'trial within a cohort'.

PubMed

Panagioti, Maria; Reeves, David; Meacock, Rachel; Parkinson, Beth; Lovell, Karina; Hann, Mark; Howells, Kelly; Blakemore, Amy; Riste, Lisa; Coventry, Peter; Blakeman, Thomas; Sidaway, Mark; Bower, Peter

2018-05-30

Innovative ways of delivering care are needed to improve outcomes for older people with multimorbidity. Health coaching involves 'a regular series of phone calls between patient and health professional to provide support and encouragement to promote healthy behaviours'. This intervention is promising, but evidence is insufficient to support a wider role in multimorbidity care. We evaluated health coaching in older people with multimorbidity. We used the innovative 'Trials within Cohorts' design. A cohort was recruited, and a trial was conducted using a 'patient-centred' consent model. A randomly selected group within the cohort were offered the intervention and were analysed as the intervention group whether they accepted the offer or not. The intervention sought to improve the skills of patients with multimorbidity to deal with a range of long-term conditions, through health coaching, social prescribing and low-intensity support for low mood. We recruited 4377 older people, and 1306 met the eligibility criteria (two or more long-term conditions and moderate 'patient activation'). We selected 504 for health coaching, and 41% consented. More than 80% of consenters received the defined 'dose' of 4+ sessions. In an intention-to-treat analysis, those selected for health coaching did not improve on any outcome (patient activation, quality of life, depression or self-care) compared to usual care. We examined health care utilisation using hospital administrative and self-report data. Patients selected for health coaching demonstrated lower levels of emergency care use, but an increase in the use of planned services and higher overall costs, as well as a quality-adjusted life year (QALY) gain. The incremental cost per QALY was £8049, with a 70-79% probability of being cost-effective at conventional levels of willingness to pay. Health coaching did not lead to significant benefits on the primary measures of patient-reported outcome. This is likely related to relatively low

The Changing Role of Health Care Professionals in Nursing Homes: A Systematic Literature Review of a Decade of Change

PubMed Central

van Stenis, Arend R.; van Wingerden, Jessica; Kolkhuis Tanke, Isolde

2017-01-01

Although the role of health care professionals is known to have changed over the last years, few formal efforts have been made to examine this change through means of a scientific review. Therefore, the goal of this paper was to investigate the changing role of health care professionals in nursing homes, as well as the conditions that make this change possible. A systematic review of health care literature published in the last decade (2007–2017) was utilized to address these goals. Our findings suggest that although health care in nursing homes is shifting from task-oriented care to relation-oriented care (e.g., through an increased focus on patient dignity), various obstacles (e.g., negative self-image, work pressure, and a lack of developmental opportunities), needs (e.g., shared values, personal development, personal empowerment, team development, and demonstrating expertise), and competences (e.g., communication skills, attentiveness, negotiation skills, flexibility, teamwork, expertise, and coaching and leadership skills) still need to be addressed in order to successfully facilitate this change. As such, this paper provides various implications for health care research, health care institutions, practitioners, HR professionals and managers, and occupational health research. PMID:29184529

Home Rx: The Health Benefits of Home Performance

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wilson, Jonathan; Jacobs, David; Reddy, Amanda

Evidence in a new, groundbreaking U.S. Department of Energy report, Home Rx: The Health Benefits of Home Performance, shows that home performance upgrades can improve the quality of a home’s indoor environment by reducing the prevalence of harmful indoor air pollutants and contaminants. Until recently, no systematic review of this evidence had been conducted, limiting full understanding of the link between home performance and health. This new report summarizes current knowledge and identifies research gaps. The design characteristics and results of each of the 40 studies considered in the report are summarized in a searchable matrix.

A Mobile Phone-Based Health Coaching Intervention for Weight Loss and Blood Pressure Reduction in a National Payer Population: A Retrospective Study.

PubMed

Mao, Alice Yuqing; Chen, Connie; Magana, Candy; Caballero Barajas, Karla; Olayiwola, J Nwando

2017-06-08

The prevalence of obesity and associated metabolic conditions continue to be challenging and costly to address for health care systems; 71% of American adults were overweight, with 35% of men and 40% of women diagnosed with obesity in 2014. Digital health coaching is an innovative approach to decreasing the barriers of cost and accessibility of receiving health coaching for the prevention and management of chronic disease in overweight or obese individuals. To evaluate the early impact of a mobile phone-based health coaching service on weight loss and blood pressure management in a commercially insured population. This was a retrospective study using existing registry data from a pilot commercial collaboration between Vida Health and a large national insurance provider, which enrolled adult members who were overweight (body mass index >25 kg/m2) and able to engage in a mobile phone-based coaching intervention. Participants received 4 months of intensive health coaching via live video, phone, and text message through the Vida Health app. Participants were also provided with a wireless scale, pedometer, and blood pressure cuff. Of the 1012 enrolled, 763 (75.40%) participants had an initial weight upon enrollment and final weight between 3 and 5 months from enrollment; they served as our intervention group. There were 73 participants out of the 1012 (7.21%) who had weight data 4 months prior to and after Vida coaching, who served as the matched-pair control group. Participants in the intervention group lost an average of 3.23% total body weight (TBW) at 4 months of coaching and 28.6% (218/763) intervention participants achieved a clinically significant weight loss of 5% or more of TBW, with an average of 9.46% weight loss in this cohort. In the matched-pair control group, participants gained on average 1.81% TBW in 4 months without Vida coaching and lost, on average, 2.47% TBW after 4 months of Vida coaching, demonstrating a statistically significant difference of 4

A Coaching Intervention to Promote Nutrition and Bone Health in Deployed Soldiers

DTIC Science & Technology

2015-03-13

to Promote Nutrition and Bone Health in Deployed Soldiers 5b. GRANT NUMBER HU0001-10-1-TS15 5c. PROGRAM ELEMENT NUMBER N/A 6. AUTHOR(S...Purpose: The purpose of this study was to determine if telehealth coaching is superior to one-time nutrition and fitness education regarding...leisure activities. All soldiers received one-time nutrition and fitness education prior to deployment; Telehealth Group received health-related

Teacher Consultation and Coaching within Mental Health Practice: Classroom and Child Effects in Urban Elementary Schools

PubMed Central

Cappella, Elise; Hamre, Bridget K.; Kim, Ha Yeon; Henry, David B.; Frazier, Stacy L.; Atkins, Marc S.; Schoenwald, Sonja K.

2012-01-01

Objective To examine effects of a teacher consultation and coaching program delivered by school and community mental health professionals on change in observed classroom interactions and child functioning across one school year. Method Thirty-six classrooms within five urban elementary schools (87% Latino, 11% Black) were randomly assigned to intervention (training + consultation/coaching) and control (training only) conditions. Classroom and child outcomes (n = 364; 43% girls) were assessed in the fall and spring. Results Random effects regression models showed main effects of intervention on teacher-student relationship closeness, academic self-concept, and peer victimization. Results of multiple regression models showed levels of observed teacher emotional support in the fall moderated intervention impact on emotional support at the end of the school year. Conclusions Results suggest teacher consultation and coaching can be integrated within existing mental health activities in urban schools and impact classroom effectiveness and child adaptation across multiple domains. PMID:22428941

Nursing perception of patient transitions from hospitals to home with home health.

PubMed

Smith, Shannon Bright; Alexander, Judith W

2012-01-01

The study's purpose was to determine nurses' opinions of sending patients from the hospital to home with home health services. The study occurred in the Charleston, South Carolina, Tricounty area (Berkeley, Charleston, and Dorchester counties). Home health agencies and hospitals were invited to participate. The study used a survey design to gather information on nursing perceptions of current practices and needed changes to improve transition of patients. The population was nurses (licensed practical nurses (LPNs) and registered nurses (RNs)) employed at inpatient hospitals or home health agencies in the area. Thirty-four RNs responded with no LPNs respondents. Agency administrators/chief nursing officers agreed for their agencies to participate and distributed the survey using a Research Electronic Data Capture (REDCap) Internet-based survey tool. Using the survey results and information from a literature review, the study developed a list of propositions, which participating administrators reviewed, for improving transitions to home. Both home health and hospital nurses reported a need to improve the process of sending patients from hospital to home with home health services. This study provides hospitals and home health agencies with propositions to facilitate the establishment of a process to communicate effectively patients care needs and streamline the discharging patients from the hospital to home health care; thus, improving patient transition. Case managers and discharge planners will need interagency collaboration along with evidence-based interventions to transition patients from the hospital to home with home health services with various populations. Direct patient care nurses in both hospital and home health settings should share the same accountability as case managers to ensure successful transitions.

Smart homes and home health monitoring technologies for older adults: A systematic review.

PubMed

Liu, Lili; Stroulia, Eleni; Nikolaidis, Ioanis; Miguel-Cruz, Antonio; Rios Rincon, Adriana

2016-07-01

Around the world, populations are aging and there is a growing concern about ways that older adults can maintain their health and well-being while living in their homes. The aim of this paper was to conduct a systematic literature review to determine: (1) the levels of technology readiness among older adults and, (2) evidence for smart homes and home-based health-monitoring technologies that support aging in place for older adults who have complex needs. We identified and analyzed 48 of 1863 relevant papers. Our analyses found that: (1) technology-readiness level for smart homes and home health monitoring technologies is low; (2) the highest level of evidence is 1b (i.e., one randomized controlled trial with a PEDro score ≥6); smart homes and home health monitoring technologies are used to monitor activities of daily living, cognitive decline and mental health, and heart conditions in older adults with complex needs; (3) there is no evidence that smart homes and home health monitoring technologies help address disability prediction and health-related quality of life, or fall prevention; and (4) there is conflicting evidence that smart homes and home health monitoring technologies help address chronic obstructive pulmonary disease. The level of technology readiness for smart homes and home health monitoring technologies is still low. The highest level of evidence found was in a study that supported home health technologies for use in monitoring activities of daily living, cognitive decline, mental health, and heart conditions in older adults with complex needs. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Randomized Trial to Reduce Air Particle Levels in Homes of Smokers and Children.

PubMed

Hughes, Suzanne C; Bellettiere, John; Nguyen, Benjamin; Liles, Sandy; Klepeis, Neil E; Quintana, Penelope J E; Berardi, Vincent; Obayashi, Saori; Bradley, Savannah; Hofstetter, C Richard; Hovell, Melbourne F

2018-03-01

Exposure to fine particulate matter in the home from sources such as smoking, cooking, and cleaning may put residents, especially children, at risk for detrimental health effects. A randomized clinical trial was conducted from 2011 to 2016 to determine whether real-time feedback in the home plus brief coaching of parents or guardians could reduce fine particle levels in homes with smokers and children. A randomized trial with two groups-intervention and control. A total of 298 participants from predominantly low-income households with an adult smoker and a child aged <14 years. Participants were recruited during 2012-2015 from multiple sources in San Diego, mainly Women, Infants and Children Program sites. The multicomponent intervention consisted of continuous lights and brief sound alerts based on fine particle levels in real time and four brief coaching sessions using particle level graphs and motivational interviewing techniques. Motivational interviewing coaching focused on particle reduction to protect children and other occupants from elevated particle levels, especially from tobacco-related sources. In-home air particle levels were measured by laser particle counters continuously in both study groups. The two outcomes were daily mean particle counts and percentage time with high particle concentrations (>15,000 particles/0.01 ft 3 ). Linear mixed models were used to analyze the differential change in the outcomes over time by group, during 2016-2017. Intervention homes had significantly larger reductions than controls in daily geometric mean particle concentrations (18.8% reduction vs 6.5% reduction, p<0.001). Intervention homes' average percentage time with high particle concentrations decreased 45.1% compared with a 4.2% increase among controls (difference between groups p<0.001). Real-time feedback for air particle levels and brief coaching can reduce fine particle levels in homes with smokers and young children. Results set the stage for refining

Providers' Reported and Actual Use of Coaching Strategies in Natural Environments

ERIC Educational Resources Information Center

Salisbury, Christine; Cambray-Engstrom, Elizabeth; Woods, Juliann

2012-01-01

This case study examined the agreement between reported and actual use of coaching strategies based on home visit data collected on a diverse sample of providers and families. Paired videotape and contact note data of and from providers during home visits were collected over a six month period and analyzed using structured protocols. Results of…

Implementing an error disclosure coaching model: A multicenter case study.

PubMed

White, Andrew A; Brock, Douglas M; McCotter, Patricia I; Shannon, Sarah E; Gallagher, Thomas H

2017-01-01

National guidelines call for health care organizations to provide around-the-clock coaching for medical error disclosure. However, frontline clinicians may not always seek risk managers for coaching. As part of a demonstration project designed to improve patient safety and reduce malpractice liability, we trained multidisciplinary disclosure coaches at 8 health care organizations in Washington State. The training was highly rated by participants, although not all emerged confident in their coaching skill. This multisite intervention can serve as a model for other organizations looking to enhance existing disclosure capabilities. Success likely requires cultural change and repeated practice opportunities for coaches. © 2017 American Society for Healthcare Risk Management of the American Hospital Association.

Behavioral Characteristics of "Favorite" Coaches: Implications for Coach Education

ERIC Educational Resources Information Center

Stewart, Craig; Owens, Lynn

2011-01-01

The purpose of this paper was to use athletes' and former athletes' memories of their favorite coach to improve coach education curriculum. Player preferences of coaching behavior can affect both their attitudes toward their sport experiences and team performance. By identifying positive coaching behaviors as recalled by athletes, coach educators…

The health care home model: primary health care meeting public health goals.

PubMed

Grant, Roy; Greene, Danielle

2012-06-01

In November 2010, the American Public Health Association endorsed the health care home model as an important way that primary care may contribute to meeting the public health goals of increasing access to care, reducing health disparities, and better integrating health care with public health systems. Here we summarize the elements of the health care home (also called the medical home) model, evidence for its clinical and public health efficacy, and its place within the context of health care reform legislation. The model also has limitations, especially with regard to its degree of involvement with the communities in which care is delivered. Several actions could be undertaken to further develop, implement, and sustain the health care home.

The impact of health coaching on medication adherence in patients with poorly controlled diabetes, hypertension, and/or hyperlipidemia: a randomized controlled trial.

PubMed

Thom, David H; Willard-Grace, Rachel; Hessler, Danielle; DeVore, Denise; Prado, Camille; Bodenheimer, Thomas; Chen, Ellen

2015-01-01

Lack of concordance between medications listed in the medical record and taken by the patient contributes to poor outcomes. We sought to determine whether patients who received health coaching by medical assistants improved their medication concordance and adherence. This was a nonblinded, randomized, controlled, pragmatic intervention trial. English- or Spanish-speaking patients, age 18 to 75 years, with poorly controlled type 2 diabetes, hypertension, and/or hyperlipidemia were enrolled from 2 urban safety net clinics and randomized to receive 12 months of health coaching versus usual care. Outcomes included concordance between medications documented in the medical record and those reported by the patient and adherence based on the patient-reported number of days (of the last 7) on which patient took all prescribed medications. The proportion of medications completely concordant increased in the coached group versus the usual care group (difference in change, 10%; P = .05). The proportion of medications listed in the chart but not taken significantly decreased in the coached group compared with the usual care group (difference in change, 17%; P = .013). The mean number of adherent days increased in the coached but not in the usual care group (difference in change, 1.08; P < .001). Health coaching by medical assistants significantly increases medication concordance and adherence. © Copyright 2015 by the American Board of Family Medicine.

Home Health Agency Work Environments and Hospitalizations

PubMed Central

Flynn, Linda; Lake, Eileen T.; Aiken, Linda H.

2014-01-01

Background: An important goal of home health care is to assist patients to remain in community living arrangements. Yet home care often fails to prevent hospitalizations and to facilitate discharges to community living, thus putting patients at risk of additional health challenges and increasing care costs. Objectives: To determine the relationship between home health agency work environments and agency-level rates of acute hospitalization and discharges to community living. Methods and Design: Analysis of linked Center for Medicare and Medicaid Services Home Health Compare data and nurse survey data from 118 home health agencies. Robust regression models were used to estimate the effect of work environment ratings on between-agency variation in rates of acute hospitalization and community discharge. Results: Home health agencies with good work environments had lower rates of acute hospitalizations and higher rates of patient discharges to community living arrangements compared with home health agencies with poor work environments. Conclusion: Improved work environments in home health agencies hold promise for optimizing patient outcomes and reducing use of expensive hospital and institutional care. PMID:25215647

Home health agency work environments and hospitalizations.

PubMed

Jarrín, Olga; Flynn, Linda; Lake, Eileen T; Aiken, Linda H

2014-10-01

An important goal of home health care is to assist patients to remain in community living arrangements. Yet home care often fails to prevent hospitalizations and to facilitate discharges to community living, thus putting patients at risk of additional health challenges and increasing care costs. To determine the relationship between home health agency work environments and agency-level rates of acute hospitalization and discharges to community living. Analysis of linked Center for Medicare and Medicaid Services Home Health Compare data and nurse survey data from 118 home health agencies. Robust regression models were used to estimate the effect of work environment ratings on between-agency variation in rates of acute hospitalization and community discharge. Home health agencies with good work environments had lower rates of acute hospitalizations and higher rates of patient discharges to community living arrangements compared with home health agencies with poor work environments. Improved work environments in home health agencies hold promise for optimizing patient outcomes and reducing use of expensive hospital and institutional care.

Parallel processes: using motivational interviewing as an implementation coaching strategy.

PubMed

Hettema, Jennifer E; Ernst, Denise; Williams, Jessica Roberts; Miller, Kristin J

2014-07-01

In addition to its clinical efficacy as a communication style for strengthening motivation and commitment to change, motivational interviewing (MI) has been hypothesized to be a potential tool for facilitating evidence-based practice adoption decisions. This paper reports on the rationale and content of MI-based implementation coaching Webinars that, as part of a larger active dissemination strategy, were found to be more effective than passive dissemination strategies at promoting adoption decisions among behavioral health and health providers and administrators. The Motivational Interviewing Treatment Integrity scale (MITI 3.1.1) was used to rate coaching Webinars from 17 community behavioral health organizations and 17 community health centers. The MITI coding system was found to be applicable to the coaching Webinars, and raters achieved high levels of agreement on global and behavior count measurements of fidelity to MI. Results revealed that implementation coaches maintained fidelity to the MI model, exceeding competency benchmarks for almost all measures. Findings suggest that it is feasible to implement MI as a coaching tool.

What is the effect of health coaching on physical activity participation in people aged 60 years and over? A systematic review of randomised controlled trials.

PubMed

Oliveira, Juliana S; Sherrington, Catherine; Amorim, Anita B; Dario, Amabile B; Tiedemann, Anne

2017-10-01

Physical inactivity is common in older age, yet increased activity benefits older people in terms of preventing chronic disease and maximising independence. Health coaching is a behaviour change intervention that has been shown to increase physical activity in clinical populations. This systematic review and meta-analysis investigated the effect of health coaching on physical activity, mobility, quality of life and mood in older people. MEDLINE, EMBASE, CENTRAL, PsycINFO, PEDro, SPORTDiscus, LILACS and CINAHL databases were used to identify randomised controlled trials which evaluated the effect of health coaching on physical activity (primary outcome) among people aged 60+. Secondary outcomes were mobility, quality of life and mood. We calculated standardised mean differences (SMDs, Hedges' g) with 95% CIs from random effects meta-analyses. 27 eligible trials were included. Health coaching had a small, statistically significant effect on physical activity (27 studies; SMD = 0.27; 95% CI 0.18 to 0.37; p<0.001). There was no evidence of an effect of health coaching on mobility (eight studies; SMD = 0.10; 95% CI -0.03 to 0.23; p=0.13), quality of life (eight studies; SMD = 0.07; 95% CI -0.06 to 0.20; p<0.05) or mood (five studies; SMD = 0.02; 95% CI -0.12 to 0.16; p=0.83). Health coaching significantly increased physical activity in people aged 60+. There was no evidence of an effect of health coaching on quality of life, mobility and mood, so different approaches may be required to impact on these outcomes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Coaching in self-efficacy improves care responses, health and well-being in dementia carers: a pre/post-test/follow-up study.

PubMed

Chenoweth, Lynn; Stein-Parbury, Jane; White, Danielle; McNeill, Georgene; Jeon, Yun-Hee; Zaratan, Beverley

2016-05-04

Maintaining the health and well-being of family carers of people with dementia is vital, given their potential for experiencing burden associated with the role. The study aimed to help dementia carers develop self-efficacy, be less hassled by the caring role and improve their health and well-being with goal-directed behaviour, by participating in an eight module carer coaching program. The study used mixed methods in a pre/post-test/follow-up design over 24 months, with assignment of consented dementia carers to either individualised (n = 16) or group coaching (n = 32), or usual carer support services (n = 43), depending on preference. Care-giving self-efficacy and hassles, carer health, well-being and goal-directed behaviours were assessed over time. Analysis of Variance (ANOVA) was used to compare changes over time and the effects of coaching on carer self-efficacy, hassles and health, using the Univariate General Linear Model (GLM). All carers were hassled by many aspects of caring at baseline. Participants receiving coaching reported non-significant improvements in most areas of self-efficacy for caring, hassles associated with caring and self-reported health at post-test and follow-up, than did carers receiving usual carer support. Group coaching had greater success in helping carers to achieve their goals and to seek help from informal and formal support networks and services. The study outcomes were generally positive, but need to be interpreted cautiously, given some methodological limitations. It has been shown, however, that health staff can assist dementia carers to develop self-efficacy in better managing their family member's limitations and behaviour, seek help from others and attend to their health. Teaching carers to use goal-directed behaviour may help them achieve these outcomes.

Using e-Coaching to Support an Early Intervention Provider's Implementation of a Functional Assessment-Based Intervention

ERIC Educational Resources Information Center

Fettig, Angel; Barton, Erin E.; Carter, Alice S.; Eisenhower, Abbey S.

2016-01-01

This study examined the effects of e-coaching on the implementation of a functional assessment-based intervention delivered by an early intervention provider in reducing challenging behaviors during home visits. A multiple baseline design across behavior support plan components was used with a provider-child dyad. The e-coaching intervention…

Gym-based exercise was more costly compared with home-based exercise with telephone support when used as maintenance programs for adults with chronic health conditions: cost-effectiveness analysis of a randomised trial.

