Wolever, RQ, Psujek J, Liebowitz R, Shaw A, Gresko J, Little K, Brantley J, Edelman D, Moon S, Smith L, Yancy Jr W, Olsen M, Jeffreys A, Stat M, Oddone E, Gaudet T.

Use of health coaching to implement an integrative model of care: RCT for coronary risk prevention.

Duke Center for Integrative Medicine, Duke University Medical Center, DUMC 3022, Durham, NC 27710. quill004@mc.duke.edu

Health Coaching is a collaborative, solution-focused process in which the coach facilitates behavior change through education and supportive, motivational questioning. The Duke Center for Integrative Medicine (DCIM) has evolved the role of health coaches to implement an integrative model of care that requires medical patients to increase personal accountability to heal. We tested the use of coaches to implement the model in an RCT (N=154) of primary care participants at moderate risk for coronary heart disease (CHD). Intervention participants received an intensive, standardized intervention that focused on behavioral goal attainment in multiple domains. Outcomes were assessed at baseline, 5 and 10 months. Ten-year risk of CHD was computed using a standard Framingham Risk Calculator. Linear mixed effects modeling demonstrated significant improvement in 10-year risk for intervention participants compared to usual care (UC) (P=0.04). Framingham risk scores (95% Confidence Intervals) for intervention vs UC at baseline and 10 months were: 9.3% (7.6,11.0) vs 11.1% (9.5, 12.8) and 7.8% (6.0,9.5) vs 9.8% (8.3,11.2). Intervention participants increased their readiness to change in multiple domains and enacted significant health behaviors over time. For example, intervention participants increased their days per week of exercise faster than UC participants (3.7 vs 2.4 at 10 months; p=0.002). The conceptual framework of the model as well as the concept of health coaching will also be presented.

 

Back