PubMed

Jansons, Paul; Robins, Lauren; O'Brien, Lisa; Haines, Terry

2018-01-01

What is the comparative cost-effectiveness of a gym-based maintenance exercise program versus a home-based maintenance program with telephone support for adults with chronic health conditions who have previously completed a short-term, supervised group exercise program? A randomised, controlled trial with blinded outcome assessment at baseline and at 3, 6, 9 and 12 months. The economic evaluation took the form of a trial-based, comparative, incremental cost-utility analysis undertaken from a societal perspective with a 12-month time horizon. People with chronic health conditions who had completed a 6-week exercise program at a community health service. One group of participants received a gym-based exercise program and health coaching for 12 months. The other group received a home-based exercise program and health coaching for 12 months with telephone follow-up for the first 10 weeks. Healthcare costs were collected from government databases and participant self-report, productivity costs from self-report, and health utility was measured using the European Quality of Life Instrument (EQ-5D-3L). Of the 105 participants included in this trial, 100 provided sufficient cost and utility measurements to enable inclusion in the economic analyses. Gym-based follow-up would cost an additional AUD491,572 from a societal perspective to gain 1 quality-adjusted life year or 1year gained in perfect health compared with the home-based approach. There was considerable uncertainty in this finding, in that there was a 37% probability that the home-based approach was both less costly and more effective than the gym-based approach. The gym-based approach was more costly than the home-based maintenance intervention with telephone support. The uncertainty of these findings suggests that if either intervention is already established in a community setting, then the other intervention is unlikely to replace it efficiently. ACTRN12610001035011. [Jansons P, Robins L, O'Brien L, Haines T

Mentorship and coaching to support strengthening healthcare systems: lessons learned across the five Population Health Implementation and Training partnership projects in sub-Saharan Africa.

PubMed

Manzi, Anatole; Hirschhorn, Lisa R; Sherr, Kenneth; Chirwa, Cindy; Baynes, Colin; Awoonor-Williams, John Koku

2017-12-21

Despite global efforts to increase health workforce capacity through training and guidelines, challenges remain in bridging the gap between knowledge and quality clinical practice and addressing health system deficiencies preventing health workers from providing high quality care. In many developing countries, supervision activities focus on data collection, auditing and report completion rather than catalyzing learning and supporting system quality improvement. To address this gap, mentorship and coaching interventions were implemented in projects in five African countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia) as components of health systems strengthening (HSS) strategies funded through the Doris Duke Charitable Foundation's African Health Initiative. We report on lessons learned from a cross-country evaluation. The evaluation was designed based on a conceptual model derived from the project-specific interventions. Semi-structured interviews were administered to key informants to capture data in six categories: 1) mentorship and coaching goals, 2) selection and training of mentors and coaches, 3) integration with the existing systems, 4) monitoring and evaluation, 5) reported outcomes, and 6) challenges and successes. A review of project-published articles and technical reports from the individual projects supplemented interview information. Although there was heterogeneity in the approaches to mentorship and coaching and targeted areas of the country projects, all led to improvements in core health system areas, including quality of clinical care, data-driven decision making, leadership and accountability, and staff satisfaction. Adaptation of approaches to reflect local context encouraged their adoption and improved their effectiveness and sustainability. We found that incorporating mentorship and coaching activities into HSS strategies was associated with improvements in quality of care and health systems, and mentorship and coaching represents an

Athletes' assessment of the coach--the coach evaluation questionnaire.

PubMed

Rushall, B S; Wiznuk, K

1985-09-01

The purpose of this study was to provide an assessment tool to judge coaching performance that was appropriate for completion by athletes. The questionnaire underwent a variety of developmental stages. In its final form, it contained 36 items. The tool was shown to be a valid, reliable, and standardized questionnaire. It demonstrated discriminability and provoked honest, accurate responding in subjects. The test was capable of providing immediate feedback to coaches seeking information about athletes' perceptions of their coaching performance. Responses on the developed scale were weighted to reflect the desirability of the coaching characteristics of a good coach. The questionnaire provides a total score which can be interpreted by the coach as a measure of how much of an "ideal" coach exists in him/her.

Pre-Implementation Strategies to Adapt and Implement a Veteran Peer Coaching Intervention to Improve Mental Health Treatment Engagement Among Rural Veterans.

PubMed

Koenig, Christopher J; Abraham, Traci; Zamora, Kara A; Hill, Coleen; Kelly, P Adam; Uddo, Madeline; Hamilton, Michelle; Pyne, Jeffrey M; Seal, Karen H

2016-09-01

Telephone motivational coaching has been shown to increase urban veteran mental health treatment initiation. However, no studies have tested telephone motivational coaching delivered by veteran peers to facilitate mental health treatment initiation and engagement. This study describes pre-implementation strategies with 8 Veterans Affairs (VA) community-based outpatient clinics in the West and Mid-South United States to adapt and implement a multisite pragmatic randomized controlled trial of telephone peer motivational coaching for rural veterans. We used 2 pre-implementation strategies, Formative Evaluation (FE) research and Evidence-Based Quality Improvement (EBQI) meetings to adapt the intervention to stakeholders' needs and cultural contexts. FE data were qualitative, semi-structured interviews with rural veterans and VA clinic staff. Results were rapidly analyzed and presented to stakeholders during EBQI meetings to optimize the intervention implementation. FE research results showed that VA clinic providers felt overwhelmed by veterans' mental health needs and acknowledged limited mental health services at VA clinics. Rural veteran interviews indicated geographical, logistical, and cultural barriers to VA mental health treatment initiation and a preference for self-care to cope with mental health symptoms. EBQI meetings resulted in several intervention adaptations, including veteran study recruitment, peer veteran coach training, and an expanded definition of mental health care outcomes. As the VA moves to cultivate community partnerships in order to personalize and expand access to care for rural veterans, pre-implementation processes with engaged stakeholders, such as those described here, can help guide other researchers and clinicians to achieve proactive and veteran-centered health care services. © 2016 National Rural Health Association.

The nurse manager: change agent, change coach?

PubMed

Stefancyk, Amanda; Hancock, Beverly; Meadows, Mary T

2013-01-01

Change in today's health care landscape is a daily, if not hourly, reality. The nurse manager must have strong leadership skills to navigate through change with a focus on the patient and the provision of safe and reliable care. The historical term for those leading change is "change agent." In this article, the authors introduce the idea of a change coach, building on the nurse manager foundational skill of coaching and weaving this concept into the manager's role in change. A change coach uses the coaching behaviors including guidance, facilitation, and inspiration to inspire others toward change, altering human capabilities, and supporting and influencing others toward change. An exemplar of the nurse manager's role as a change coach in practice is provided using American Organization of Nurse Executives' Care Innovation and Transformation initiative. It is the agile manager that is able to successfully move between the roles of change agent and change coach to continuously transform the environment and how care is delivered.

Addressing the Health and Wellness Needs of Vulnerable Rockaway Residents in the Wake of Hurricane Sandy: Findings From a Health Coaching and Community Health Worker Program.

PubMed

Russell, David; Oberlink, Mia R; Shah, Shivani; Evans, Lauren; Bassuk, Karen

To describe the design and participants of a program that employed health coaches and community health workers to address the social, health, and long-term disaster recovery needs of Rockaway residents roughly 2 years after Hurricane Sandy made landfall. Baseline and exit questionnaires, containing demographic, health, and health care utilization measures, were administered to participants at the start and end of the program. Enrollment and encounter information was captured in program administrative records. Descriptive statistics were used to summarize participant characteristics, personal goals, referrals to local organizations and agencies, and outcomes. Qualitative analyses were used to identify recurring themes in challenges faced by participants and barriers to health and wellness. The program served 732 community residents, of whom 455 (62%) completed baseline and exit questionnaires. Participants were directly and/or indirectly impacted by Hurricane Sandy through property damage, closures of health care facilities, limited employment opportunities, and trouble securing affordable housing. Furthermore, many participants faced considerable adversities and struggled to manage chronic health conditions. Personal goals set by participants included locating health care and other resources (44%), weight management and healthy eating (35%), and self-management of chronic conditions (24%). Health coaches and community health workers engaged participants an average of 4 times-providing counseling and referrals to local organizations and services, including medical and dental services (29%), city-issued identification cards (27%), and health insurance and other entitlements (23%). Comparisons of baseline and exit surveys indicated significant improvements in self-reported health, health care utilization, and confidence managing health issues. No significant improvement was observed in the use of preventive health care services. The program represents a model for

Cost-effectiveness implications based on a comparison of nursing home and home health case mix.

PubMed Central

Kramer, A M; Shaughnessy, P W; Pettigrew, M L

1985-01-01

Case-mix differences between 653 home health care patients and 650 nursing home patients, and between 455 Medicare home health patients and 447 Medicare nursing home patients were assessed using random samples selected from 20 home health agencies and 46 nursing homes in 12 states in 1982 and 1983. Home health patients were younger, had shorter lengths of stay, and were less functionally disabled than nursing home patients. Traditional long-term care problems requiring personal care were more common among nursing home patients, whereas problems requiring skilled nursing services were more prevalent among home health patients. Considering Medicare patients only, nursing home patients were much more likely to be dependent in activities of daily living (ADLs) than home health patients. Medicare nursing home and home health patients were relatively similar in terms of long-term care problems, and differences in medical problems were less pronounced than between all nursing home and all home health patients. From the standpoint of cost-effectiveness, it would appear that home health care might provide a substitute for acute care hospital use at the end of a hospital stay, and appears to be a more viable option in the care of patients who are not severely disabled and do not have profound functional problems. The Medicare skilled nursing facility, however, is likely to continue to have a crucial role in posthospital care as the treatment modality of choice for individuals who require both highly skilled care and functional assistance. PMID:3932258

Coaching as Professional Learning: Guidance for Implementing Effective Coaching Systems

ERIC Educational Resources Information Center

Vermont Agency of Education, 2016

2016-01-01

To build collective capacity within organizations, schools and districts across the world have implemented coaching as an effective method for systemic reform. Vermont in particular has a wide variety of coaches, including instructional coaches and systems coaches, as well as a variety of interpretations of the coaching practice. Many schools…

Perspectives on Effective Coaching by Those Who Have Been Coached

ERIC Educational Resources Information Center

Carter, Alison; Blackman, Anna; Hicks, Ben; Williams, Matthew; Hay, Rachel

2017-01-01

Studies on coaching have largely explored effectiveness from the perspective of a coach or employing organization rather than that of the employee or coachee. There has also been a focus on "successful" coaching, but little is known about unsuccessful coaching or the hindrances to achieving coaching success. Many empirical studies on…

Lived Experience and Community Sport Coaching: A Phenomenological Investigation

ERIC Educational Resources Information Center

Cronin, Colum; Armour, Kathleen M.

2015-01-01

Coaching in the participation domain is the act of coaching participants that are less intensely engaged in sport than performance orientated athletes. This form of coaching is a popular activity occurring in community settings such as schools or sport clubs, and it is often undertaken with a broad range of social and health outcomes in mind. The…

Understanding How Ontario High School Teacher-Coaches Learn to Coach

ERIC Educational Resources Information Center

Winchester, Geoff; Culver, Diane; Camiré, Martin

2013-01-01

Background: There are approximately 52,000 teacher-coaches coaching 750,000 high school student-athletes in Canada. Despite this large population, Canadian high school teacher-coaches remain relatively unstudied. High school coaches in Canada are often asked to coach sports with which they are unfamiliar, and because they are not required to…

Huddle-coaching: a dynamic intervention for trainees and staff to support team-based care.

PubMed

Shunk, Rebecca; Dulay, Maya; Chou, Calvin L; Janson, Susan; O'Brien, Bridget C

2014-02-01

Many outpatient clinics where health professionals train will transition to a team-based medical home model over the next several years. Therefore, training programs need innovative approaches to prepare and incorporate trainees into team-based delivery systems. To address this need, educators at the San Francisco Veterans Affairs (VA) Medical Center included trainees in preclinic team "huddles," or briefing meetings to facilitate care coordination, and developed an interprofessional huddle-coaching program for nurse practitioner students and internal medicine residents who function as primary providers for patient panels in VA outpatient primary care clinics. The program aimed to support trainees' partnerships with staff and full participation in the VA's Patient Aligned Care Teams. The huddle-coaching program focuses on structuring the huddle process via scheduling, checklists, and designated huddle coaches; building relationships among team members through team-building activities; and teaching core skills to support collaborative practice. A multifaceted evaluation of the program showed positive results. Participants rated training sessions and team-building activities favorably. In interviews, trainees valued their team members and identified improvements in efficiency and quality of patient care as a result of the team-based approach. Huddle checklists and scores on the Team Development Measure indicated progress in team processes and relationships as the year progressed. These findings suggest that the huddle-coaching program was a worthwhile investment in trainee development that also supported the clinic's larger mission to deliver team-based, patient-aligned care. As more training sites shift to team-based care, the huddle-coaching program offers a strategy for successfully incorporating trainees.

What Is Best for Esther? Building Improvement Coaching Capacity With and for Users in Health and Social Care--A Case Study.

PubMed

Vackerberg, Nicoline; Levander, Märta Sund; Thor, Johan

2016-01-01

While coaching and customer involvement can enhance the improvement of health and social care, many organizations struggle to develop their improvement capability; it is unclear how best to accomplish this. We examined one attempt at training improvement coaches. The program, set in the Esther Network for integrated care in rural Jönköping County, Sweden, included eight 1-day sessions spanning 7 months in 2011. A senior citizen joined the faculty in all training sessions. Aiming to discern which elements in the program were essential for assuming the role of improvement coach, we used a case-study design with a qualitative approach. Our focus group interviews included 17 informants: 11 coaches, 3 faculty members, and 3 senior citizens. We performed manifest content analysis of the interview data. Creating will, ideas, execution, and sustainability emerged as crucial elements. These elements were promoted by customer focus--embodied by the senior citizen trainer--shared values and a solution-focused approach, by the supportive coach network and by participants' expanded systems understanding. These elements emerged as more important than specific improvement tools and are worth considering also elsewhere when seeking to develop improvement capability in health and social care organizations.

What Is Best for Esther? Building Improvement Coaching Capacity With and for Users in Health and Social Care—A Case Study

PubMed Central

Levander, Märta Sund; Thor, Johan

2016-01-01

While coaching and customer involvement can enhance the improvement of health and social care, many organizations struggle to develop their improvement capability; it is unclear how best to accomplish this. We examined one attempt at training improvement coaches. The program, set in the Esther Network for integrated care in rural Jönköping County, Sweden, included eight 1-day sessions spanning 7 months in 2011. A senior citizen joined the faculty in all training sessions. Aiming to discern which elements in the program were essential for assuming the role of improvement coach, we used a case-study design with a qualitative approach. Our focus group interviews included 17 informants: 11 coaches, 3 faculty members, and 3 senior citizens. We performed manifest content analysis of the interview data. Creating will, ideas, execution, and sustainability emerged as crucial elements. These elements were promoted by customer focus—embodied by the senior citizen trainer—shared values and a solution-focused approach, by the supportive coach network and by participants' expanded systems understanding. These elements emerged as more important than specific improvement tools and are worth considering also elsewhere when seeking to develop improvement capability in health and social care organizations. PMID:26783868

Leadership Coaching: Coaching Competencies and Best Practices

ERIC Educational Resources Information Center

Wise, Donald; Hammack, Marc

2011-01-01

Leadership coaching is now seen as a valuable tool to assist school leaders. Through a survey of school principals, this study identified specific coaching competencies used by leadership coaches that were perceived by principals to influence key best practices for schools. These best practices have in turn been correlated to increased student…

Coaching Older Adults and Carers to have their preferences Heard (COACH): A randomised controlled trial in an intermediate care setting (study protocol).

PubMed

Masters, Stacey; Gordon, Jason; Whitehead, Craig; Davies, Owen; Giles, Lynne C; Ratcliffe, Julie

2012-01-01

Frail older people who are considering movement into residential aged care or returning home following a hospital admission often face complex and difficult decisions.Despite research interest in this area, a recent Cochrane review was unable to identify any studies of interventions to support decision-making in this group that met the experimental or quasi-experimental study design criteria. This study tests the impact of a multi-component coaching intervention on the quality of preparation for care transitions, targeted to older adults and informal carers. In addition, the study assesses the impact of investing specialist geriatric resources into consultations with families in an intermediate care setting where decisions about future care needs are being made. This study was a randomised controlled trial of 230 older adults admitted to intermediate care in Australia. Masked assessment at 3 and 12 months examined physical functioning, health-related quality of life and utilisation of health and aged care resources. A geriatrician and specialist nurse delivered a coaching intervention to both the older person and their carer/family. Components of the intervention included provision of a Question Prompt List prior to meeting with a geriatrician (to clarify medical conditions and treatments, medications, 'red flags', end of life decisions and options for future health care) and a follow-up meeting with a nurse who remained in telephone contact. Participants received a printed summary and an audio recording of the meeting with the geriatrician. The costs and outcomes of the intervention are compared with usual care. Australian New Zealand Clinical Trials Registry (ACTRN12607000638437).

Home Health Care: Services and Cost

ERIC Educational Resources Information Center

Widmer, Geraldine; And Others

1978-01-01

Findings from a study of home care services in one New York district document the value and relatively modest costs of home health care for the chronically ill and dependent elderly. Professional nurses coordinated the care, but most of the direct services were provided by home health aides and housekeepers. (MF)

Coaching Behavior of Girls Youth Softball Coaches.

ERIC Educational Resources Information Center

Rupnow, Allan; Stotlar, David

A study examined coaches' behavior and classified the types and rates of coaches' behavior by time of athletic season (early or late), win/loss record, and throughout the time frame within a single contest. Subjects included all the volunteer coaches in a 13 team, softball program for 10-12 year old girls. The season consisted of a double…

Behavioral health and health care reform models: patient-centered medical home, health home, and accountable care organization.

PubMed

Bao, Yuhua; Casalino, Lawrence P; Pincus, Harold Alan

2013-01-01

Discussions of health care delivery and payment reforms have largely been silent about how behavioral health could be incorporated into reform initiatives. This paper draws attention to four patient populations defined by the severity of their behavioral health conditions and insurance status. It discusses the potentials and limitations of three prominent models promoted by the Affordable Care Act to serve populations with behavioral health conditions: the Patient-Centered Medical Home, the Health Home initiative within Medicaid, and the Accountable Care Organization. To incorporate behavioral health into health reform, policymakers and practitioners may consider embedding in the reform efforts explicit tools-accountability measures and payment designs-to improve access to and quality of care for patients with behavioral health needs.

Coaching the Multiplicity of Mind: A Strengths-based Model

PubMed Central

2013-01-01

Professional health and wellness coaches are passionate about helping people learn, change, and grow. We are lifelong students of what enables humans to perform at our best. The phrase coaching the whole person is common coaching parlance; full engagement in self-care often requires that clients shift a spectrum of beliefs, motives, and perspectives in order to make changes that are sustainable. Just as important is the need for coaches to fully engage in their own self-care in order to best serve their clients. PMID:24416685

Effect of a Motivational Interviewing-Based Health Coaching on Quality of Life in Subjects With COPD.

PubMed

Rehman, Hamid; Karpman, Craig; Vickers Douglas, Kristin; Benzo, Roberto P

2017-08-01

Improving quality of life (QOL) is a key goal in the care of patients with COPD. Pulmonary rehabilitation (PR) has clearly been shown to improve QOL, but is not accessible to many eligible patients. There is a need for alternative programs designed to improve patient well-being that are accessible to all patients with COPD. Our goal was to pilot test a simple, telephone-based health-coaching intervention that was recently shown to decrease readmission among hospitalized COPD patients and stable COPD patients eligible for PR. Subjects received a 3-month intervention consisting of 10 health-coaching telephone calls based on motivational interviewing principles. Outcome measures included dyspnea level, measured by the modified Medical Research Council scale, and QOL, measured by the Chronic Respiratory Questionnaire and a single-item general self-rated health status. Fifty subjects with moderate to severe COPD were enrolled in the study. Forty-four subjects (86%) completed the study intervention. Dyspnea measured by the modified Medical Research Council score improved significantly after the intervention ( P = .002). The domains of fatigue, emotional function, and mastery on the Chronic Respiratory Disease Questionnaire and the single-item QOL question also improved significantly after the 3 months of health coaching ( P = .001, P = .001, P = .007, and P = .03, respectively). Thirty-six (71%) subjects had a clinically meaningful improvement in at least 1 study end point (either in the severity of dyspnea or a domain of QOL). Thirty subjects (58%) had an improvement of ≥0.5 points, the minimum clinically important difference in at least 1 component of the Chronic Respiratory Disease Questionnaire. A telephone-delivered motivational interviewing-based coaching program for COPD patients is a feasible, well-accepted (by both participants and providers), simple, and novel intervention to improve the well-being of patients with COPD. This pilot study provides insight into

The Experience of Critical Self-Reflection by Life Coaches: A Phenomenological Study

ERIC Educational Resources Information Center

Shaw, Deanna Lynn

2012-01-01

The purpose of this study was to describe the experience of critical self-reflection by life coaches. Life coaching is expanding within many disciplines including education, health care, business, social work, and wellness. Life coaching involves a coach working with an individual or groups aimed at effecting change for professional and personal…

Dietary Intervention for Glucose Tolerance In Teens (DIG IT): Protocol of a randomized controlled trial using health coaching to prevent youth-onset type 2 diabetes.

PubMed

Wagner, Kelly A; Braun, Ethan; Armah, Seth M; Horan, Diarmuid; Smith, Lisa G; Pike, Julie; Tu, Wanzhu; Hamilton, Marc T; Delp, Edward J; Campbell, Wayne W; Boushey, Carol J; Hannon, Tamara S; Gletsu-Miller, Nana

2017-02-01

Youth-onset type 2 diabetes (T2D) is a disease that is newly emerging and behavioral strategies for its prevention are limited. Interventions that target the lifestyle behaviors of adolescents, to improve poor dietary quality and reduce excessive sedentariness, promise to reduce the risk of developing T2D. Health coaching is effective for promoting healthy behaviors in patients who have chronic disease, but few experimental studies are in adolescents. This randomized controlled trial, in adolescents with prediabetes, will determine the effectiveness of a health coaching intervention to facilitate adoption of healthy diet and activity behaviors that delay or prevent development of T2D. The Dietary Intervention for Glucose Tolerance In Teens (DIG IT) trial will involve an evaluation of a health coaching intervention in adolescents with prediabetes. Eligible participants will be randomized to receive 6months of health coaching or a single dietary consultation that is standard-of-care. The primary outcome will be 2-hour oral glucose tolerance test concentration. Secondary outcomes will include measures of glycemia and insulin action as well as dietary, physical activity and sedentary behaviors measured using an electronic food record, and by inclinometer. Data will be collected before and after the intervention (at 6months) and at 12months (to assess sustainability). This trial will determine whether a health coaching intervention, a personalized and low-cost approach to modify dietary and activity behaviors, is effective and sustainable for prevention of youth-onset T2D, relative to standard-of-care. Health coaching has the potential to be widely implemented in clinical or community settings. Copyright © 2016 Elsevier Inc. All rights reserved.

Impact and Acceptability of the Coach and Teacher Training within a School-Based Sport-for-Health Smoking Prevention Intervention: Smokefree Sports

ERIC Educational Resources Information Center

Garnham-Lee, Katy; Trigwell, Joanne; McGee, Ciara E.; Knowles, Zoe; Foweather, Lawrence

2016-01-01

This study evaluated the impact and acceptability of a three-hour bespoke training workshop for sports coaches and teachers to subsequently deliver a sport-for-health smoking prevention intervention in primary schools. Questionnaires were completed pre- and post-training by both teachers (N = 24) and coaches (N = 8), and post-intervention by…

Behavioral Health and Health Care Reform Models: Patient-Centered Medical Home, Health Home, and Accountable Care Organization

PubMed Central

Bao, Yuhua; Casalino, Lawrence P.; Pincus, Harold Alan

2012-01-01

Discussions of health care delivery and payment reforms have largely been silent about how behavioral health could be incorporated into reform initiatives. This paper draws attention to four patient populations defined by the severity of their behavioral health conditions and insurance status. It discusses the potentials and limitations of three prominent models promoted by the Affordable Care Act to serve populations with behavioral health conditions: the Patient Centered Medical Home, the Health Home initiative within Medicaid, and the Accountable Care Organization. To incorporate behavioral health into health reform, policymakers and practitioners may consider embedding in the reform efforts explicit tools – accountability measures and payment designs – to improve access to and quality of care for patients with behavioral health needs. PMID:23188486

Health promotion profile of youth sports clubs in Finland: club officials' and coaches' perceptions.

PubMed

Kokko, Sami; Kannas, Lasse; Villberg, Jari

2009-03-01

The purpose of this article is to examine the current health promotion orientation of youth sports clubs in Finland in view of the standards created previously for the health promoting sports club (HPSC). Ninety-seven youth sports clubs participated, and 273 sports club officials and 240 coaches answered the questionnaires. To describe clubs health promotion orientations, an HPSC index was created. The HPSC index was formulated on sub-indices by factor analysis. The sub-indices were: policy, ideology, practice and environment indexes. The results indicate that youth sports clubs are fairly health promoting in general. On average, the clubs fulfilled 12 standards for HPSC out of 22. Every fourth club was categorized as higher health promoting (> or = 15 fulfilled standards), and every third as lower health promoting (<11 fulfilled standards). The variation between clubs was wide. The clubs that had been recognized as exemplary and hence certified by the Young Finland Association were more likely to recognize health promotion than non-certified clubs (OR = 2.36, p = 0.016). The sports club officials were twice as likely to evaluate their clubs as higher health promoting than the coaches (OR = 2.04, p = 0.041). Under the sub-indices, ideologies were recognized best, others less. These findings indicate that minority of the youth sports clubs have realized health promotion comprehensively as a part of their activities. There is a lot of need for development, especially in the area of health promotion policies and practices. The instruments used proved valid and reliable and can therefore be recommended for international use.

Proposal for Voluntary Coaching Certification and Formulation of the Illinois Athletic Coaching Certification Board.

ERIC Educational Resources Information Center

Buckellew, Wm.; And Others

A proposal developed by the Illinois Association for Professional Preparation in Health, Physical Education, and Recreation and the Illinois Association for Health, Physical Education and Recreation for a program involving voluntary coaching certification in Illinois is described. Topics discussed include: (1) the certifying body's composition and…

The Coach-Coachee Relationship in Executive Coaching: A Field Study

ERIC Educational Resources Information Center

Baron, Louis; Morin, Lucie

2009-01-01

Numerous authors have suggested that the working relationship between coach and coachee constitutes an essential condition to the success of executive coaching. This study empirically investigated the links between the coach-coachee relationship and the success of a coaching intervention in an organizational setting. Data were collected from two…

Perspectives on Agile Coaching

NASA Astrophysics Data System (ADS)

Fraser, Steven; Lundh, Erik; Davies, Rachel; Eckstein, Jutta; Larsen, Diana; Vilkki, Kati

There are many perspectives to agile coaching including: growing coaching expertise, selecting the appropriate coach for your context; and eva luating value. A coach is often an itinerant who may observe, mentor, negotiate, influence, lead, and/or architect everything from team organization to system architecture. With roots in diverse fields ranging from technology to sociology coaches have differing motivations and experience bases. This panel will bring together coaches to debate and discuss various perspectives on agile coaching. Some of the questions to be addressed will include: What are the skills required for effective coaching? What should be the expectations for teams or individu als being coached? Should coaches be: a corporate resource (internal team of consultants working with multiple internal teams); an integral part of a specific team; or external contractors? How should coaches exercise influence and au thority? How should management assess the value of a coaching engagement? Do you have what it takes to be a coach? - This panel will bring together sea soned agile coaches to offer their experience and advice on how to be the best you can be!

Health coaching by medical assistants to improve control of diabetes, hypertension, and hyperlipidemia in low-income patients: a randomized controlled trial.

PubMed

Willard-Grace, Rachel; Chen, Ellen H; Hessler, Danielle; DeVore, Denise; Prado, Camille; Bodenheimer, Thomas; Thom, David H

2015-03-01

Health coaching by medical assistants could be a financially viable model for providing self-management support in primary care if its effectiveness were demonstrated. We investigated whether in-clinic health coaching by medical assistants improves control of cardiovascular and metabolic risk factors when compared with usual care. We conducted a 12-month randomized controlled trial of 441 patients at 2 safety net primary care clinics in San Francisco, California. The primary outcome was a composite measure of being at or below goal at 12 months for at least 1 of 3 uncontrolled conditions at baseline as defined by hemoglobin A1c, systolic blood pressure, and low-density lipoprotein (LDL) cholesterol. Secondary outcomes were meeting all 3 goals and meeting individual goals. Data were analyzed using χ(2) tests and linear regression models. Participants in the coaching arm were more likely to achieve both the primary composite measure of 1 of the clinical goals (46.4% vs 34.3%, P = .02) and the secondary composite measure of reaching all clinical goals (34.0% vs 24.7%, P = .05). Almost twice as many coached patients achieved the hemoglobin A1c goal (48.6% vs 27.6%, P = .01). At the larger study site, coached patients were more likely to achieve the LDL cholesterol goal (41.8% vs 25.4%, P = .04). The proportion of patients meeting the systolic blood pressure goal did not differ significantly. Medical assistants serving as in-clinic health coaches improved control of hemoglobin A1c and LDL levels, but not blood pressure, compared with usual care. Our results highlight the need to understand the relationship between patients' clinical conditions, interventions, and the contextual features of implementation. © 2015 Annals of Family Medicine, Inc.

Health Coaching by Medical Assistants to Improve Control of Diabetes, Hypertension, and Hyperlipidemia in Low-Income Patients: A Randomized Controlled Trial

PubMed Central

Willard-Grace, Rachel; Chen, Ellen H.; Hessler, Danielle; DeVore, Denise; Prado, Camille; Bodenheimer, Thomas; Thom, David H.

2015-01-01

PURPOSE Health coaching by medical assistants could be a financially viable model for providing self-management support in primary care if its effectiveness were demonstrated. We investigated whether in-clinic health coaching by medical assistants improves control of cardiovascular and metabolic risk factors when compared with usual care. METHODS We conducted a 12-month randomized controlled trial of 441 patients at 2 safety net primary care clinics in San Francisco, California. The primary outcome was a composite measure of being at or below goal at 12 months for at least 1 of 3 uncontrolled conditions at baseline as defined by hemoglobin A1c, systolic blood pressure, and low-density lipoprotein (LDL) cholesterol. Secondary outcomes were meeting all 3 goals and meeting individual goals. Data were analyzed using χ2 tests and linear regression models. RESULTS Participants in the coaching arm were more likely to achieve both the primary composite measure of 1 of the clinical goals (46.4% vs 34.3%, P = .02) and the secondary composite measure of reaching all clinical goals (34.0% vs 24.7%, P = .05). Almost twice as many coached patients achieved the hemoglobin A1c goal (48.6% vs 27.6%, P = .01). At the larger study site, coached patients were more likely to achieve the LDL cholesterol goal (41.8% vs 25.4%, P = .04). The proportion of patients meeting the systolic blood pressure goal did not differ significantly. CONCLUSIONS Medical assistants serving as in-clinic health coaches improved control of hemoglobin A1c and LDL levels, but not blood pressure, compared with usual care. Our results highlight the need to understand the relationship between patients’ clinical conditions, interventions, and the contextual features of implementation. PMID:25755034

Professional Nurse Coaching: Advances in National and Global Healthcare transformation.

PubMed

Dossey, Barbara M; Hess, Darlene

2013-07-01

Nurse coaches are responding to the mandate of Florence Nightingale (1820-1910)-the foundational philosopher of modern nursing-to advocate, identify, and focus on factors that promote health, healthy people, and healthy communities that are recognized today as environmental and social determinants of health.(1) (,) (2) The Institute of Medicine report(3) and other health initiatives suggest the need for increased education and leadership from nurses to address the healthcare needs of our nation and world. Nurse coaches are strategically pos-i tioned and equipped to implement health-promoting and evidence-based strategies with clients and support behavioral and lifestyle changes to enhance growth, overall health, and well-being. With possibilities not yet imagined, employment opportunities for nurses who incorporate coaching into professional practice are developing across the entire spectrum of health, well-ness, and healing.

Professional Nurse Coaching: Advances in National and Global Healthcare transformation

PubMed Central

Hess, Darlene

2013-01-01

Nurse coaches are responding to the mandate of Florence Nightingale (1820-1910)—the foundational philosopher of modern nursing—to advocate, identify, and focus on factors that promote health, healthy people, and healthy communities that are recognized today as environmental and social determinants of health.1,2 The Institute of Medicine report3 and other health initiatives suggest the need for increased education and leadership from nurses to address the healthcare needs of our nation and world. Nurse coaches are strategically pos-i tioned and equipped to implement health-promoting and evidence-based strategies with clients and support behavioral and lifestyle changes to enhance growth, overall health, and well-being. With possibilities not yet imagined, employment opportunities for nurses who incorporate coaching into professional practice are developing across the entire spectrum of health, well-ness, and healing. PMID:24416681

Innovations in coaching and mentoring: implications for nurse leadership development.

PubMed

Fielden, Sandra L; Davidson, Marilyn J; Sutherland, Valerie J

2009-05-01

This longitudinal study sought to examine ways in which coaching and mentoring relationships impact on the professional development of nurses in terms of career and leadership behaviours, and evaluating the differences and similarities between those coaching and mentoring relationships. According to the UK government, leadership in nursing is essential to the improvement of service delivery, and the development and training of all nurses is vital in achieving effective change. A coaching and mentoring programme was used to explore the comparative advantages of these two approaches for the leadership development of nurses in acute, primary care and mental health settings. A longitudinal in-depth study was conducted to measure differences and similarities between the mentoring and coaching process as a result of a six-month coaching/mentoring programme. Five nurses from six UK Health Care Trusts were allocated to a coaching group (n = 15) or a mentoring group (n = 15), these were coached or mentored by a member of the senior directorate from their own Trust. Qualitative and quantitative data were collected at three time points (T1 = baseline, T2 = 4 months and T3 = 9 months) using semi-structured interviews and questionnaires. While mentoring was perceived to be 'support' and coaching was described as 'action', descriptions of the actual process and content were quite similar. However, while both groups reported significant development in terms of career development, leadership skills and capabilities, mentees reported the highest level of development with significantly higher scores in eight areas of leadership and management and in three areas of career impact. Implications for nurses and health services are discussed.

Medicare and Medicaid Programs; CY 2017 Home Health Prospective Payment System Rate Update; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements. Final rule.

PubMed

2016-11-03

This final rule updates the Home Health Prospective Payment System (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor; effective for home health episodes of care ending on or after January 1, 2017. This rule also: Implements the last year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates; updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the 2nd-year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity (that is, nominal case-mix growth) between CY 2012 and CY 2014; finalizes changes to the methodology used to calculate payments made under the HH PPS for high-cost "outlier" episodes of care; implements changes in payment for furnishing Negative Pressure Wound Therapy (NPWT) using a disposable device for patients under a home health plan of care; discusses our efforts to monitor the potential impacts of the rebasing adjustments; includes an update on subsequent research and analysis as a result of the findings from the home health study; and finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model, which was implemented on January 1, 2016; and updates to the Home Health Quality Reporting Program (HH QRP).

Safety Risks Among Home Infusion Nurses and Other Home Health Care Providers

PubMed Central

Galligan, Catherine; Quinn, Margaret

2017-01-01

In the United States, home health care (HHC) is a rapidly growing industry and home infusion therapy is a rapidly growing market. HHC can present substantial occupational safety and health (OSH) risks. This article summarizes major OSH risks relevant to home infusion therapy by illustrating them through real-life scenarios collected systematically using qualitative research methods by the National Institute for Occupational Safety and Health-funded research projects at the University of Massachusetts Lowell. The need for home infusion therapy will continue to grow in the future, and safety interventions to prevent or minimize OSH risks are essential. PMID:28683000

Depression in Home-Based Care: The Role of the Home Health Nurse.

PubMed

Groh, Carla J; Dumlao, Manuel S

2016-01-01

Depression is a major health issue among older adults receiving home-based services yet is underdiagnosed and undertreated, which can result in negative health outcomes. Despite the recognized need for improved mental health services, significant gaps and barriers exist that contribute to less than optimal home-based depression management interventions. Home healthcare clinicians are well positioned to drive this effort for improving depression care with enhanced learning. Thus, the purpose of this article is to provide guidelines on improving depression care in homebound older adults based on four clinical functions central to home healthcare: screening, assessment, medication management, and patient/family education.

Practices of depression care in home health care: Home health clinician perspectives

PubMed Central

Bao, Yuhua; Eggman, Ashley A.; Richardson, Joshua E.; Sheeran, Thomas; Bruce, Martha L.

2015-01-01

Objective To assess any gaps between published best practices and real-world practices of treating depression in home health care (HHC), and barriers to closing any gaps. Methods A qualitative study based on semi-structured interviews with HHC nurses and administrators from five home health agencies in five states (n=20). Audio-recorded interviews were transcribed and analyzed by a multi-disciplinary team using grounded theory method to identify themes. Results Routine home health nursing care overlapped with all functional areas of depression care. However, there were reported gaps between best practices and real-world practices. Gaps were associated with perceived scope of practice by HHC nurses, knowledge gaps and low self-efficacy in depression treatment, stigma attached to depression, poor quality of antidepressant management in primary care, and poor communication between HHC and primary care. Conclusions Strategies to close gaps between typical and best practices need to enhance HHC clinician knowledge and self-efficacy with depression treatment and improve the quality of antidepressant management and communication with primary care. PMID:26423098

Marketing in home health care. A practical approach.

PubMed

Freitag, E M

1988-06-01

Home health marketing brings special problems and opportunities. One cannot rely on physical factors such as the physical plant and food service of a hospital or on the durability of a consumer product to judge home health. Opportunities exist within home health to identify activities that carry marketing value. Applying marketing principles to activities such as intake, customer service and public relations allows the home health agency to build referrals by meeting the wants and needs of the market. The home health organization needs to consider different wants and needs of those involved in the home health transaction: the decision maker, the purchaser, and the user. The success of the marketing function in meeting the organization's objectives will be aided by the placement of marketing at the senior management level.

Private investment purchase and nursing home financial health.

PubMed

Orfaly Cadigan, Rebecca; Stevenson, David G; Caudry, Daryl J; Grabowski, David C

2015-02-01

To explore the impact of nursing home acquisition by private investment firms on nursing home costs, revenue, and overall financial health. Merged data from the Medicare Cost Reports and the Online Survey, Certification, and Reporting system for the period 1998-2010. Regression specification incorporating facility and time fixed effects. We found little impact on the financial health of nursing homes following purchase by private investment companies. However, our findings did suggest that private investment firms acquired nursing home chains in good financial health, possibly to derive profit from the company's real estate holdings. Private investment acquired facilities are an important feature of today's nursing home sector. Although we did not observe a negative impact on the financial health of nursing homes, this development raises important issues about ownership oversight and transparency for the entire nursing home sector. © Health Research and Educational Trust.

Nutrition Knowledge and Practices of Varsity Coaches at a Canadian University.

PubMed

Danaher, Kavanagh; Curley, Tristaca

2014-12-01

Coaches' sports nutrition knowledge and subsequent nutrition recommendations can have an impact on athletes' health and performance. The purpose of this study was to determine sports nutrition knowledge and nutrition recommendation practices of varsity coaches at one Canadian university and to determine if the coaches' nutrition knowledge influenced nutrition recommendations to athletes. The coaches' accessibility to sports dietitians was also examined. Coaches (n = 5) completed a modified psychometrically validated nutrition knowledge questionnaire and a semi-structured interview. Mean scores were calculated for questionnaire answers based on the correct answer and the coach's degree of certainty in their answer. Interviews were analyzed using thematic analysis. Results showed a low nutrition knowledge, yet all coaches made nutrition recommendations to their athletes for fluid needs, dietary supplementation, and weight management; areas that may be potentially detrimental to the health of athletes. In addition, they made recommendations with regard to fluid needs, training diet, precompetition diet, recovery diet (i.e., post training or competition), dietary supplementation, and weight management; areas that could have potentially negative performance consequences to the athlete. It was determined that coaches had low nutrition knowledge scores and still made nutrition recommendations to athletes. The importance of sports dietitian involvement in varsity athletics is emphasized.

42 CFR 440.70 - Home health services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Home health services. 440.70 Section 440.70 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.70 Home health services. (a...

42 CFR 440.70 - Home health services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Home health services. 440.70 Section 440.70 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.70 Home health services. (a...

42 CFR 440.70 - Home health services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Home health services. 440.70 Section 440.70 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.70 Home health services. (a...

42 CFR 440.70 - Home health services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Home health services. 440.70 Section 440.70 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.70 Home health services. (a...

42 CFR 440.70 - Home health services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Home health services. 440.70 Section 440.70 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.70 Home health services. (a...

Behavioral health coaching for rural veterans with diabetes and depression: a patient randomized effectiveness implementation trial.

PubMed

Cully, Jeffrey A; Breland, Jessica Y; Robertson, Suzanne; Utech, Anne E; Hundt, Natalie; Kunik, Mark E; Petersen, Nancy J; Masozera, Nicholas; Rao, Radha; Naik, Aanand D

2014-04-28

Depression and diabetes cause significant burden for patients and the healthcare system and, when co-occurring, result in poorer self-care behaviors and worse glycemic control than for either condition alone. However, the clinical management of these comorbid conditions is complicated by a host of patient, provider, and system-level barriers that are especially problematic for patients in rural locations. Patient-centered medical homes provide an opportunity to integrate mental and physical health care to address the multifaceted needs of complex comorbid conditions. Presently, there is a need to not only develop robust clinical interventions for complex medically ill patients but also to find feasible ways to embed these interventions into the frontlines of existing primary care practices. This randomized controlled trial uses a hybrid effectiveness-implementation design to evaluate the Healthy Outcomes through Patient Empowerment (HOPE) intervention, which seeks to simultaneously address diabetes and depression for rural veterans in Southeast Texas. A total of 242 Veterans with uncontrolled diabetes and comorbid symptoms of depression will be recruited and randomized to either the HOPE intervention or to a usual-care arm. Participants will be evaluated on a host of diabetes and depression-related measures at baseline and 6- and 12-month follow-up. The trial has two primary goals: 1) to examine the effectiveness of the intervention on both physical (diabetes) and emotional health (depression) outcomes and 2) to simultaneously pilot test a multifaceted implementation strategy designed to increase fidelity and utilization of the intervention by coaches interfacing within the primary care setting. This ongoing blended effectiveness-implementation design holds the potential to advance the science and practice of caring for complex medically ill patients within the constraints of a busy patient-centered medical home. Behavioral Activation Therapy for Rural Veterans

The Impact of Home Health Length of Stay and Number of Skilled Nursing Visits on Hospitalization among Medicare-Reimbursed Skilled Home Health Beneficiaries

PubMed Central

O'Connor, Melissa; Hanlon, Alexandra; Naylor, Mary D.; Bowles, Kathryn H.

2015-01-01

The implementation of the Home Health Prospective Payment System in 2000 led to a dramatic reduction in home health length of stay and number of skilled nursing visits among Medicare beneficiaries. While policy leaders have focused on the rising costs of home health care, its potential underutilization and the relationship between service use and patient outcomes including hospitalization rates have not been rigorously examined. A secondary analysis of five Medicare-owned assessment and claims data sets for the year 2009 was conducted among two independently randomly selected samples of Medicare-reimbursed home health recipients (each n=31,485) to examine the relationship between home health length of stay or number of skilled nursing visits and hospitalization rates within 90 days of discharge from home health. Patients who had a home health length of stay of at least 22 days or received at least 4 skilled nursing visits had significantly lower odds of hospitalization than patients with shorter home health stays and fewer skilled nursing visits. Additional study is needed to clarify the best way to structure home health services and determine readiness for discharge to reduce hospitalization among this chronically ill population. In the mean time, the findings of this study suggest that home health providers should consider the benefits of at least four SNV and/or a home health LOS of 22 days or longer. PMID:25990046

Educating refugees to improve their home environmental health.

PubMed

Korfmacher, Katrina Smith; George, Valerie

2012-01-01

Rochester's Healthy Home was a hands-on home environmental health museum that educated more than 3500 visitors between June 2006 and December 2009. The Healthy Home provided visitors with the tools, resources, and motivation to make their homes healthier by reducing environmental hazards. The Healthy Home focused on empowering low-income renters to protect their families from home health risks, but served a broad audience. On the basis of the Healthy Home's initial successes with diverse visitors, in 2009 the county health department provided funding for a 6-month project to educate 200 recently arrived refugees. This report summarizes the project's innovative approach to home health education, presents evaluation data on impacts on refugees and other visitors, suggests implications for resettlement agencies, and provides guidelines for those interested in replicating this approach in their own community.

Examining coaches' perceptions of how their stress influences the coach-athlete relationship.

PubMed

Thelwell, Richard C; Wagstaff, Christopher R D; Chapman, Michael T; Kenttä, Göran

2017-10-01

This study extends recent coach stress research by evaluating how coaches perceive their stress experiences to affect athletes, and the broader coach-athlete relationship. A total of 12 coaches working across a range of team sports at the elite level took part in semi-structured interviews to investigate the 3 study aims: how they perceive athletes to detect signals of coach stress; how they perceive their stress experiences to affect athletes; and, how effective they perceive themselves to be when experiencing stress. Following content analysis, data suggested that coaches perceived athletes able to detect when they were experiencing stress typically via communication, behavioural, and stylistic cues. Although coaches perceived their stress to have some positive effects on athletes, the overwhelming effects were negative and affected "performance and development", "psychological and emotional", and "behavioural and interaction" factors. Coaches also perceived themselves to be less effective when stressed, and this was reflected in their perceptions of competence, self-awareness, and coaching quality. An impactful finding is that coaches are aware of how a range of stress responses are expressed by themselves, and to how they affect athletes, and their coaching quality. Altogether, findings support the emerging view that coach stress affects their own, and athlete performance.

The effectiveness of the use of a digital activity coaching system in addition to a two-week home-based exercise program in patients after total knee arthroplasty: study protocol for a randomized controlled trial.

PubMed

Harmelink, Karen E M; Zeegers, A V C M; Tönis, Thijs M; Hullegie, Wim; Nijhuis-van der Sanden, Maria W G; Staal, J Bart

2017-07-05

There is consistent evidence that supervised programs are not superior to home-based programs after total knee arthroplasty (TKA), especially in patients without complications. Home-based exercise programs are effective, but we hypothesize that their effectiveness can be improved by increasing the adherence to physical therapy advice to reach an adequate exercise level during the program and thereafter. Our hypothesis is that an activity coaching system (accelerometer-based activity sensor), alongside a home-based exercise program, will increase adherence to exercises and the activity level, thereby improving physical functioning and recovery. The objective of this study is to determine the effectiveness of an activity coaching system in addition to a home-based exercise program after a TKA compared to only the home-based exercise program with physical functioning as outcome. This study is a single-blind randomized controlled trial. Both the intervention (n = 55) and the control group (n = 55) receive a two-week home-based exercise program, and the intervention group receives an additional activity coaching system. This is a hand-held electronic device together with an app on a smartphone providing information and advice on exercise behavior during the day. The primary outcome is physical functioning, measured with the Timed Up and Go test (TUG) after two weeks, six weeks and three months. Secondary outcomes are 1) adherence to the activity level (activity diary); 2) physical functioning, measured with the 2-Minute Walk Test (2MWT) and the Knee Osteoarthritis Outcome Score; 3) quality of life (SF-36); 4) healthcare use up to one year postoperatively and 5) cost-effectiveness. Data are collected preoperatively, three days, two and six weeks, three months and one year postoperatively. The strengths of the study are the use of both performance-based tests and self-reported questionnaires and the personalized tailored program after TKA given by specialized physical

Enhancing the Provision of Coach Education: The Recommendations of UK Coaching Practitioners

ERIC Educational Resources Information Center

Nelson, Lee; Cushion, Christopher; Potrac, Paul

2013-01-01

Background: Coach education has been identified as a key vehicle for raising the standard of coaching practice. However, the existing body of literature suggests that coach education has had a limited impact on the learning and development of coaching practitioners. In this respect, it has been contended that coach educations ills might be…

Implementing Home Health Standards in Clinical Practice.

PubMed

Gorski, Lisa A

2016-02-01

In 1986, the American Nurses Association (ANA) published the first Standards of Home Health Practice. Revised in 1992 and expanded in 1999 to become Home Health Nursing: Scope and Standards of Practice, it was revised in 2008 and again in 2014. In the 2014 edition, there are 6 standards of home healthcare nursing practice and 10 standards of professional performance for home healthcare nursing. The focus of this article is to describe the home healthcare standards and to provide guidance for implementation in clinical practice. It is strongly encouraged that home healthcare administrators, educators, and staff obtain a copy of the standards and fully read this essential home healthcare resource.

Coaches' and Principals' Conceptualizations of the Roles of Elementary Mathematics Coaches

ERIC Educational Resources Information Center

Salkind, Gwenanne M.

2010-01-01

Many schools employ coaches to support mathematics instruction and student learning. This research study investigated the roles of coaches from five school districts in Virginia. Participants included 125 elementary mathematics coaches and 59 principals. Results from cross-sectional surveys revealed that most coaches did not have a degree in…

The First Step: Assessing the Coaching Philosophies of Pre-Service Coaches

ERIC Educational Resources Information Center

Collins, Karen; Barber, Heather; Moore, Kristina; Laws, Amanda

2011-01-01

Coaches are influential in creating positive and achievement-oriented sport environments and the development of a sound philosophy is the key to successful coaching (Martens, 2004). Yet, few coaches spend significant time early in their careers developing and modifying their philosophical beliefs (Wilcox & Trudel, 1998). While coaching educators…

The impact of home health length of stay and number of skilled nursing visits on hospitalization among Medicare-reimbursed skilled home health beneficiaries.

PubMed

O'Connor, Melissa; Hanlon, Alexandra; Naylor, Mary D; Bowles, Kathryn H

2015-08-01

The implementation of the Home Health Prospective Payment System in 2000 led to a dramatic reduction in home health length of stay and number of skilled nursing visits among Medicare beneficiaries. While policy leaders have focused on the rising costs of home health care, its potential underutilization, and the relationship between service use and patient outcomes including hospitalization rates have not been rigorously examined. A secondary analysis of five Medicare-owned assessment and claims data sets for the year 2009 was conducted among two independently randomly selected samples of Medicare-reimbursed home health recipients (each n = 31,485) to examine the relationship between home health length of stay or number of skilled nursing visits and hospitalization rates within 90 days of discharge from home health. Patients who had a home health length of stay of at least 22 days or received at least four skilled nursing visits had significantly lower odds of hospitalization than patients with shorter home health stays and fewer skilled nursing visits. Additional study is needed to clarify the best way to structure home health services and determine readiness for discharge to reduce hospitalization among this chronically ill population. In the mean time, the findings of this study suggest that home health providers should consider the benefits of at least four SNV and/or a home health LOS of 22 days or longer. © 2015 Wiley Periodicals, Inc.

42 CFR 441.15 - Home health services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Home health services. 441.15 Section 441.15 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Provisions § 441.15 Home health services. With respect to the services defined in § 440.70 of this subchapter...

42 CFR 441.15 - Home health services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Home health services. 441.15 Section 441.15 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Provisions § 441.15 Home health services. With respect to the services defined in § 440.70 of this subchapter...

42 CFR 441.15 - Home health services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Home health services. 441.15 Section 441.15 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Provisions § 441.15 Home health services. With respect to the services defined in § 440.70 of this subchapter...

42 CFR 441.15 - Home health services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Home health services. 441.15 Section 441.15 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Provisions § 441.15 Home health services. With respect to the services defined in § 440.70 of this subchapter...

42 CFR 441.15 - Home health services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Home health services. 441.15 Section 441.15 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Provisions § 441.15 Home health services. With respect to the services defined in § 440.70 of this subchapter...

Considering Student Coaching

ERIC Educational Resources Information Center

Keen, James P.

2014-01-01

What does student coaching involve and what considerations make sense in deciding to engage an outside contractor to provide personal coaching? The author explores coaching in light of his own professional experience and uses this reflection as a platform from which to consider the pros and cons of student coaching when deciding whether to choose…

Conflict coaching training for nurse managers: a case study of a two-hospital health system.

PubMed

Brinkert, Ross

2011-01-01

This study evaluated the application of the Comprehensive Conflict Coaching model in a hospital environment. Conflict coaching involves a coach working with a client to improve the client's conflict understanding, interaction strategies and/or interaction skills. The training of nurse managers as conflict coaches is an innovative continuing education programme that partially addresses conflict-related concerns in nursing. Twenty nurse managers trained as conflict coaches and each coached a supervisee. Qualitative data were gathered from nurse managers, supervisees and senior nursing leaders over an 8-month period and organized using standard programme evaluation themes. Benefits included supervisor conflict coaching competency and enhanced conflict communication competency for nurse managers and supervisees facing specific conflict situations. Challenges included the management of programme tensions. Additional benefits and challenges are discussed, along with study limitations. Conflict coaching was a practical and effective means of developing the conflict communication competencies of nurse managers and supervisees. Additional research is needed. Conflict is common in nursing. Conflict coaching is a new conflict communication and supervision intervention that demonstrates initial promise. Conflict coaching seems to work best when supported by a positive conflict culture and integrated with other conflict intervention processes. © 2010 The Author. Journal compilation © 2010 Blackwell Publishing Ltd.

A systematic review of interventions to increase awareness of mental health and well-being in athletes, coaches and officials.

PubMed

Breslin, Gavin; Shannon, Stephen; Haughey, Tandy; Donnelly, Paul; Leavey, Gerard

2017-08-31

The aim of the current study was to conduct a systematic review determining the effect of sport-specific mental health awareness programs to improve mental health knowledge and help-seeking among sports coaches, athletes and officials. The second aim was to review the study quality and to report on the validity of measures that were used to determine the effectiveness of programs. Sport-specific mental health awareness programs adopting an experimental or quasi-experimental design were included for synthesis. Six electronic databases were searched: PsycINFO, MEDLINE (OVID interface), Scopus, Cochrane, CINAHL and SPORTDiscus. Each database was searched from its year of inception to October 2016. Risk of bias was assessed using the Cochrane and QATSQ tools. Ten studies were included from the 1216 studies retrieved: four comprising coaches or service providers, one with officials, four with athletes, and one involved a combination of coaches and athletes. A range of outcomes was used to assess indices of mental health awareness and well-being. Mental health referral efficacy was improved in six studies, while three reported an increase in knowledge about mental health disorders. However, seven studies did not report effect sizes for their outcomes, limiting clinically meaningful interpretations. Furthermore, there was substantial heterogeneity and limited validity in the outcome measures of mental health knowledge and referral efficacy. Seven studies demonstrated a high risk of bias. Further, well-designed controlled intervention studies are required. Researchers, practitioners and policy makers should adhere to available methodological guidance and apply the psychological theory of behaviour change when developing and evaluating complex interventions. PROSPERO CRD42016040178.

A learning-based agent for home neurorehabilitation.

PubMed

Lydakis, Andreas; Meng, Yuanliang; Munroe, Christopher; Wu, Yi-Ning; Begum, Momotaz

2017-07-01

This paper presents the iterative development of an artificially intelligent system to promote home-based neurorehabilitation. Although proper, structured practice of rehabilitation exercises at home is the key to successful recovery of motor functions, there is no home-program out there which can monitor a patient's exercise-related activities and provide corrective feedback in real time. To this end, we designed a Learning from Demonstration (LfD) based home-rehabilitation framework that combines advanced robot learning algorithms with commercially available wearable technologies. The proposed system uses exercise-related motion information and electromyography signals (EMG) of a patient to train a Markov Decision Process (MDP). The trained MDP model can enable an agent to serve as a coach for a patient. On a system level, this is the first initiative, to the best of our knowledge, to employ LfD in an health-care application to enable lay users to program an intelligent system. From a rehabilitation research perspective, this is a completely novel initiative to employ machine learning to provide interactive corrective feedback to a patient in home settings.

Coaching for ADHD

ERIC Educational Resources Information Center

Murphy, Kevin; Ratey, Nancy; Maynard, Sandy; Sussman, Susan; Wright, Sarah D.

2010-01-01

Despite limited scientific study on ADHD coaching as an intervention for adults with ADHD, the field of ADHD coaching has grown significantly and gained popularity in recent years. ADHD coaching is becoming a bona fide profession where one must advance through a rigorous training process, in order to be certified as a professional ADHD coach.…

The Future of Home Health project: developing the framework for health care at home.

PubMed

Lee, Teresa; Schiller, Jennifer

2015-02-01

In addition to providing high-quality care to vulnerable patient populations, home healthcare offers the least costly option for patients and the healthcare system, particularly in postacute care. As the baby boom generation ages, policymakers are expressing concerns about rising costs, variation in home healthcare service use, and program integrity. The Alliance for Home Health Quality and Innovation seeks to develop a research-based strategic framework for the future of home healthcare for older Americans and those with disabilities. This article describes the initiative and invites readers to provide comments and suggestions.

42 CFR § 484.325 - Payments for home health services under Home Health Value-Based Purchasing (HHVBP) Model.

Code of Federal Regulations, 2010 CFR

2017-10-01

... Purchasing (HHVBP) Model. CMS will determine a payment adjustment up to the maximum applicable percentage... Total Performance Score using a linear exchange function. Payment adjustments made under the HHVBP Model... 42 Public Health 5 2017-10-01 2017-10-01 false Payments for home health services under Home Health...

42 CFR § 484.325 - Payments for home health services under Home Health Value-Based Purchasing (HHVBP) Model.

Code of Federal Regulations, 2010 CFR

2016-10-01

... Purchasing (HHVBP) Model. CMS will determine a payment adjustment up to the maximum applicable percentage... Total Performance Score using a linear exchange function. Payment adjustments made under the HHVBP Model... 42 Public Health 5 2016-10-01 2016-10-01 false Payments for home health services under Home Health...

Home Health Care With Telemonitoring Improves Health Status for Older Adults with Heart Failure

PubMed Central

Madigan, Elizabeth; Schmotzer, Brian J.; Struk, Cynthia J.; DiCarlo, Christina M.; Kikano, George; Piña, Ileana L.; Boxer, Rebecca S.

2014-01-01

Home telemonitoring can augment home health care services during a patient's transition from hospital to home. Home health care agencies commonly use telemonitors for patients with heart failure although studies have shown mixed results in the use of telemonitors to reduce rehospitalizations. This randomized trial investigated if older patients with heart failure admitted to home health care following a hospitalization would have a reduction in rehospitalizations and improved health status if they received telemonitoring. Patients were followed up to 180 days post-discharge from home health care services. Results showed no difference in the time to rehospitalizations or emergency visits between those who received a telemonitoring vs. usual care. Older heart failure patients who received telemonitoring had better health status by home health care discharge than those who received usual care. Therefore for older adults with heart failure telemonitoring may be important adjunct to home health care services to improve health status. PMID:23438509

Locating the Coaching Process in Practice: Models "for" and "of" Coaching

ERIC Educational Resources Information Center

Cushion, Christopher J.; Armour, Kathleen M.; Jones, Robyn L.

2006-01-01

Background: Despite an increasing recognition of the existence of a process of coaching, and a resulting increase in research activity, there remains a lack of a clear conceptual base for sports coaching. This situation has left coaching without a clear set of concepts and principles that reflect coaching practice. Purpose: The aim of this paper…

Nursing Assistant/Homemaker-Home Health Aide Component.

ERIC Educational Resources Information Center

East Hartford Board of Education, CT.

The demand for the services of homemaker-home health aides has increased tremendously. In one year, for example, the Visiting Nurse and Home Care Association of East Hartford, Connecticut, had a nearly 155 percent increase in the demand for homemaker-home health aide service. The East Hartford Public Schools developed a vocational program that…

Home Health Care

MedlinePlus

... neighbors, and your local Area Agency on Aging (AAA) to learn more about the home health care ... and assistance provider or Area Agency on Aging (AAA). For help connecting to these agencies, contact the ...

Transforming home health nursing with telehealth technology.

PubMed

Farrar, Francisca Cisneros

2015-06-01

Telehealth technology is an evidence-based delivery model tool that can be integrated into the plan of care for mental health patients. Telehealth technology empowers access to health care, can help decrease or prevent hospital readmissions, assist home health nurses provide shared decision making, and focuses on collaborative care. Telehealth and the recovery model have transformed the role of the home health nurse. Nurses need to be proactive and respond to rapidly emerging technologies that are transforming their role in home care. Copyright © 2015 Elsevier Inc. All rights reserved.

Private Investment Purchase and Nursing Home Financial Health

PubMed Central

Cadigan, Rebecca Orfaly; Stevenson, David G; Caudry, Daryl J; Grabowski, David C

2015-01-01

Objective To explore the impact of nursing home acquisition by private investment firms on nursing home costs, revenue, and overall financial health. Data Sources Merged data from the Medicare Cost Reports and the Online Survey, Certification, and Reporting system for the period 1998–2010. Study Design Regression specification incorporating facility and time fixed effects. Principal Findings We found little impact on the financial health of nursing homes following purchase by private investment companies. However, our findings did suggest that private investment firms acquired nursing home chains in good financial health, possibly to derive profit from the company’s real estate holdings. Conclusions Private investment acquired facilities are an important feature of today’s nursing home sector. Although we did not observe a negative impact on the financial health of nursing homes, this development raises important issues about ownership oversight and transparency for the entire nursing home sector. PMID:25104476

The "Health Coaching" programme: a new patient-centred and visually supported approach for health behaviour change in primary care.

PubMed

Neuner-Jehle, Stefan; Schmid, Margareta; Grüninger, Ueli

2013-07-17

Health related behaviour is an important determinant of chronic disease, with a high impact on public health. Motivating and assisting people to change their unfavourable health behaviour is thus a major challenge for health professionals. The objective of the study was to develop a structured programme of counselling in primary care practice, and to test its feasibility and acceptance among general practitioners (GPs) and their patients. Our new concept integrates change of roles, shared responsibility, patient-centredness, and modern communication techniques-such as motivational interviewing. A new colour-coded visual communication tool is used for the purpose of leading through the 4-step counselling process. As doctors' communication skills are crucial, communication training is a mandatory part of the programme. We tested the feasibility and acceptance of the "Health Coaching" programme with 20 GPs and 1045 patients, using questionnaires and semistructured interviewing techniques. The main outcomes were participation rates; the duration of counselling; patients' self-rated behavioural change in their areas of choice; and ratings of motivational, conceptual, acceptance, and feasibility issues. In total, 37% (n=350) of the patients enrolled in step 1 completed the entire 4-Step counselling process, with each step taking 8-22 minutes. 50% of ratings (n=303) improved by one or two categories in the three-colour circle, and the proportion of favourable health behaviour ratings increased from 9% to 39%. The ratings for motivation, concept, acceptance, and feasibility of the "Health Coaching" programme were consistently high. Our innovative, patient-centred counselling programme for health behaviour change was well accepted and feasible among patients and physicians in a primary care setting. Randomised controlled studies will have to establish cost-effectiveness and promote dissemination.

Home e-health system integration in the Smart Home through a common media server.

PubMed

Pau, I; Seoane, F; Lindecrantz, K; Valero, M A; Carracedo, J

2009-01-01

Home e-health systems and services are revealed as one of the most important challenges to promote Quality of Life related to Health in the Information Society. Leading companies have worked on e-health systems although the majority of them are addressed to hospital or primary care settings. The solution detailed in this paper offers a personal health system to be integrated with Smart Home services platform to support home based e-care. Thus, the home e-health system and architecture detailed in this research work is ready to supply a seamless personal care solution both from the biomedical data analysis, service provision, security guarantee and information management s point of view. The solution is ready to be integrated within the Accessible Digital Home, a living lab managed by Universidad Politécnica de Madrid for R&D activities.

Sex Discrimination in Coaching.

ERIC Educational Resources Information Center

Dessem, Lawrence

1980-01-01

Even in situations in which the underpayment of girls' coaches is due to the sex of the students coached rather than to the sex of the coaches, the coaches and the girls coached are victims of unlawful discrimination. Available from Harvard Women's Law Journal, Harvard Law School, Cambridge, MA 02138. (Author/IRT)

The Role of Physical and Health Educators and Coaches in the Prevention of Eating Disorders.

ERIC Educational Resources Information Center

Moriarty, Dick; And Others

All teachers, coaches, and guidance counselors should be concerned about eating disorders as a health and life threatening illness. While no reliable research studies or statistics exist on the incidence of eating disorders among athletes and aerobic exercisers, estimates suggest that 10-20% of the female high school population and a much higher…

Measuring and Assuring the Quality of Home Health Care

PubMed Central

Shaughnessy, Peter W.; Crisler, Kathryn S.; Schlenker, Robert E.; Arnold, Angela G.; Kramer, Andrew M.; Powell, Martha C.; Hittle, David F.

1994-01-01

The growth in home health care in the United States since 1970, and the exponential increase in the provision of Medicare-covered home health services over the past 5 years, underscores the critical need to assess the effectiveness of home health care in our society. This article presents conceptual and applied topics and approaches involved in assessing effectiveness through measuring the outcomes of home health care. Definitions are provided for a number of terms that relate to quality of care, outcome measures, risk adjustment, and quality assurance (QA) in home health care. The goal is to provide an overview of a potential systemwide approach to outcome-based QA that has its basis in a partnership between the home health industry and payers or regulators. PMID:10140157

42 CFR 424.22 - Requirements for home health services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 3 2014-10-01 2014-10-01 false Requirements for home health services. 424.22 Section 424.22 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Requirements § 424.22 Requirements for home health services. Medicare Part A or Part B pays for home health...

42 CFR 424.22 - Requirements for home health services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Requirements for home health services. 424.22 Section 424.22 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... § 424.22 Requirements for home health services. Medicare Part A or Part B pays for home health services...

42 CFR 424.22 - Requirements for home health services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 3 2012-10-01 2012-10-01 false Requirements for home health services. 424.22 Section 424.22 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Requirements § 424.22 Requirements for home health services. Medicare Part A or Part B pays for home health...

The Heart of Coaching

ERIC Educational Resources Information Center

Docheff, Dennis M.; Gerdes, Dan

2015-01-01

This article challenges coaches to address the more personal, human elements of coaching--the HEART of coaching. While there is much research on numerous aspects of coaching, this article provides ideas that make a lasting impact on the hearts of athletes. Using HEART as an acronym, five elements of effective coaching are presented: Humility,…

Addition of telephone coaching to a physiotherapist-delivered physical activity program in people with knee osteoarthritis: A randomised controlled trial protocol

PubMed Central

2012-01-01

Background Knee osteoarthritis (OA) is one of the most common and costly chronic musculoskeletal conditions world-wide and is associated with substantial pain and disability. Many people with knee OA also experience co-morbidities that further add to the OA burden. Uptake of and adherence to physical activity recommendations is suboptimal in this patient population, leading to poorer OA outcomes and greater impact of associated co-morbidities. This pragmatic randomised controlled trial will investigate the clinical- and cost-effectiveness of adding telephone coaching to a physiotherapist-delivered physical activity intervention for people with knee OA. Methods/Design 168 people with clinically diagnosed knee OA will be recruited from the community in metropolitan and regional areas and randomly allocated to physiotherapy only, or physiotherapy plus nurse-delivered telephone coaching. Physiotherapy involves five treatment sessions over 6 months, incorporating a home exercise program of 4–6 exercises (targeting knee extensor and hip abductor strength) and advice to increase daily physical activity. Telephone coaching comprises 6–12 telephone calls over 6 months by health practitioners trained in applying the Health Change Australia (HCA) Model of Health Change to provide behaviour change support. The telephone coaching intervention aims to maximise adherence to the physiotherapy program, as well as facilitate increased levels of participation in general physical activity. The primary outcomes are pain measured by an 11-point numeric rating scale and self-reported physical function measured by the Western Ontario and McMaster Universities Osteoarthritis Index subscale after 6 months. Secondary outcomes include physical activity levels, quality-of-life, and potential moderators and mediators of outcomes including self-efficacy, pain coping and depression. Relative cost-effectiveness will be determined from health service usage and outcome data. Follow

Development of HIHM (Home Integrated Health Monitor) for ubiquitous home healthcare.

PubMed

Kim, Jung Soo; Kim, Beom Oh; Park, Kwang Suk

2007-01-01

Home Integrated Health Monitor (HIHM) was developed for ubiquitous home healthcare. From quantitative analysis, we have elicited modal of chair. The HIHM could detect Electrocardiogram (ECG) and Photoplethysmography (PPG) non-intrusively. Also, it could estimate blood pressure (BP) non-intrusively, measure blood glucose and ear temperature. Detected signals and information were transmitted to home gateway and home server through Zigbee communication technology. Home server carried them to Healthcare Center, and specialists such as medical doctors could monitor by Internet. There was also feedback system. This device has a potential to study about ubiquitous home healthcare.

42 CFR 484.245 - Accelerated payments for home health agencies.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Accelerated payments for home health agencies. 484... HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION HOME HEALTH SERVICES Prospective Payment System for Home Health Agencies § 484.245 Accelerated payments for home health agencies. (a) General rule...

42 CFR 484.245 - Accelerated payments for home health agencies.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 5 2012-10-01 2012-10-01 false Accelerated payments for home health agencies. 484... HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION HOME HEALTH SERVICES Prospective Payment System for Home Health Agencies § 484.245 Accelerated payments for home health agencies. (a) General rule...

42 CFR 484.245 - Accelerated payments for home health agencies.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Accelerated payments for home health agencies. 484... HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION HOME HEALTH SERVICES Prospective Payment System for Home Health Agencies § 484.245 Accelerated payments for home health agencies. (a) General rule...

Nursing students' attitudes about home health nursing.

PubMed

Prestia, Mindy; Murphy, Susan; Yoder, Marian

2008-09-01

In an effort to address the home care nursing shortage, this pilot study was designed to measure nursing students' attitudes toward home health nursing and to test the Home Health Attitude Questionnaire developed specifically for this study based on the Theory of Planned Behavior. Senior undergraduate nursing students and registered nursing to bachelor of science in nursing students completed the questionnaire.

Assessing Commercially Available Personal Health Records for Home Health: Recommendations for Design.

PubMed

Kneale, Laura; Choi, Yong; Demiris, George

2016-01-01

Home health nurses and clients experience unmet information needs when transitioning from hospital to home health. Personal health records (PHRs) support consumer-centered information management activities. Previous work has assessed PHRs associated with healthcare providers, but these systems leave home health nurses unable to access necessary information. To evaluate the ability of publically available PHRs to accept, manage, and share information from a home health case study. Two researchers accessed the publically available PHRs on myPHR.com, and attempted to enter, manage, and share the case study data. We qualitatively described the PHR features, and identified gaps between the case study information and PHR functionality. Eighteen PHRs were identified in our initial search. Seven systems met our inclusion criteria, and are included in this review. The PHRs were able to accept basic medical information. Gaps occurred when entering, managing, and/or sharing data from the acute care and home health episodes. The PHRs that were reviewed were unable to effectively manage the case study information. Therefore, increasing consumer health literacy through these systems may be difficult. The PHRs that we reviewed were also unable to electronically share their data. The gap between the existing functionality and the information needs from the case study may make these PHRs difficult to use for home health environments. Additional work is needed to increase the functionality of the PHR systems to better fit the data needs of home health clients.

Healthful Homes for Urban Youths and Families

ERIC Educational Resources Information Center

Bothell, Joan; Gaudio, Mary-Margaret; Gray, Sharon

2017-01-01

The concept of a "healthful home" offers the basis for a comprehensive approach to addressing the well-established relationship between health and housing. Many environmental health hazards found in homes--such as lead, mold, environmental tobacco smoke, and pesticides--can be reduced or eliminated through the use of scientifically…

Coaching Conversations in Early Childhood Programs: The Contributions of Coach and Coachee

ERIC Educational Resources Information Center

Jayaraman, Gayatri; Marvin, Christine; Knoche, Lisa; Bainter, Sue

2015-01-01

Studies to date have linked early childhood (EC) coaching to child, family, and teacher outcomes but have not investigated "what" is happening in a coaching conversation. This exploratory study specifically unpacks nuances associated with the coaching conversation process and associations between the EC coaches' behaviors and coachees'…

Health patterns of cardiac surgery clients using home health care nursing services.

PubMed

Redeker, N S; Brassard, A B

1996-12-01

The purpose of this study was to examine the health patterns of cardiac surgical patients in the home health care population and their relationships to outcomes and duration of home health care using Gordon's Functional Health Pattern framework. Home health care records of 96 cardiac surgical clients were reviewed. Admission health pattern data, reasons for admission, duration and outcomes of home care services, characteristics of hospital experience, and demographic data were analyzed. Dysfunctional health patterns were primarily in the area of activity/exercise. The most common reasons for admission were monitoring of cardiopulmonary status, wound care, and instruction on diet, medications, and cardiac regimen. The mean duration of home care was 28.8 days. Thirty percent of the sample were readmitted to the hospital. Duration of home care was shorter for those who were married and for those who reported weakness, tiredness, or fatigue as a chief complaint. Readmission to the hospital was more likely for those who had complications during their initial hospital stay and those who required at least partial assistance with bathing, dressing, feeding, or toileting. Implications for practice and research are discussed.

Handball coaches' perceptions about the value of working competences according to their coaching background.

PubMed

Mesquita, Isabel; Borges, Mario; Rosado, Antonio; Souza, Adriano De

2011-01-01

The purpose of this study was to analyze the value attributed to given working competences, by Portuguese handball coaches according to their coaching background, certification level, coaching experience, and level of education. A sample of 207 handball coaches responded to a questionnaire which included demographic characteristics and a scale focused on perceptions of the level of importance attributed to working competences. Data analysis included an exploratory factorial analysis applying Maximum Likelihood Factoring (MLF) and Oblimin rotation. These factors were submitted to a One-way ANOVA and Tukey's post hoc multiple comparisons to analyse coaches' perceptions according to their coaching background. A six factor solution was found where three major domains of competences were highlighted; the first one related to training and competition (e.g. planning and conducting the training, team administration in competition, annual and multi-annual planning, and coaching methodology); the second one related to social and cultural issues and management (e.g. implementation of youth sport development projects, team leadership and coach education) and the third one related to the cognitive background (meta-cognitive competences). The importance ascribed to some working competences was influenced by their coaching experience and certification level. Highly experienced and qualified coaches perceived competences of everyday practice, social, cultural and management issues related to training and competition as more important than the other coaches. This study suggests the need to consider some working competences, until now not explicitly present in the Portuguese coaching education curriculum which could enable coaches to choose the best way to practice/work in a manner that will foster and support their professional development. Key pointsThree major domains of competences were highlighted by Portuguese handball coaches. The first one related to training and competition

Coaching and barriers to weight loss: an integrative review.

PubMed

Muñoz Obino, Karen Fernanda; Aguiar Pereira, Caroline; Caron-Lienert, Rafaela Siviero

2017-01-01

Coaching is proposed to raise a patient's awareness and responsibility for their health behaviour change by transforming the professional-patient relationship. To review the scientific literature on how coaching can assist in weight loss and improve a patient's state of health. An integrative literature search was performed using PubMed, Latin American and Caribbean Literature in Health Sciences, and Scientific Electronic Library Online. We selected articles that were published in Portuguese, English, and Spanish over the last 10 years. Data analysis was performed using a validated data collection instrument. Among the 289 articles identified in the search, 276 were excluded because they did not address the leading research question, their full texts were not available on the Internet, or they were duplicate publications. Therefore, for the analysis, we selected 13 articles that we classified as randomized clinical studies (46.15%; n=6), cohort studies (30.76%; n=4), cross-sectional studies (7.69%; n=1), case studies (7.69%; n=1), and review articles (7.69%; n=1). Joint intervention (combined in-person and telecoaching sessions) constituted the majority of session types. The use of technical coaching was superior in reducing anthropometric measurements and increasing the levels of motivation and personal satisfaction compared with formal health education alone. Coaching is an efficient, cost-effective method for combining formal education and treatment of health in the weight-loss process. Additional randomized studies are needed to demonstrate its effectiveness with respect to chronic disease indicators.

Is home health care a substitute for hospital care?

PubMed

Lichtenberg, Frank R

2012-01-01

A previous study used aggregate (region-level) data to investigate whether home health care serves as a substitute for inpatient hospital care and concluded that "there is no evidence that services provided at home replace hospital services." However, that study was based on a cross-section of regions observed at a single point of time and did not control for unobserved regional heterogeneity. In this article, state-level employment data are used to reexamine whether home health care serves as a substitute for inpatient hospital care. This analysis is based on longitudinal (panel) data--observations on states in two time periods--which enable the reduction or elimination of biases that arise from use of cross-sectional data. This study finds that states that had higher home health care employment growth during the period 1998-2008 tended to have lower hospital employment growth, controlling for changes in population. Moreover, states that had higher home health care payroll growth tended to have lower hospital payroll growth. The estimates indicate that the reduction in hospital payroll associated with a $1,000 increase in home health payroll is not less than $1,542, and may be as high as $2,315. This study does not find a significant relationship between growth in utilization of home health care and growth in utilization of nursing and residential care facilities. An important reason why home health care may serve as a substitute for hospital care is that the availability of home health care may allow patients to be discharged from the hospital earlier. Hospital discharge data from the Healthcare Cost and Utilization Project are used to test the hypothesis that use of home health care reduces the length of hospital stays. Major Diagnostic Categories with larger increases in the fraction of patients discharged to home health care tended to have larger declines in mean length of stay (LOS). Between 1998 and 2008, mean LOS declined by 4.1%, from 4.78 to 4.59 days

Participant perspectives of a 6-month telephone-based lifestyle coaching program.

PubMed

McGill, Bronwyn; O'Hara, Blythe J; Phongsavan, Philayrath

2018-06-14

Objectives and importance of study: Low program completion rates can undermine the public health impact of even the most effective program. Participant experiences with lifestyle programs are not well reported, but are important for program improvement and retention. The purpose of this study was to understand participant perceptions of the Get Healthy Information and Coaching Service (GHS), a 6-month telephone-based health coaching program to promote lifestyle change. We were particularly interested in participants' initial expectations, their actual experience and, for those who did not complete the program, what influenced their withdrawal. The study included qualitative semistructured interviews and a quantitative sociodemographic survey. A random sample of GHS participants (n = 59) was recruited to take part in semistructured interviews about their perceptions and experiences of the coaching program. Researchers conducted independent thematic analysis of the interview transcripts. Sociodemographic details were obtained from a quantitative survey of all GHS participants. Participants expected that coaching would provide support, information and motivation, and would hold them accountable. Coach support was the most valued aspect of the participants' experience. Despite high attrition rates, participants were mostly positive about their coaching experience. Service structure or individual circumstances, rather than the program itself, were the main reasons for withdrawal. A positive coaching experience was underpinned by good participant-coach rapport, which facilitated participant adherence and motivation to achieve their goals and complete the program. It is possible that participants who start to achieve their goals are motivated to continue with the program, and that their motivation moves from relying on their coach to being more intrinsically motivated. Reasons for high attrition provide insights into the coaching structure and process, and suggest that

Teacher Consultation and Coaching within Mental Health Practice: Classroom and Child Effects in Urban Elementary Schools

ERIC Educational Resources Information Center

Cappella, Elise; Hamre, Bridget K.; Kim, Ha Yeon; Henry, David B.; Frazier, Stacy L.; Atkins, Marc S.; Schoenwald, Sonja K.

2012-01-01

Objective: To examine effects of a teacher consultation and coaching program delivered by school and community mental health professionals on change in observed classroom interactions and child functioning across one school year. Method: Thirty-six classrooms within 5 urban elementary schools (87% Latino, 11% Black) were randomly assigned to…

Home Health Care: What It Is and What to Expect

MedlinePlus

... care + Share widget - Select to show What’s home health care? What's home health care? Home health care is a wide range of ... listed. What should I expect from my home health care? Doctor’s orders are needed to start care. Once ...

Comparison of Long-term Care in Nursing Homes Versus Home Health: Costs and Outcomes in Alabama.

PubMed

Blackburn, Justin; Locher, Julie L; Kilgore, Meredith L

2016-04-01

To compare acute care outcomes and costs among nursing home residents with community-dwelling home health recipients. A matched retrospective cohort study of Alabamians aged more than or equal to 65 years admitted to a nursing home or home health between March 31, 2007 and December 31, 2008 (N = 1,291 pairs). Medicare claims were compared up to one year after admission into either setting. Death, emergency department and inpatient visits, inpatient length of stay, and acute care costs were compared using t tests. Medicaid long-term care costs were compared for a subset of matched beneficiaries. After one year, 77.7% of home health beneficiaries were alive compared with 76.2% of nursing home beneficiaries (p < .001). Home health beneficiaries averaged 0.2 hospital visits and 0.1 emergency department visits more than nursing home beneficiaries, differences that were statistically significant. Overall acute care costs were not statistically different; home health beneficiaries' costs averaged $31,423, nursing home beneficiaries' $32,239 (p = .5032). Among 426 dual-eligible pairs, Medicaid long-term care costs averaged $4,582 greater for nursing home residents (p < .001). Using data from Medicare claims, beneficiaries with similar functional status, medical diagnosis history, and demographics had similar acute care costs regardless of whether they were admitted to a nursing home or home health care. Additional research controlling for exogenous factors relating to long-term care decisions is needed. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Coaching Considerations: FAQs Useful in the Development of Literacy Coaching

ERIC Educational Resources Information Center

Fisher, Douglas

2012-01-01

The National Advisory Board for the Literacy Coaching Clearinghouse have identified a number of considerations that it believed needed further discussion as schools, districts, and states embrace literacy coaching. It negotiated and discussed a number of issues surrounding coaching and agreed on 10 key ideas that should be part of the discussions…

The Anatomy of Coaching: Coaching through Storytelling

ERIC Educational Resources Information Center

Blackstone, Phyllis A.

2007-01-01

In this article, the author posits that storytelling can be used as a method for developing positive interpersonal relationships between coaches and classroom teachers. The author argues that developing interpersonal relationships is a necessary but challenging aspect of successful coaching, and that storytelling offers a mechanism for greater…

Integrating Economic Strengthening and Family Coaching to Reduce Work-Related Health Hazards Among Children of Poor Households: Burkina Faso.

PubMed

Karimli, Leyla; Rost, Lucia; Ismayilova, Leyla

2018-01-01

This is the first randomized controlled trial in Burkina Faso testing the effect of economic strengthening alone and in combination with family coaching on child's hazardous work and work-related health outcomes. The study also tests the association between different forms of hazardous work and child's health outcomes. A total of 360 households from 12 villages participated in the study. Villages were randomly assigned to three study arms: economic intervention alone, economic intervention integrated with family coaching, and control. In each household, one female caregiver and one child aged 10-15 years were interviewed. Data were collected at baseline, 12 months, and 24 months. We ran multilevel mixed-effects models that account for both within-individual correlation over time and clustering of subjects within villages. Compared with the control group, at 24 months, children in the integrated arm experienced significant reduction in exposure to hazardous work and some forms of hazards and abuse. Results for children in the economic strengthening-only arm were more modest. In most cases, child's health was significantly associated not with specific forms of work per se, but with child's exposure to hazards and abuse while doing this form of work. We found no significant effect of intervention on child's work-related health. Economic strengthening combined with family coaching on child protection issues, rather than implemented alone, may be more effective in reducing child's exposure to hazardous work. Additional research is needed to understand gender differences and causal links between different forms of child work and health hazards. Copyright © 2017. Published by Elsevier Inc.

Improving Adherence to Essential Birth Practices Using the WHO Safe Childbirth Checklist With Peer Coaching: Experience From 60 Public Health Facilities in Uttar Pradesh, India

PubMed Central

Marx Delaney, Megan; Maji, Pinki; Kalita, Tapan; Kara, Nabihah; Rana, Darpan; Kumar, Krishan; Masoinneuve, Jenny; Cousens, Simon; Gawande, Atul A; Kumar, Vishwajeet; Kodkany, Bhala; Sharma, Narender; Saurastri, Rajiv; Pratap Singh, Vinay; Hirschhorn, Lisa R; Semrau, Katherine EA; Firestone, Rebecca

2017-01-01

Background: Adherence to evidence-based essential birth practices is critical for improving health outcomes for mothers and newborns. The WHO Safe Childbirth Checklist (SCC) incorporates these practices, which occur during 4 critical pause points: on admission, before pushing (or cesarean delivery), soon after birth, and before discharge. A peer-coaching strategy to support consistent use of the SCC may be an effective approach to increase birth attendants' adherence to these practices. Methods: We assessed data from 60 public health facilities in Uttar Pradesh, India, that received an 8-month staggered coaching intervention from December 2014 to September 2016 as part of the BetterBirth Trial, which is studying effectiveness of an SCC-centered intervention on maternal and neonatal harm. Nurse coaches recorded birth attendants' adherence to 39 essential birth practices. Practice adherence was calculated for each intervention month. After 2 months of coaching, a subsample of 15 facilities was selected for independent observation when the coach was not present. We compared adherence to the 18 practices recorded by both coaches and independent observers. Results: Coaches observed birth attendants' behavior during 5,971 deliveries. By the final month of the intervention, 35 of 39 essential birth practices had achieved >90% adherence in the presence of a coach, compared with only 7 of 39 practices during the first month. Key behaviors with the greatest improvement included explanation of danger signs, temperature measurement, assessment of fetal heart sounds, initiation of skin-to-skin contact, and breastfeeding. Without a coach present, birth attendants' average adherence to practices and checklist use was 24 percentage points lower than when a coach was present (range: −1% to 62%). Conclusion: Implementation of the WHO Safe Childbirth Checklist with coaching improved uptake of and adherence to essential birth practices. Coordination and communication among facility

Credentialed Chefs as Certified Wellness Coaches: Call for Action.

PubMed

Polak, Rani; Sforzo, Gary A; Dill, Diana; Phillips, Edward M; Moore, Margaret

2015-12-01

Beneficial relationships exist between food preparation skills and improved dietary quality, and between times spent preparing food and mortality. Food shopping, meal planning, preparation and cooking skills are valuable in supporting good health. Thus experts are proposing nutritional counseling be expanded to include these beneficial behavioral skills. Educational programs delivered by chefs have recently emerged as a way to improve engagement with nutritional guidelines. It is reasonable to assume that a chef with behavior change knowledge and skills, such as coaching, may be more effective in facilitating behavior change. We encourage chefs who wish to be involved in promoting health-related behavior change to consider continuing education in coaching knowledge and skills. We also recommend culinary schools to consider offering these courses, to aspiring chefs. Such programming will not only benefit future clients but also offers a career- enriching professional opportunity to chefs. Credentialed chefs can make a positive health impact and should be included as professionals who are eligible for the impending national certification of health and wellness coaches. Copyright © 2015. Published by Elsevier Ltd.

Constraining Medicare Home Health Reimbursement: What Are the Outcomes?

PubMed Central

McCall, Nelda; Korb, Jodi; Petersons, Andrew; Moore, Stanley

2002-01-01

The implementation of the Balanced Budget Act (BBA) of 1997 resulted in substantial decreases in the amount of Medicare home health use. Use among home health users decreased by two-fifths from fiscal year (FY) 1997, just before the passage of the BBA to FY 1999, the first full year after the implementation of the home health interim payment system. This article examines whether these dramatic reductions in use resulted in increased incidence of potential adverse outcomes, i.e., increases in hospitalizations, skilled nursing home facility admissions, emergency room (ER) use, or death among home health users. PMID:12690695

Health promotion for patients with diabetes: health coaching or formal health education?

PubMed

Basak Cinar, Ayse; Schou, Lone

2014-02-01

The purpose of this study was to determine if a Health Coaching (HC) approach compared with formal health education (HE) resulted in better health outcomes among type II diabetes (T2DM) patients in improving glycaemic control and oral health, by use of clinical and subjective outcome measures. The study is part of a prospective intervention among randomly selected T2DM patients (n = 186) in Istanbul, Turkey. The data analysed were clinical [glycated haemoglobin (HbA(1C)), clinical attachment loss (CAL)] and psychological measures [tooth-brushing self efficacy (TBSES)]. Data were collected initially and at the end of intervention. Participants were allocated randomly to HC (intervention) (n = 77) and HE (control) (n = 111) groups. At baseline, there was no statistical difference between HC and HE regarding clinical and psychological measures, (P > 0.05). At post-intervention the HC group had significantly lower HBA(1C) and CAL (reduction: 7%, 56%) than the HE group (reduction: HbA(1C) 0%; CAL 26%), (P ≤ 0.01). Similarly, HC group, compared with HE group, had better TBSES (increase: 61% vs. 25%) and stress (reduction: 16% vs. 1%), (P ≤ 0.01). Among high-risk group patients, the HC patients had significant improvements compared with the HE group (reduction: HbA(1C) 16% vs. 5%; CAL 63% vs. 18%; stress 39% vs. 2%; fold increase: TBSES 6.6 vs. 3.6) (P ≤ 0.01). The present findings may imply that HC has a significantly greater impact on better management of oral health and glycaemic control than HE. It is notable that the impact was more significant among high-risk group patients, thus HC may be recommended especially for high-risk group patients. © 2013 FDI World Dental Federation.

Primary prevention of stroke and cardiovascular disease in the community (PREVENTS): Methodology of a health wellness coaching intervention to reduce stroke and cardiovascular disease risk, a randomized clinical trial.

PubMed

Mahon, Susan; Krishnamurthi, Rita; Vandal, Alain; Witt, Emma; Barker-Collo, Suzanne; Parmar, Priya; Theadom, Alice; Barber, Alan; Arroll, Bruce; Rush, Elaine; Elder, Hinemoa; Dyer, Jesse; Feigin, Valery

2018-02-01

Rationale Stroke is a major cause of death and disability worldwide, yet 80% of strokes can be prevented through modifications of risk factors and lifestyle and by medication. While management strategies for primary stroke prevention in high cardiovascular disease risk individuals are well established, they are underutilized and existing practice of primary stroke prevention are inadequate. Behavioral interventions are emerging as highly promising strategies to improve cardiovascular disease risk factor management. Health Wellness Coaching is an innovative, patient-focused and cost-effective, multidimensional psychological intervention designed to motivate participants to adhere to recommended medication and lifestyle changes and has been shown to improve health and enhance well-being. Aims and/or hypothesis To determine the effectiveness of Health Wellness Coaching for primary stroke prevention in an ethnically diverse sample including Māori, Pacific Island, New Zealand European and Asian participants. Design A parallel, prospective, randomized, open-treatment, single-blinded end-point trial. Participants include 320 adults with absolute five-year cardiovascular disease risk ≥ 10%, calculated using the PREDICT web-based clinical tool. Randomization will be to Health Wellness Coaching or usual care groups. Participants randomized to Health Wellness Coaching will receive 15 coaching sessions over nine months. Study outcomes A substantial relative risk reduction of five-year cardiovascular disease risk at nine months post-randomization, which is defined as 10% relative risk reduction among those at moderate five-year cardiovascular disease risk (10-15%) and 25% among those at high risk (>15%). Discussion This clinical trial will determine whether Health Wellness Coaching is an effective intervention for reducing modifiable risk factors, and hence decrease the risk of stroke and cardiovascular disease.

Examination of the Relationship between Coaching Efficacy and Conflict Management Style in Soccer Coaches

ERIC Educational Resources Information Center

Balyan, Melih

2018-01-01

The purpose of the present study was to examine the relationship between coaching efficacy and conflict management style of the soccer coaches. The sample included 224 male soccer coaches ranging in coaching experience from 2 to 15 years. The Coaching Efficacy Scale and The Rahim Organizational Conflict Inventory were used to measure coaching…

3 Steps to Great Coaching: A Simple but Powerful Instructional Coaching Cycle Nets Results

ERIC Educational Resources Information Center

Knight, Jim; Elford, Marti; Hock, Michael; Dunekack, Devona; Bradley, Barbara; Deshler, Donald D.; Knight, David

2015-01-01

In this article the authors describe a three-step instructional coaching cycle that can helps coaches become more effective. The article provides the steps and related components to: (1) Identify; (2) Learn; and (3) Improve. While the instructional coaching cycle is only one effective coaching program, coaches also need professional learning that…

Key Components in eHealth Interventions Combining Self-Tracking and Persuasive eCoaching to Promote a Healthier Lifestyle: A Scoping Review

PubMed Central

Oldenhuis, Hilbrand KE; de Groot, Martijn; Polstra, Louis; Velthuijsen, Hugo; van Gemert-Pijnen, Julia EWC

2017-01-01

Background The combination of self-tracking and persuasive eCoaching in automated interventions is a new and promising approach for healthy lifestyle management. Objective The aim of this study was to identify key components of self-tracking and persuasive eCoaching in automated healthy lifestyle interventions that contribute to their effectiveness on health outcomes, usability, and adherence. A secondary aim was to identify the way in which these key components should be designed to contribute to improved health outcomes, usability, and adherence. Methods The scoping review methodology proposed by Arskey and O’Malley was applied. Scopus, EMBASE, PsycINFO, and PubMed were searched for publications dated from January 1, 2013 to January 31, 2016 that included (1) self-tracking, (2) persuasive eCoaching, and (3) healthy lifestyle intervention. Results The search resulted in 32 publications, 17 of which provided results regarding the effect on health outcomes, 27 of which provided results regarding usability, and 13 of which provided results regarding adherence. Among the 32 publications, 27 described an intervention. The most commonly applied persuasive eCoaching components in the described interventions were personalization (n=24), suggestion (n=19), goal-setting (n=17), simulation (n=17), and reminders (n=15). As for self-tracking components, most interventions utilized an accelerometer to measure steps (n=11). Furthermore, the medium through which the user could access the intervention was usually a mobile phone (n=10). The following key components and their specific design seem to influence both health outcomes and usability in a positive way: reduction by setting short-term goals to eventually reach long-term goals, personalization of goals, praise messages, reminders to input self-tracking data into the technology, use of validity-tested devices, integration of self-tracking and persuasive eCoaching, and provision of face-to-face instructions during

Psychological support for sport coaches: an exploration of practitioner psychologist perspectives.

PubMed

Kelly, Sarah; Thelwell, Richard; Barker, Jamie B; Harwood, Chris G

2018-08-01

In the present study we add to the literature by exploring the degree to which UK practitioner psychologists perceive themselves able to support sport coaches, and how professional training prepares psychologists for coach work across performance domains. Ten participants comprising seven sport and exercise psychologists with Health Care Professions Council (HCPC) practitioner psychologist status and three trainee psychologists studying towards the British Psychological Society (BPS) qualification in sport and exercise psychology (QSEP) were individually interviewed. All participants reported prior experience of working with coaches across all performance domains. We explored: practitioner's understanding of the challenges coaches face within their job; practitioner's experiences of coach work; perspectives about the ways in which practitioners could and should support coaches; and, the degree to which professional training prepares practitioners for coach work. Using recommended procedures of Connelly and Peltzer, content analysis revealed practitioners perceived the challenges faced by coaches are different at grassroots level compared to those working with elite athletes, and that practitioners require skills to provide one-to-one coach support and group-based interventions. All practitioners perceived that training programmes do not adequately equip trainees with skills required for coach work. We discuss the implications for enhancing practitioner training in the UK.

Coaching and barriers to weight loss: an integrative review

PubMed Central

Muñoz Obino, Karen Fernanda; Aguiar Pereira, Caroline; Caron-Lienert, Rafaela Siviero

2017-01-01

Introduction Coaching is proposed to raise a patient’s awareness and responsibility for their health behaviour change by transforming the professional–patient relationship. Objective To review the scientific literature on how coaching can assist in weight loss and improve a patient’s state of health. Methodology An integrative literature search was performed using PubMed, Latin American and Caribbean Literature in Health Sciences, and Scientific Electronic Library Online. We selected articles that were published in Portuguese, English, and Spanish over the last 10 years. Data analysis was performed using a validated data collection instrument. Results Among the 289 articles identified in the search, 276 were excluded because they did not address the leading research question, their full texts were not available on the Internet, or they were duplicate publications. Therefore, for the analysis, we selected 13 articles that we classified as randomized clinical studies (46.15%; n=6), cohort studies (30.76%; n=4), cross-sectional studies (7.69%; n=1), case studies (7.69%; n=1), and review articles (7.69%; n=1). Joint intervention (combined in-person and telecoaching sessions) constituted the majority of session types. The use of technical coaching was superior in reducing anthropometric measurements and increasing the levels of motivation and personal satisfaction compared with formal health education alone. Conclusion Coaching is an efficient, cost-effective method for combining formal education and treatment of health in the weight-loss process. Additional randomized studies are needed to demonstrate its effectiveness with respect to chronic disease indicators. PMID:28096687

Improving care transitions from hospital to home: standardized orders for home health nursing with remote telemonitoring.

PubMed

Heeke, Sheila; Wood, Felecia; Schuck, Jennifer

2014-01-01

A task force at a multihospital health care system partnered with home health agencies to improve gaps during the discharge transition process. A standardized order template for home health nursing and remote telemonitoring was developed to decrease discrepancies in communication between hospital health care providers and home health nurses caring for patients with heart failure. Pilot results showed significantly improved communication with no readmissions, using the order template.

The Impact of Certificate-of-Need Laws on Nursing Home and Home Health Care Expenditures.

PubMed

Rahman, Momotazur; Galarraga, Omar; Zinn, Jacqueline S; Grabowski, David C; Mor, Vincent

2016-02-01

Over the past two decades, nursing homes and home health care agencies have been influenced by several Medicare and Medicaid policy changes including the adoption of prospective payment for Medicare-paid postacute care and Medicaid-paid long-term home and community-based care reforms. This article examines how spending growth in these sectors was affected by state certificate-of-need (CON) laws, which were designed to limit the growth of providers and have remained unchanged for several decades. Compared with states without CON laws, Medicare and Medicaid spending in states with CON laws grew faster for nursing home care and more slowly for home health care. In particular, we observed the slowest growth in community-based care in states with CON for both the nursing home and home health industries. Thus, controlling for other factors, public postacute and long-term care expenditures in CON states have become dominated by nursing homes. © The Author(s) 2015.

The Impact of Certificate-of-Need Laws on Nursing Home and Home Health Care Expenditures

PubMed Central

Rahman, Momotazur; Galarraga, Omar; Zinn, Jacqueline S.; Grabowski, David C.; Mor, Vincent

2016-01-01

Over the past two decades, nursing homes and home health care agencies have been influenced by several Medicare and Medicaid policy changes including the adoption of prospective payment for Medicare-paid postacute care and Medicaid-paid long-term home and community-based care reforms. This article examines how spending growth in these sectors was affected by state certificate-of-need (CON) laws, which were designed to limit the growth of providers and have remained unchanged for several decades. Compared with states without CON laws, Medicare and Medicaid spending in states with CON laws grew faster for nursing home care and more slowly for home health care. In particular, we observed the slowest growth in community-based care in states with CON for both the nursing home and home health industries. Thus, controlling for other factors, public postacute and long-term care expenditures in CON states have become dominated by nursing homes. PMID:26223431

Mobile Web-Based Monitoring and Coaching: Feasibility in Chronic Migraine

PubMed Central

Mak, Sander B; Houtveen, Jan H; Kleiboer, Annet M; van Doornen, Lorenz JP

2007-01-01

Background The Internet can facilitate diary monitoring (experience sampling, ecological momentary assessment) and behavioral coaching. Online digital assistance (ODA) is a generic tool for mobile Web-based use, intended as an adjuvant to face-to-face or Internet-based cognitive behavioral treatment. A current ODA application was designed to support home-based training of behavioral attack prevention in chronic migraine, focusing on the identification of attack precursors and the support of preventive health behaviour. Objective The aim was to establish feasibility of the ODA approach in terms of technical problems and participant compliance, and ODA acceptability on the basis of ratings of user-friendliness, potential burden, and perceived support of the training for behavioral attack prevention in migraine. Methods ODA combines mobile electronic diary monitoring with direct human online coaching of health behavior according to the information from the diary. The diary contains three parts covering the following: (1) migraine headache and medication use, (2) attack precursors, and (3) self-relaxation and other preventive behavior; in addition, menstruation (assessed in the evening diary) and disturbed sleep (assessed in the morning diary) is monitored. The pilot study consisted of two runs conducted with a total of five women with chronic migraine without aura. ODA was tested for 8.5 days (range 4-12 days) per participant. The first test run with three participants tested 4-5 diary prompts per day. The second run with another three participants (including one subject who participated in both runs) tested a reduced prompting scheme (2-3 prompts per day) and minor adaptations to the diary. Online coaching was executed twice daily on workdays. Results ODA feasibility was established on the basis of acceptable data loss (1.2% due to the personal digital assistant; 5.6% due to failing Internet transmission) and good participant compliance (86.8% in the second run). Run

Becoming a "Good Coach"

ERIC Educational Resources Information Center

Jacobs, Frank; Claringbould, Inge; Knoppers, Annelies

2016-01-01

The purpose of this paper was to gain insight into how coaches problematized their coaching practices and the process in which they engaged to become what they perceived to be better coaches using a course based on critical reflective practice. We assumed that constant critical self-reflection would enable coaches to move closer to their…

The Coach-of-Coaches Model for Preparing Rural Special Education Teachers.

ERIC Educational Resources Information Center

Cegelka, Patricia Thomas; Fitch, Suzanne; Alvarado, Jose Luis

San Diego State University (California) has developed a coach-of-coaches model of providing support, assistance, and supervision to intern-teachers in its rural special education alternative credential program. Coaches, who are fully credentialed teachers with supervisory skills, make a minimum of nine direct and indirect (video analysis)…

Environmental Health and Safety Hazards Experienced by Home Health Care Providers

PubMed Central

Polivka, Barbara J.; Wills, Celia E.; Darragh, Amy; Lavender, Steven; Sommerich, Carolyn; Stredney, Donald

2015-01-01

The number of personnel providing in-home health care services is increasing substantially. The unique configuration of environmental hazards in individual client homes has a significant impact on the safety and health of home health care providers (HHPs). This mixed-methods study used data from a standardized questionnaire, focus groups, and individual interviews to explore environmental health and safety hazards encountered by HHPs in client homes. The participant sample (N = 68) included nurses, aides, therapists, and owners/managers from a variety of geographic locations. The most often-reported hazards were trip/slip/lift hazards, biohazards, and hazards from poor air quality, allergens, pests and rodents, and fire and burns. Frequency of identified key hazards varied by room, that is, kitchen (e.g., throw rugs, water on floor), bathroom (e.g., tight spaces for client handling), bedroom (e.g., bed too low), living room (e.g., animal waste), and hallway (e.g., clutter). Findings indicate the need for broader training to enable HHPs to identify and address hazards they encounter in client homes. PMID:26268486

Funding a Health Disparities Research Agenda: The Case of Medicare Home Health Care

ERIC Educational Resources Information Center

Davitt, Joan K.

2014-01-01

Medicare home health care provides critical skilled nursing and therapy services to patients in their homes, generally after a period in an inpatient facility or nursing home. Disparities in access to, or outcomes of, home health care can result in patient deterioration and increased cost to the Medicare program if patient care needs intensify.…

Secondary Mathematics Coaching: The Components of Effective Mathematics Coaching and Implications

ERIC Educational Resources Information Center

Bengo, Priscilla

2016-01-01

Mathematics coaching, which can be defined broadly as job-embedded learning for mathematics teachers with someone who can help, is being used in Canada to improve teaching practice and increase student achievement. Mathematics coaching research is quite new with little written on the components of effective coaching. The paper attempts to…

Implementing a Coach-Delivered Dating Violence Prevention Program with High School Athletes.

PubMed

Jaime, Maria Catrina D; McCauley, Heather L; Tancredi, Daniel J; Decker, Michele R; Silverman, Jay G; O'Connor, Brian; Miller, Elizabeth

2018-05-10

Teen dating violence and sexual violence are severe public health problems. Abusive behaviors within the context of dating or romantic relationships are associated with adverse health outcomes. Promoting positive bystander intervention and increasing knowledge of abusive behaviors are promising strategies for preventing dating and sexual violence. Coaching Boys Into Men (CBIM) is an evidence-based, athletic coach-delivered dating violence prevention program that has been shown to increase positive bystander behaviors and reduce abuse perpetration among high school male athletes. Identifying specific barriers and facilitators based on the coaches' experiences with program delivery combined with the coaches' and athletes' program perceptions may help optimize future CBIM implementation and sustainability. Semi-structured interviews with coaches (n = 36) explored the implementers' perspectives on strategies that worked well and potential barriers to program implementation. Ten focus groups with male athletes (n = 39) assessed their experiences with CBIM and the suitability of having their coaches deliver this program. Coaches described using the CBIM training cards and integrating program delivery during practice. Athletes reported coaches routinely delivering the CBIM program and adding their own personal stories or examples to the discussions. Key facilitators to program implementation include support from the violence prevention advocate, the ease of integrating CBIM into the sports season, and using the program materials. Barriers to implementation included finding sufficient time for the program, dynamics of delivering sensitive program content, and participant constraints. Coaches and athletes alike found the program feasible and acceptable to implement within the sports setting. Both coaches and athletes offered insights on the implementation and the feasibility and acceptability of CBIM within school-based athletic programs. These experiences by

Coach Education and Continuing Professional Development: Experience and Learning to Coach

ERIC Educational Resources Information Center

Cushion, Christopher J.; Armour, Kathy M.; Jones, Robyn L.

2003-01-01

Research over the last decade has demonstrated that it is experience and the observation of other coaches that remain the primary sources of knowledge for coaches. Despite this, coach education and continuing professional development fail to draw effectively on this experience. Using the work of Pierre Bourdieu, this paper attempts to understand…

A multidimensional approach to case mix for home health services.

PubMed

Manton, K G; Hausner, T

1987-01-01

Developing a case-mix methodology for home health services is more difficult than developing one for hospitalization and acute health services, because the determinants of need for home health care are more complex and because of the difficulty in defining episodes of care. To evaluate home health service case mix, a multivariate grouping methodology was applied to records from the 1982 National Long-Term Care Survey linked to Medicare records on home health reimbursements. Using this method, six distinct health and functional status dimensions were identified. These dimensions, combined with factors describing informal care resources and local market conditions, were used to explain significant proportions of the variance (r2 = .45) of individual differences in Medicare home health reimbursements and numbers of visits. Though the data were not collected for that purpose, the high level of prediction strongly suggests the feasibility of developing case-mix strategies for home health services.

Improving the Quality of Home Health Care for Children With Medical Complexity.

PubMed

Nageswaran, Savithri; Golden, Shannon L

2017-08-01

The objectives of this study are to describe the quality of home health care services for children with medical complexity, identify barriers to delivering optimal home health care, and discuss potential solutions to improve home health care delivery. In this qualitative study, we conducted 20 semistructured in-depth interviews with primary caregivers of children with medical complexity, and 4 focus groups with 18 home health nurses. During an iterative analysis process, we identified themes related to quality of home health care. There is substantial variability between home health nurses in the delivery of home health care to children. Lack of skills in nurses is common and has serious negative health consequences for children with medical complexity, including hospitalizations, emergency room visits, and need for medical procedures. Inadequate home health care also contributes to caregiver burden. A major barrier to delivering optimal home health care is the lack of training of home health nurses in pediatric care and technology use. Potential solutions for improving care include home health agencies training nurses in the care of children with medical complexity, support for nurses in clinical problem solving, and reimbursement for training nurses in pediatric home care. Caregiver-level interventions includes preparation of caregivers about: providing medical care for their children at home and addressing problems with home health care services. There are problems in the quality of home health care delivered to children with medical complexity. Training nurses in the care of children with medical complexity and preparing caregivers about home care could improve home health care quality. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

In Pursuit of Becoming a Senior Coach: The Learning Culture for Australian Football League Coaches

ERIC Educational Resources Information Center

Mallett, Clifford J.; Rossi, Tony; Rynne, Steven B.; Tinning, Richard

2016-01-01

Background and Purpose: Given the turbulent and highly contested environment in which professional coaches work, a prime concern to coach developers is how coaches learn their craft. Understanding the learning and development of senior coaches (SCs) and assistant coaches (ACs) in the Australian Football League (AFL--the peak organisation for…

Managerial Coaching

ERIC Educational Resources Information Center

Bommelje, Rick

2015-01-01

This chapter explores how coaching equips managers and supervisors to be successful in the 21st-century workplace. Coaching has benefited these professionals by providing them with viable tools to enhance the leadership and managerial tools they already possess.

Nurses' Home Health Experience. Part I: The Practice Setting.

ERIC Educational Resources Information Center

Stulginsky, Maryfran McKenzie

1993-01-01

Defines home health nursing as meeting the acute and chronic care needs of patients and their families in the home environment. Offers examples of situations in which home health nurses find themselves and their reactions to them. (JOW)

Is home health technology adequate for proactive self-care?

PubMed

Horwitz, C M; Mueller, M; Wiley, D; Tentler, A; Bocko, M; Chen, L; Leibovici, A; Quinn, J; Shar, A; Pentland, A P

2008-01-01

To understand whether home health technology in the market and in development can satisfy the needs of patients and their non-professional caregivers for proactive support in managing health and chronic conditions in the home. A panel of clinical providers and technology researchers was assembled to examine whether home health technology addresses consumer-defined requirements for self-care devices. A lexicon of home care and self-care technology terms was then created. A global survey of home health technology for patients with heart disease and dementia was conducted. The 254 items identified were categorized by conditions treated, primary user, function, and purpose. A focus group of patients and caregivers was convened to describe their expectations of self-care technology. Items identified in the database were then assessed for these attributes. Patients and family caregivers indicated a need for intelligent self-care technology which supports early diagnosis of health changes, intervention enablement, and improvement of communication quality among patients and the health care system. Of these, only intervention enablement was commonly found in the home health technology items identified. An opportunity exists to meet consumer self-care needs through increased research and development in intelligent self-care technology.

A multidimensional approach to case mix for home health services

PubMed Central

Manton, Kenneth G.; Hausner, Tony

1987-01-01

Developing a case-mix methodology for home health services is more difficult than developing one for hospitalization and acute health services, because the determinants of need for home health care are more complex and because of the difficulty in defining episodes of care. To evaluate home health service case mix, a multivariate grouping methodology was applied to records from the 1982 National Long-Term Care Survey linked to Medicare records on home health reimbursements. Using this method, six distinct health and functional status dimensions were identified. These dimensions, combined with factors describing informal care resources and local market conditions, were used to explain significant proportions of the variance (r2 = .45) of individual differences in Medicare home health reimbursements and numbers of visits. Though the data were not collected for that purpose, the high level of prediction strongly suggests the feasibility of developing case-mix strategies for home health services. PMID:10312187

Athletes' Evaluations of Their Head Coach's Coaching Competency

ERIC Educational Resources Information Center

Myers, Nicholas D.; Feltz, Deborah L.; Maier, Kimberly S.; Wolfe, Edward W.; Reckase, Mark D.

2006-01-01

This study provided initial validity evidence for multidimensional measures of coaching competency derived from the Coaching Competency Scale (CCS). Data were collected from intercollegiate men's (n = 8) and women's (n = 13) soccer and women's ice hockey teams (n = 11). The total number of athletes was 585. Within teams, a multidimensional…

The Effect of Entry Regulation in the Health Care Sector: the Case of Home Health

PubMed Central

Polsky, Daniel; David, Guy; Yang, Jianing; Kinosian, Bruce; Werner, Rachel

2013-01-01

The consequences of government regulation in the post-acute care sector are not well understood. We examine the effect of entry regulation on quality of care in home health care by analyzing the universe of hospital discharges during 2006 for publicly insured beneficiaries (about 4.5 million) and subsequent home health admissions to determine whether there is a significant difference in home health utilization, hospital readmission rates, and health care expenditures in states with and without Certificate of Need laws (CON) regulating entry. We identify these effects by looking across regulated and nonregulated states within Hospital Referral Regions, which characterize well-defined health care markets and frequently cross state boundaries. We find that CON states use home health less frequently, but system-wide rehospitalization rates, overall Medicare expenditures, and home health practice patterns are similar. Removing CON for home health would have negligible system-wide effects on health care costs and quality. PMID:24497648

Team Dynamics. Implications for Coaching.

ERIC Educational Resources Information Center

Freishlag, Jerry

1985-01-01

A recent survey of coaches ranks team cohesion as the most critical problem coaches face. Optimal interpersonal relationships among athletes and their coaches can maximize collective performance. Team dynamics are discussed and coaching tips are provided. (MT)

Nutritional Knowledge of UK Coaches

PubMed Central

Cockburn, Emma; Fortune, Alistair; Briggs, Marc; Rumbold, Penny

2014-01-01

Athletes obtain nutritional information from their coaches, yet their competency in this area is lacking. Currently, no research exists in the UK which has a different coach education system to many other countries. Therefore, the aim of this study was to evaluate the sports nutrition knowledge of UK coaching certificate (UKCC) level 2 and 3, hockey and netball qualified coaches. All coaches (n = 163) completed a sports nutrition questionnaire to identify: (a) if they provided nutritional advice; (b) their level of sport nutrition knowledge; and (c) factors that may have contributed to their level of knowledge. Over half the coaches provided advice to their athletes (n = 93, 57.1%), even though they were not competent to do so. Coaches responded correctly to 60.3 ± 10.5% of all knowledge questions with no differences between those providing advice and those who did not (p > 0.05). Those coaches who had undertaken formal nutrition training achieved higher scores than those who had not (p < 0.05). In conclusion, UK sports coaches would benefit from continued professional development in sports nutrition to enhance their coaching practice. PMID:24727434

42 CFR 484.245 - Accelerated payments for home health agencies.

Code of Federal Regulations, 2013 CFR

2013-10-01

...) Recovery of payment. Recovery of the accelerated payment is made by recoupment as HHA bills are processed... 42 Public Health 5 2013-10-01 2013-10-01 false Accelerated payments for home health agencies. 484... for Home Health Agencies § 484.245 Accelerated payments for home health agencies. (a) General rule...

42 CFR 484.245 - Accelerated payments for home health agencies.

Code of Federal Regulations, 2014 CFR

2014-10-01

...) Recovery of payment. Recovery of the accelerated payment is made by recoupment as HHA bills are processed... 42 Public Health 5 2014-10-01 2014-10-01 false Accelerated payments for home health agencies. 484... for Home Health Agencies § 484.245 Accelerated payments for home health agencies. (a) General rule...

Key Components in eHealth Interventions Combining Self-Tracking and Persuasive eCoaching to Promote a Healthier Lifestyle: A Scoping Review.

PubMed

Lentferink, Aniek J; Oldenhuis, Hilbrand Ke; de Groot, Martijn; Polstra, Louis; Velthuijsen, Hugo; van Gemert-Pijnen, Julia Ewc

2017-08-01

The combination of self-tracking and persuasive eCoaching in automated interventions is a new and promising approach for healthy lifestyle management. The aim of this study was to identify key components of self-tracking and persuasive eCoaching in automated healthy lifestyle interventions that contribute to their effectiveness on health outcomes, usability, and adherence. A secondary aim was to identify the way in which these key components should be designed to contribute to improved health outcomes, usability, and adherence. The scoping review methodology proposed by Arskey and O'Malley was applied. Scopus, EMBASE, PsycINFO, and PubMed were searched for publications dated from January 1, 2013 to January 31, 2016 that included (1) self-tracking, (2) persuasive eCoaching, and (3) healthy lifestyle intervention. The search resulted in 32 publications, 17 of which provided results regarding the effect on health outcomes, 27 of which provided results regarding usability, and 13 of which provided results regarding adherence. Among the 32 publications, 27 described an intervention. The most commonly applied persuasive eCoaching components in the described interventions were personalization (n=24), suggestion (n=19), goal-setting (n=17), simulation (n=17), and reminders (n=15). As for self-tracking components, most interventions utilized an accelerometer to measure steps (n=11). Furthermore, the medium through which the user could access the intervention was usually a mobile phone (n=10). The following key components and their specific design seem to influence both health outcomes and usability in a positive way: reduction by setting short-term goals to eventually reach long-term goals, personalization of goals, praise messages, reminders to input self-tracking data into the technology, use of validity-tested devices, integration of self-tracking and persuasive eCoaching, and provision of face-to-face instructions during implementation. In addition, health outcomes or

Coaching the Debriefer: Peer Coaching to Improve Debriefing Quality in Simulation Programs.

PubMed

Cheng, Adam; Grant, Vincent; Huffman, James; Burgess, Gavin; Szyld, Demian; Robinson, Traci; Eppich, Walter

2017-10-01

Formal faculty development programs for simulation educators are costly and time-consuming. Peer coaching integrated into the teaching flow can enhance an educator's debriefing skills. We provide a practical guide for the who, what, when, where, why, and how of peer coaching for debriefing in simulation-based education. Peer coaching offers advantages such as psychological safety and team building, and it can benefit both the educator who is receiving feedback and the coach who is providing it. A feedback form for effective peer coaching includes the following: (1) psychological safety, (2) framework, (3) method/strategy, (4) content, (5) learner centeredness, (6) co-facilitation, (7) time management, (8) difficult situations, (9) debriefing adjuncts, and (10) individual style and experience. Institutional backing of peer coaching programs can facilitate implementation and sustainability. Program leaders should communicate the need and benefits, establish program goals, and provide assessment tools, training, structure, and evaluation to optimize chances of success.

Motivation Coaching Training for Instructional Coaches: A Pilot Study of Motivational Interviewing Skills Training

ERIC Educational Resources Information Center

Lyons, Michael D.; Jones, Sara J.; Smith, Bradley H.; McQuillin, Samuel D.; Richardson, Georgette; Reid, Erin; McClellan, Anne

2017-01-01

In our paper we describe a newly developed teacher coaching model that provides training on motivational interviewing (MI) to improve instructional coaches' effectiveness with classroom teachers. Participants were 38 coaches who completed a three-day coaching training. At pre- and post-test, the participants completed role plays with an actor who…

Evaluation of Home Health Care Devices: Remote Usability Assessment.

PubMed

Kortum, Philip; Peres, S Camille

2015-06-05

An increasing amount of health care is now performed in a home setting, away from the hospital. While there is growing anecdotal evidence about the difficulty patients and caregivers have using increasingly complex health care devices in the home, there has been little systematic scientific study to quantify the global nature of home health care device usability in the field. Research has tended to focus on a handful of devices, making it difficult to gain a broad view of the usability of home-care devices in general. The objective of this paper is to describe a remote usability assessment method using the System Usability Scale (SUS), and to report on the usability of a broad range of health care devices using this metric. A total of 271 participants selected and rated up to 10 home health care devices of their choice using the SUS, which scores usability from 0 (unusable) to 100 (highly usable). Participants rated a total of 455 devices in their own home without an experimenter present. Usability scores ranged from 98 (oxygen masks) to 59 (home hormone test kits). An analysis conducted on devices that had at least 10 ratings showed that the effect of device on SUS scores was significant (P<.001), and that the usability of these devices was on the low end when compared with other commonly used items in the home, such as microwave ovens and telephones. A large database of usability scores for home health care devices collected using this remote methodology would be beneficial for physicians, patients, and their caregivers.

Coaches' Coaching Competence in Relation to Athletes' Perceived Progress in Elite Sport

ERIC Educational Resources Information Center

Moen, Frode; Federici, Roger A.

2013-01-01

This article looks at whether higher levels of perceived coaching competencies focusing on relational issues, were associated with higher satisfaction among elite athletes with their progress in sport. In order to explore this, we investigated elite athletes' perceptions of their coaches' coaching competence (CCS) and how these perceptions related…

Black Coaches and Their Perspectives on the Black Coaches and Administrators: A Qualitative Analysis

ERIC Educational Resources Information Center

Kelly, Daniel G., II; Pastore, Donna L.; Hodge, Samuel R.; Seifried, Chad

2015-01-01

The purpose of this study was to analyze Black male collegiate coaches' understandings and perspectives about building a coaching career in NCAA Division I athletics and the function of the Black Coaches and Administrators (BCA) as a mechanism to help facilitate more coaching opportunities. The participants were seven Black male assistant coaches…

Payment reform will shift home health agency valuation parameters.

PubMed

Hahn, A D

1998-12-01

Changes authorized by the Balanced Budget Act of 1997 have removed many of the payment benefits that motivated past home health agency acquisition activity and temporarily have slowed the rapid pace of acquisitions of home health agencies. The act required that Medicare's cost-based payment system be replaced with a prospective payment system (PPS) and established an interim payment system to provide a framework for home health agencies to make the transition to the PPS. As a consequence, realistic valuations of home health agencies will be determined primarily by cash flows, with consideration given to operational factors, such as quality of patient care, service territory, and information systems capabilities. The limitations imposed by the change in payment mechanism will cause acquisition interest to shift away from home health agencies with higher utilization and revenue expansion to agencies able to control costs and achieve operating leverage.

How access to long-term care affects home health transfers.

PubMed

Kenney, G M

1993-01-01

This study examines the determinants of home health use after hospitalization for acute illness for eleven diagnosis-related groups (DRGs) in 1985, drawing on data from four primary sources: Medicare hospital bills, Medicare home health bills, the Medicare and Medicaid Automated Certification System files, and the American Hospital Association Survey. Separate Tobit models are estimated for each DRG. The analysis shows that transfers to home health care are heavily influenced by the hospital's long-term care arrangement and by conditions in local nursing home and home health care markets. Especially important is whether a hospital has its own long-term care unit, swing beds, or both, and whether nursing home beds are available in the local area. Patients discharged from hospitals are more likely to use home health care in areas with a low supply of nursing home beds and low Medicaid reimbursement levels for skilled nursing facilities. The results of this study have implications for proposals to extend Medicare's Prospective Payment System for hospital services to include postacute care. Proponents of a "bundled payment" that encompasses both acute and postacute services argue that the current system leads to inefficiencies and inequities. This analysis points to systematic relationships between home health and nursing home services, which should be factored into the development of a bundled payment policy.

Health coaching to improve self-management and quality of life for low income patients with chronic obstructive pulmonary disease (COPD): protocol for a randomized controlled trial.

PubMed

Huang, Beatrice; Willard-Grace, Rachel; De Vore, Denise; Wolf, Jessica; Chirinos, Chris; Tsao, Stephanie; Hessler, Danielle; Su, George; Thom, David H

2017-06-09

Chronic obstructive pulmonary disease (COPD) severely hinders quality of life for those affected and is costly to the health care system. Care gaps in areas such as pharmacotherapy, inhaler technique, and knowledge of disease are prevalent, particularly for vulnerable populations served by community clinics. Non-professionally licensed health coaches have been shown to be an effective and cost-efficient solution in bridging care gaps and facilitating self-management for patients with other chronic diseases, but no research to date has explored their efficacy in improving care for people living with COPD. This is multi-site, single blinded, randomized controlled trial evaluates the efficacy of health coaches to facilitate patient self-management of disease and improve quality of life for patients with moderate to severe COPD. Spirometry, survey, and an exercise capacity test are conducted at baseline and at 9 months. A short survey is administered by phone at 3 and 6 months post-enrollment. The nine month health coaching intervention focuses on enhancing disease understanding and symptom awareness, improving use of inhalers; making personalized plans to increase physical activity, smoking cessation, or otherwise improve disease management; and facilitating care coordination. The results of this study will provide evidence regarding the efficacy and feasibility of health coaching to improve self-management and quality of life for urban underserved patients with moderate to severe COPD. ClinicalTrials.gov identifier NCT02234284 . Registered 12 August 2014.

The safety net medical home initiative: transforming care for vulnerable populations.

PubMed

Sugarman, Jonathan R; Phillips, Kathryn E; Wagner, Edward H; Coleman, Katie; Abrams, Melinda K

2014-11-01

Despite findings that medical homes may reduce or eliminate health care disparities among underserved and minority populations, most previous medical home pilot and demonstration projects have focused on health care delivery systems serving commercially insured patients and Medicare beneficiaries. To develop a replicable approach to support medical home transformation among diverse practices serving vulnerable and underserved populations. Facilitated by a national program team, convening organizations in 5 states provided coaching and learning community support to safety net practices over a 4-year period. To guide transformation, we developed a framework of change concepts aligned with supporting tools including implementation guides, activity checklists, and measurement instruments. Sixty-five health centers, homeless clinics, private practices, residency training centers, and other safety net practices in Colorado, Idaho, Massachusetts, Oregon, and Pennsylvania. We evaluated implementation of the change concepts using the Patient-Centered Medical Home-Assessment, and conducted a survey of participating practices to assess perceptions of the impact of the technical assistance. All practices implemented key features of the medical home model, and nearly half (47.6%) implemented the 33 identified key changes to a substantial degree as evidenced by level A Patient-Centered Medical Home-Assessment scores. Two thirds of practices that achieved substantial implementation did so only after participating in the initiative for >2 years. By the end of the initiative, 83.1% of sites achieved external recognition as medical homes. Despite resource constraints and high-need populations, safety net clinics made considerable progress toward medical home implementation when provided robust, multimodal support over a 4-year period.

Usage of an Internet smoking cessation resource: the Australian QuitCoach.

PubMed

Balmford, James; Borland, Ron; Li, Lin; Ferretter, Ian

2009-01-01

The QuitCoach (http://www.quitcoach.org.au) is a tailored, Internet-delivered smoking cessation advice program. This paper compares QuitCoach users both with smokers in general, and with callers to a telephone-based smoking cessation service (the Victorian Quitline). It also explores patterns of QuitCoach usage by time of year and day of the week. Data are from responses to the QuitCoach online assessment collected between 2003 and 2007 (n = 28 247). Comparison data are from the Victorian Quitline service, from the first five waves of the International Tobacco Control Four Country Survey, the 2004-05 National Health Survey, and from anti-smoking Target Audience Rating Points for Australia. QuitCoach users were more likely to be female and younger than both smokers in general and Quitline users. They were intermediate in nicotine dependence. QuitCoach users are less likely to have just quit than Quitline callers. Half of QuitCoach users first use after setting a quit date. Usage is related to anti-smoking advertising and to day of week, being highest earlier in the week. The QuitCoach successfully targets the moderately addicted. Use is sensitive to anti-smoking campaigns. There is a need for greater promotion of the QuitCoach as a resource with the capacity to meet the needs of those already quit and those still uncertain as to whether to try.

42 CFR 413.125 - Payment for home health agency services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Payment for home health agency services. 413.125... Categories of Costs § 413.125 Payment for home health agency services. (a) For additional rules on the allowability of certain costs incurred by home health agencies, see §§ 409.46 and 409.49(b) of this chapter. (b...

42 CFR 413.125 - Payment for home health agency services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 2 2012-10-01 2012-10-01 false Payment for home health agency services. 413.125... Categories of Costs § 413.125 Payment for home health agency services. (a) For additional rules on the allowability of certain costs incurred by home health agencies, see §§ 409.46 and 409.49(b) of this chapter. (b...

42 CFR 413.125 - Payment for home health agency services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false Payment for home health agency services. 413.125... Categories of Costs § 413.125 Payment for home health agency services. (a) For additional rules on the allowability of certain costs incurred by home health agencies, see §§ 409.46 and 409.49(b) of this chapter. (b...

Medical home services for children with behavioral health conditions.

PubMed

Sheldrick, Radley C; Perrin, Ellen C

2010-01-01

Whether medical services received by children and youth with behavioral health conditions are consistent with a Medical Home has not been systematically studied. The objectives of this study were to examine the variation among four behavioral health conditions in regard to services related to the Medical Home. Cross-sectional analyses of the 2003 National Survey of Children's Health were conducted. Multiple logistic regression analyses tested the impact of behavioral health conditions on medical needs, on Medical Home components, and on likelihood of having a Medical Home overall. Autism, Depression/Anxiety, and Behavior/Conduct problems were associated with reduced likelihood of having a Medical Home, whereas Attention-Deficit Hyperactivity Disorder was associated with increased likelihood. All health conditions predicted increased access to a primary care physician (PCP) and a preventive visit in the past year. However, all were also associated with higher needs for specialty care and all behavioral health conditions except Attention-Deficit Hyperactivity Disorder were associated with difficulties accessing this care. A detailed examination of the receipt of services among children and youth with behavioral health conditions reveals two primary reasons why such care is less likely to be consistent with a Medical Home model: (1) parents are more likely to report needing specialty care; and (2) these needs are less likely to be met. These data suggest that the reason why services received by children and youth with behavioral health conditions are not consistent with the Medical Home has more to do with difficulty accessing specialty care than with problems accessing quality primary care.

Mathematics Coaching in High School: The Impact of Coach and Teacher Interactions

ERIC Educational Resources Information Center

Pusey, Eleanor Louise

2013-01-01

This dissertation study examined a high school mathematics coach in the context of a three-year project called MAST (Mathematics Achievement Success Today) that provided summer content courses, lesson study, and mathematics coaching for high school teachers. This study focused in particular on the work of the MAST project coach as she interacted…

Professional Preparation in Physical Education and Coaching.

ERIC Educational Resources Information Center

American Association for Health, Physical Education, and Recreation, Washington, DC.

This booklet is the product of a conference of the American Association of Health, Physical Education, and Recreation, the purpose of which was to revise professional preparation quidelines in dance, physical education, recreation education, and health and safety education. This report includes sections on physical education and coaching and on…

Integrative Health Coach Training: A Model for Shifting the Paradigm Toward Patient-centricity and Meeting New National Prevention Goals.

PubMed

Smith, Linda L; Lake, Noelle H; Simmons, Leigh Ann; Perlman, Adam; Wroth, Shelley; Wolever, Ruth Q

2013-05-01

To describe the evolution, training, and results of an emerging allied health profession skilled in eliciting sustainable health-related behavior change and charged with improving patient engagement. Through techniques sourced from humanistic and positive psychology, solution-focused and mindfulness-based therapies, and leadership coaching, Integrative Health Coaching (IHC) provides a mechanism to empower patients through various stages of learning and change. IHC also provides a method for the creation and implementation of forward-focused personalized health plans. Clinical studies employing Duke University Integrative Medicine's model of IHC have demonstrated improvements in measures of diabetes and diabetes risk, weight management, and risk for cardiovascular disease and stroke. By supporting and enabling individuals in making major lifestyle changes for the improvement of their health, IHC carries the potential to reduce rates and morbidity of chronic disease and impact myriad aspects of healthcare. As a model of educational and clinical innovation aimed at patient empowerment and lifestyle modification, IHC is aligned well with the tenets and goals of recently sanctioned federal healthcare reform, specifically the creation of the first National Prevention and Health Promotion Strategy. IHC may allow greater patient-centricity while targeting the lifestyle-related chronic disease that lies at the heart of the current healthcare crisis.

Integrative Health Coach Training: A Model for Shifting the Paradigm Toward Patient-centricity and Meeting New National Prevention Goals

PubMed Central

Smith, Linda L.; Lake, Noelle H.; Simmons, Leigh Ann; Perlman, Adam; Wroth, Shelley

2013-01-01

Objective: To describe the evolution, training, and results of an emerging allied health profession skilled in eliciting sustainable health-related behavior change and charged with improving patient engagement. Methods: Through techniques sourced from humanistic and positive psychology, solution-focused and mindfulness-based therapies, and leadership coaching, Integrative Health Coaching (IHC) provides a mechanism to empower patients through various stages of learning and change. IHC also provides a method for the creation and implementation of forward-focused personalized health plans. Results: Clinical studies employing Duke University Integrative Medicine's model of IHC have demonstrated improvements in measures of diabetes and diabetes risk, weight management, and risk for cardiovascular disease and stroke. By supporting and enabling individuals in making major lifestyle changes for the improvement of their health, IHC carries the potential to reduce rates and morbidity of chronic disease and impact myriad aspects of healthcare. Conclusion: As a model of educational and clinical innovation aimed at patient empowerment and lifestyle modification, IHC is aligned well with the tenets and goals of recently sanctioned federal healthcare reform, specifically the creation of the first National Prevention and Health Promotion Strategy. Practice Implications: IHC may allow greater patient-centricity while targeting the lifestyle-related chronic disease that lies at the heart of the current healthcare crisis. PMID:24416674

Informal Math Coaching by Instant Messaging: Two Case Studies of How University Students Coach K-12 Students

ERIC Educational Resources Information Center

Hrastinski, Stefan; Edman, Anneli; Andersson, Fredrik; Kawnine, Tanvir; Soames, Carol-Ann

2014-01-01

The aim of this study is to describe and explore how instant messaging (IM) can be used to support informal math coaching. We have studied two projects where university students use IM to coach K-12 students in mathematics. The coaches were interviewed with a focus on how informal coaching works by examining coaching challenges, how coaching can…

Comparing the Effectiveness of Individual Coaching, Self-Coaching, and Group Training: How Leadership Makes the Difference.

PubMed

Losch, Sabine; Traut-Mattausch, Eva; Mühlberger, Maximilian D; Jonas, Eva

2016-01-01

Few empirical studies have used a randomized controlled design to evaluate the impact of coaching, and there are even fewer that have compared coaching with other interventions. In the current field study, we investigated the relative effectiveness of coaching as an intervention to reduce procrastination. In a randomized controlled study, participants (N = 84) were assigned to an individual coaching, a self-coaching, a group training, or a control group condition. Results indicate that individual coaching and group training were effective in reducing procrastination and facilitating goal attainment. Individual coaching created a high degree of satisfaction and was superior in helping participants attaining their goals, whereas group training successfully promoted the acquisition of relevant knowledge. The results for the self-coaching condition show that independently performing exercises without being supported by a coach is not sufficient for high goal attainment. Moreover, mediation analysis show that a coach's transformational and transactional leadership behavior influenced participants' perceived autonomy support and intrinsic motivation, resulting in beneficial coaching outcomes. The results may guide the selection of appropriate human resource development methods: If there is a general need to systematically prepare employees to perform on specific tasks, group training seems appropriate due to lower costs. However, when certain aspects of working conditions or individual development goals are paramount, coaching might be indicated. However, further research is needed to compare the relative effectiveness of coaching with other interventions in different contexts.

Predictors of Intent to Leave the Job Among Home Health Workers: Analysis of the National Home Health Aide Survey.

PubMed

Stone, Robyn; Wilhelm, Jess; Bishop, Christine E; Bryant, Natasha S; Hermer, Linda; Squillace, Marie R

2017-10-01

To identify agency policies and workplace characteristics that are associated with intent to leave the job among home health workers employed by certified agencies. Data are from the 2007 National Home and Hospice Care Survey/National Home Health Aide Survey, a nationally representative, linked data set of home health and hospice agencies and their workers. Logistic regression with survey weights was conducted to identify agency and workplace factors associated with intent to leave the job, controlling for worker, agency, and labor market characteristics. Job satisfaction, consistent patient assignment, and provision of health insurance were associated with lower intent to leave the job. By contrast, being assigned insufficient work hours and on-the-job injuries were associated with greater intent to leave the job after controlling for fixed worker, agency, and labor market characteristics. African American workers and workers with a higher household income also expressed greater intent to leave the job. This is the first analysis to use a weighted, nationally representative sample of home health workers linked with agency-level data. The findings suggest that intention to leave the job may be reduced through policies that prevent injuries, improve consistency of client assignment, improve experiences among African American workers, and offer sufficient hours to workers who want them. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Patient classification tool in home health care.

PubMed

Pavasaris, B

1989-01-01

Medicare's system of diagnosis related groups for health care cost reimbursements is inadequate for the special requirements of home health care. A visiting nurses association's patient classification tool correlates a meticulous record of professional time spent per patient with patient diagnosis and level of care, aimed at helping policymakers develop a more equitable DRG-based prospective payment formula for home care costs.

Effect Of Telephone Calls And Text Messages On Goal Attainment In A Ehealth Coaching Service.

PubMed

Brivio, Eleonora; Gatti, Fabiana; Galimberti, Carlo; Gambini, Paolo; Binello, Maurizio

2015-01-01

Yukendu is a personal mobile coaching service that supports people in reaching good levels of psychological and physical wellbeing through the use of an app and a telephone-based relationship with a health coach. The aim of this contribution is to describe the results obtained in a sample of 171 clients (female, n=150) and investigate the main factors in attaining their health-related goals. Results show that 61,98% (n=106) of the sample attained the results they wanted totally or partially. The regression model (number of phone calls, text messages, plan duration, achieved weight loss) accounts for 56,9% of data variance in achieved weight loss. Significant predictors of achieved weight loss are average number of calls (B=.388, p<.05), texts exchange (B=.331, p<.05) and plan duration (B=.291). These results suggest therefore that in the first phase of health behavioral change, eHealth coaching efficacy lies primarily in the communication between coach and coachee.

Student-Centered Coaching: The Moves

ERIC Educational Resources Information Center

Sweeney, Diane; Harris, Leanna S.

2017-01-01

Student-centered coaching is a highly-effective, evidence-based coaching model that shifts the focus from "fixing" teachers to collaborating with them to design instruction that targets student outcomes. But what does this look like in practice? "Student-Centered Coaching: The Moves" shows you the day-to-day coaching moves that…

A Novel Use of Peer Coaching to Teach Primary Palliative Care Skills: Coaching Consultation.

PubMed

Jacobsen, Juliet; Alexander Cole, Corinne; Daubman, Bethany-Rose; Banerji, Debjani; Greer, Joseph A; O'Brien, Karen; Doyle, Kathleen; Jackson, Vicki A

2017-10-01

We aim to address palliative care workforce shortages by teaching clinicians how to provide primary palliative care through peer coaching. We offered peer coaching to internal medicine residents and hospitalists (attendings, nurse practioners, and physician assistants). An audit of peer coaching encounters and coachee feedback to better understand the applicability of peer coaching in the inpatient setting to teach primary palliative care. Residents and hospitalist attendings participated in peer coaching for a broad range of palliative care-related questions about pain and symptom management (44%), communication (34%), and hospice (22%). Clinicians billed for 68% of encounters using a time-based billing model. Content analysis of coachee feedback identified that the most useful elements of coaching are easy access to expertise, tailored teaching, and being in partnership. Peer coaching can be provided in the inpatient setting to teach primary palliative care and potentially extend the palliative care work force. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

How the Iranian Football Coaches and Players Know About Doping?

PubMed Central

Seif Barghi, Tohid; Halabchi, Farzin; Dvorak, Jiri; Hosseinnejad, Heydar

2015-01-01

Background: Nowadays, doping is an intricate dilemma. Football is the nationally popular sport in Iran. On the other hand, doping is a serious health hazard sport faces today. Studies dealing with athletes’ knowledge, attitudes and behavior concerning doping in football are scarce. Objectives: Therefore, we aimed to investigate the knowledge and attitudes toward doping among the football coaches and players. Patients and Methods: In a cross sectional study, 375 participants (239 football players and 136 coaches) were studied. A specially made questionnaire was applied. In this study, football teams of different provinces of the country were selected by randomized clustered sampling and questionnaires were distributed among coaches and players. Results: Knowledge of football coaches and players in three categories of doping definitions, recognition of prohibited drugs and side effects of anabolic steroids was poor or moderate in 45.3%, 88.5% and 96.5%, respectively. Conclusions: Football players and coaches have poor knowledge about doping in Iran. Moreover, they believe in some inappropriate myths without any scientific or rational basis.It seems necessary to design a comprehensive educational program for all of the athletes and coaches in Iran. PMID:26448840

Therapeutic alliance in dietetic practice for weight loss: Insights from health coaching.

PubMed

Nagy, Annaliese; McMahon, Anne; Tapsell, Linda; Deane, Frank; Arenson, Danielle

2018-02-13

The psychological construct of 'therapeutic alliance' can be used to better understand the effectiveness of consultations, particularly goal setting for weight management. We analysed audio-recorded health coaching sessions during a weight loss trial to explore relationships between therapeutic alliance and various contextual factors. Audio recordings of 50 health coaching sessions were analysed. After assessing fidelity to the protocol, therapeutic alliance was measured using an adapted Working Alliance Inventory Observer-rated Short Version (WAI-O-S), and examined by (i) identifying relationships between contextual factors and WAI-O-S scores (Spearman's coefficients); (ii) testing the impact of preparatory exercises and body mass index on WAI-O-S scores (one-way analysis of variance and least-squared differences tests) and (iii) comparing differences in WAI-O-S scores based on relationship status, gender and follow-up session completion (independent samples t-tests). Fidelity was high (mean 88%). WAI-O-S total scores ranged from 55 to 70 (out of 84). Session duration was significantly correlated with WAI-O-S component of 'Bond' (r = 0.42, P = 0.002). Those who completed preparatory exercises had significantly higher total WAI-O-S scores, 'Goal' and 'Task' scores. Participants who completed the follow-up session scored significantly higher for 'Goal' compared to no follow-up. Spending more time in a session appears related to increased bonding, a key component of therapeutic alliance. Preparatory work may help build therapeutic alliance and agreement on goals appears to influence follow-up completion. These exploratory findings provide directions for research addressing the professional relationship in dietetic consultations for weight loss. © 2018 Dietitians Association of Australia.

Coaching Discourse: Supporting Teachers' Professional Learning

ERIC Educational Resources Information Center

Heineke, Sally F.

2013-01-01

Although coaching is used in many schools to facilitate teachers' professional learning, few studies look closely at coaching discourse. Exploring how coaching facilitates teachers' professional development, this study used tape-recorded coaching sessions and individual post-interviews to examine the one-on-one coaching interactions of 4…

A Temporal Map of Coaching.

PubMed

Theeboom, Tim; Van Vianen, Annelies E M; Beersma, Bianca

2017-01-01

Economic pressures on companies, technological developments, and less stable career paths pose potential threats to the well-being of employees (e.g., stress, burn-out) and require constant adaptation. In the light of these challenges, it is not surprising that employees often seek the support of a coach. The role of a coach is to foster change by facilitating a coachees' movement through a self-regulatory cycle with the ultimate aim of stimulating sustained well-being and functioning. While meta-analytic research indicates that coaching interventions can be effectively applied to assist employees in dealing with change, the current literature on coaching lacks solid theoretical frameworks that are needed to build a cumulative knowledge-base and to inspire evidence-based practice. In this conceptual analysis, we examine the coaching process through a temporal lens. By doing so, we provide an integrated theoretical framework: a temporal map of coaching. In this framework, we link seminal concepts in psychology to the coaching process, and describe which competencies of coachees are crucial in the different stages of change that coaching aims to bring about. During the preparatory contemplation stage, targeting coachees' awareness by enhancing their mindfulness and environmental receptiveness is important. During the contemplation stage, coachees' willingness and perceived ability to change are central competencies. We propose that coaches should therefore foster intrinsic goal orientation and self-efficacy during this stage. During the planning stage, coaches should focus on goal-setting and implementation intentions. Finally, during the maintenance/termination stage, stimulating coachees' reflection is especially important in order to help them to integrate their learning experiences. The framework delineated in this paper contributes to the understanding of coaching as a tool to assist employees in dealing with the challenges of an increasingly dynamic work

A Temporal Map of Coaching

PubMed Central

Theeboom, Tim; Van Vianen, Annelies E. M.; Beersma, Bianca

2017-01-01

Economic pressures on companies, technological developments, and less stable career paths pose potential threats to the well-being of employees (e.g., stress, burn-out) and require constant adaptation. In the light of these challenges, it is not surprising that employees often seek the support of a coach. The role of a coach is to foster change by facilitating a coachees’ movement through a self-regulatory cycle with the ultimate aim of stimulating sustained well-being and functioning. While meta-analytic research indicates that coaching interventions can be effectively applied to assist employees in dealing with change, the current literature on coaching lacks solid theoretical frameworks that are needed to build a cumulative knowledge-base and to inspire evidence-based practice. In this conceptual analysis, we examine the coaching process through a temporal lens. By doing so, we provide an integrated theoretical framework: a temporal map of coaching. In this framework, we link seminal concepts in psychology to the coaching process, and describe which competencies of coachees are crucial in the different stages of change that coaching aims to bring about. During the preparatory contemplation stage, targeting coachees’ awareness by enhancing their mindfulness and environmental receptiveness is important. During the contemplation stage, coachees’ willingness and perceived ability to change are central competencies. We propose that coaches should therefore foster intrinsic goal orientation and self-efficacy during this stage. During the planning stage, coaches should focus on goal-setting and implementation intentions. Finally, during the maintenance/termination stage, stimulating coachees’ reflection is especially important in order to help them to integrate their learning experiences. The framework delineated in this paper contributes to the understanding of coaching as a tool to assist employees in dealing with the challenges of an increasingly dynamic

Coaching to vision versus coaching to improvement needs: a preliminary investigation on the differential impacts of fostering positive and negative emotion during real time executive coaching sessions.

PubMed

Howard, Anita R

2015-01-01

Drawing on intentional change theory (ICT; Boyatzis, 2006), this study examined the differential impact of inducing coaching recipients' vision/positive emotion versus improvement needs/negative emotion during real time executive coaching sessions. A core aim of the study was to empirically test two central ICT propositions on the effects of using the coached person's Positive Emotional Attractor (vision/PEA) versus Negative Emotional Attractor (improvement needs/NEA) as the anchoring framework of a onetime, one-on-one coaching session on appraisal of 360° feedback and discussion of possible change goals. Eighteen coaching recipients were randomly assigned to two coaching conditions, the coaching to vision/PEA condition and the coaching to improvement needs/NEA condition. Two main hypotheses were tested. Hypothesis1 predicted that participants in the vision/PEA condition would show higher levels of expressed positive emotion during appraisal of 360° feedback results and discussion of change goals than recipients in the improvement needs/NEA condition. Hypothesis2 predicted that vision/PEA participants would show lower levels of stress immediately after the coaching session than improvement needs/NEA participants. Findings showed that coaching to vision/the PEA fostered significantly lower levels of expressed negative emotion and anger during appraisal of 360° feedback results as compared to coaching to improvements needs/the NEA. Vision-focused coaching also fostered significantly greater exploration of personal passions and future desires, and more positive engagement during 360° feedback appraisal. No significant differences between the two conditions were found in emotional processing during discussion of change goals or levels of stress immediately after the coaching session. Current findings suggest that vision/PEA arousal versus improvement needs/NEA arousal impact the coaching process in quite different ways; that the coach's initial framing of the

Disparities in home health service providers among Medicare beneficiaries with stroke.

PubMed

Iyer, Medha; Bhavsar, Grishma P; Bennett, Kevin J; Probst, Janice C

2016-01-01

This study examined the intensity of home health services, as defined by the number of visits and service delivery by rehabilitation specialists, among Medicare beneficiaries with stroke. A cross-sectional secondary data analysis was conducted using 2009 home health claims data obtained from the Centers for Medicare and Medicaid Services' Research Data Assistance Center. There were no significant rural-urban differences in the number of home health visits. Rural beneficiaries were significantly less likely than urban beneficiaries to receive services from rehabilitation specialists. Current home health payment reform recommendations may have unintended consequences for rural home health beneficiaries who need therapy services.

Leadership Coaching That Transforms

ERIC Educational Resources Information Center

Aguilar, Elena

2017-01-01

Leading a school can be a lonely, challenging job, Elena Aguilar has found in her years coaching principals. Aguilar describes how coaching approach she's developed--transformational coaching--helps principals get three things most of them need: a neutral person they can talk with confidentially, job-embedded professional development, and a safe…

Post-Hospital Home Health Care for Medicare Patients

PubMed Central

Kane, Robert L.; Finch, Michael; Chen, Qing; Blewett, Lynn; Burns, Risa; Moskowitz, Mark

1994-01-01

Medicare patients in five diagnosis-related groups (DRGs) associated with heavy use of post-hospital care discharged from 52 hospitals in 3 cities were followed up at 6 weeks, 6 months, and 1 year to determine the factors associated with their being discharged home with or without home health care and the correlates of improvement in their functional status. Models correctly predicted those discharged home from those going to institutions in a range from 54 to 82 percent of cases. The amount of the variance in the change in function for those who went home (with or without home health care) explained by the models tested ranged from 19 percent to 73 percent. Total Medicare costs for the patients who went home were considerably less in the year subsequent to the hospitalization compared with those discharged to institutional care. PMID:10140151

Comparing the Effectiveness of Individual Coaching, Self-Coaching, and Group Training: How Leadership Makes the Difference

PubMed Central

Losch, Sabine; Traut-Mattausch, Eva; Mühlberger, Maximilian D.; Jonas, Eva

2016-01-01

Few empirical studies have used a randomized controlled design to evaluate the impact of coaching, and there are even fewer that have compared coaching with other interventions. In the current field study, we investigated the relative effectiveness of coaching as an intervention to reduce procrastination. In a randomized controlled study, participants (N = 84) were assigned to an individual coaching, a self-coaching, a group training, or a control group condition. Results indicate that individual coaching and group training were effective in reducing procrastination and facilitating goal attainment. Individual coaching created a high degree of satisfaction and was superior in helping participants attaining their goals, whereas group training successfully promoted the acquisition of relevant knowledge. The results for the self-coaching condition show that independently performing exercises without being supported by a coach is not sufficient for high goal attainment. Moreover, mediation analysis show that a coach’s transformational and transactional leadership behavior influenced participants’ perceived autonomy support and intrinsic motivation, resulting in beneficial coaching outcomes. The results may guide the selection of appropriate human resource development methods: If there is a general need to systematically prepare employees to perform on specific tasks, group training seems appropriate due to lower costs. However, when certain aspects of working conditions or individual development goals are paramount, coaching might be indicated. However, further research is needed to compare the relative effectiveness of coaching with other interventions in different contexts. PMID:27199857

Job Satisfaction of NAIA Head Coaches at Small Faith-Based Colleges: The Teacher-Coach Model

ERIC Educational Resources Information Center

Stiemsma, Craig L.

2010-01-01

The head coaches at smaller colleges usually have other job responsibilities that include teaching, along with the responsibilities of coaching, recruiting, scheduling, and other coaching-related jobs. There is often a dual role involved for these coaches who try to juggle two different jobs that sometimes require different skill sets and involve…

Medicare and Medicaid Programs; CY 2018 Home Health Prospective Payment System Rate Update and CY 2019 Case-Mix Adjustment Methodology Refinements; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements. Final rule.

PubMed

2017-11-07

This final rule updates the home health prospective payment system (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor, effective for home health episodes of care ending on or after January 1, 2018. This rule also: Updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the third year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity (that is, nominal case-mix growth) between calendar year (CY) 2012 and CY 2014; and discusses our efforts to monitor the potential impacts of the rebasing adjustments that were implemented in CY 2014 through CY 2017. In addition, this rule finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model and to the Home Health Quality Reporting Program (HH QRP). We are not finalizing the implementation of the Home Health Groupings Model (HHGM) in this final rule.

Smartphone-Enabled Health Coach Intervention for People With Diabetes From a Modest Socioeconomic Strata Community: Single-Arm Longitudinal Feasibility Study

PubMed Central

2014-01-01

Background Lower socioeconomic strata (SES) populations have higher chronic disease risks. Smartphone-based interventions can support adoption of health behaviors that may, in turn, reduce the risks of type 2 diabetes-related complications, overcoming the obstacles that some patients may have with regular clinical contact (eg, shiftwork, travel difficulties, miscommunication). Objective The intent of the study was to develop and test a smartphone-assisted intervention that improves behavioral management of type 2 diabetes in an ethnically diverse, lower SES population within an urban community health setting. Methods This single-arm pilot study assessed a smartphone application developed with investigator assistance and delivered by health coaches. Participants were recruited from the Black Creek Community Health Centre in Toronto and had minimal prior experience with smartphones. Results A total of 21 subjects consented and 19 participants completed the 6-month trial; 12 had baseline glycosylated hemoglobin (HbA1c) levels >7.0% and these subjects demonstrated a mean reduction of 0.43% (SD 0.63) (P<.05) with minimal changes in medication. Conclusions This project supported the feasibility of smartphone-based health coaching for individuals from lower SES with minimal prior smartphone experience. PMID:24907918

Smartphone-enabled health coach intervention for people with diabetes from a modest socioeconomic strata community: single-arm longitudinal feasibility study.

PubMed

Wayne, Noah; Ritvo, Paul

2014-06-06

Lower socioeconomic strata (SES) populations have higher chronic disease risks. Smartphone-based interventions can support adoption of health behaviors that may, in turn, reduce the risks of type 2 diabetes-related complications, overcoming the obstacles that some patients may have with regular clinical contact (eg, shiftwork, travel difficulties, miscommunication). The intent of the study was to develop and test a smartphone-assisted intervention that improves behavioral management of type 2 diabetes in an ethnically diverse, lower SES population within an urban community health setting. This single-arm pilot study assessed a smartphone application developed with investigator assistance and delivered by health coaches. Participants were recruited from the Black Creek Community Health Centre in Toronto and had minimal prior experience with smartphones. A total of 21 subjects consented and 19 participants completed the 6-month trial; 12 had baseline glycosylated hemoglobin (HbA1c) levels >7.0% and these subjects demonstrated a mean reduction of 0.43% (SD 0.63) (P<.05) with minimal changes in medication. This project supported the feasibility of smartphone-based health coaching for individuals from lower SES with minimal prior smartphone experience.

The Future of Home Health Care: A Strategic Framework for Optimizing Value.

PubMed

Landers, Steven; Madigan, Elizabeth; Leff, Bruce; Rosati, Robert J; McCann, Barbara A; Hornbake, Rodney; MacMillan, Richard; Jones, Kate; Bowles, Kathryn; Dowding, Dawn; Lee, Teresa; Moorhead, Tracey; Rodriguez, Sally; Breese, Erica

2016-11-01

The Future of Home Health project sought to support transformation of home health and home-based care to meet the needs of patients in the evolving U.S. health care system. Interviews with key thought leaders and stakeholders resulted in key themes about the future of home health care. By synthesizing this qualitative research, a literature review, case studies, and the themes from a 2014 Institute of Medicine and National Research Council workshop on "The Future of Home Health Care," the authors articulate a vision for home-based care and recommend a bold framework for the Medicare-certified home health agency of the future. The authors also identify challenges and recommendations for achievement of this framework.

Understanding dual enrollees' use of Medicare home health services: the effects of differences in Medicaid home care programs.

PubMed

Kenney, G; Rajan, S

2000-01-01

Both the Medicare and Medicaid programs have experienced considerable growth in spending on home care in recent years. As policymakers adopt measures (such as those legislated in the Balanced Budget Act of 1997) to curb the rate of spending growth on home care services, it is important to understand interactions between the Medicare and Medicaid home care programs in serving the dually enrolled population. This study examines the potential effects of the Medicaid home care program on Medicare home health utilization using multivariate models. The study relied on data from the Health Care Financing Administration's Medicare Current Beneficiary Survey (MCBS), a longitudinal survey of Medicare enrollees. The primary MCBS file used was from Round 1 of the survey, which was fielded between September and December 1991. The unit of analysis was individuals. The authors used descriptive and multivariate methods to explore the relationship between Medicare coverage and state home care program characteristics. Included were variables that have been found to be significant determinants of Medicare home health utilization in other studies as well as variables to indicate the availability and generosity of Medicaid home care services in each state represented in the survey. The findings were consistent with those of previous studies, in that dual enrollees were disproportionate users of Medicare home health services, accounting for only 16% of enrollees but receiving 40% of all visits. In addition, lower levels of Medicare home health use were observed in states with relatively higher Medicaid spending on home health and personal care services, but this relationship appeared to be heavily dominated by the inclusion of enrollees living in New York State. When individuals from New York were excluded from the analysis, we found a negative but statistically significant relationship between Medicaid outlays on home health and personal care services and Medicare home health

Recreational and Developmental Youth Coach Learning

ERIC Educational Resources Information Center

Rocchi, Meredith; Couture, A. Lauren

2018-01-01

Background: Within the field of coach development, previous research has ascertained that elite coaches learn through a variety of formal, non-formal, and informal sources. Little is known, however, about how coaches from different coaching contexts such as recreational and developmental learn to coach. Purpose: The purpose of this study was to…

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