Health Coach Program to Improve Chronic Disease Outcomes Following an Emergency Department Visit

NCT02386540 | Completed

• 1 other identifier: IRB 14-08123E
• Study Type: interventional
• Target: 295
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to determine whether health coaching initiated in the emergency department (ED) reduces subsequent ED visits, increases primary care visits, and positively impacts health outcomes in patients with diabetes and/or hypertension.

Conditions

Diabetes Mellitus; Hypertension

Keywords

Community Health Workers; Community Health Workers: utilization; Emergency Service; Primary Health Care/utilization; Health Services Accessibility

Outcome Measures

Primary Outcomes (1)

• Number of emergency department visits

  Self-reported measure collected via follow-up phone surveys at 1, 3, and 6 months.

  6 month period after enrollment

Secondary Outcomes (7)

• Number of primary care visits

  6 month period after enrollment

• Physical health and mental health (Validated measure - SF-12v2)

  Baseline, 1 month, 3 months, and 6 months after enrollment

• Medication adherence (Validated measure - Morisky Medication Adherence Scale, MMAS-8)

  Baseline, 1 month, 3 months, and 6 months after enrollment

• Patient activation (Validated measure - Patient Activation Measure, PAM)

  Baseline, 1 month, 3 months, and 6 months after enrollment

• Type and frequency of health coach contact

  6 months after enrollment

Study Arms (2)

Health Coaching

EXPERIMENTAL

Patients randomized to the experimental arm receive six months of post-ED health coaching from the Alameda County Health Coach Program (ACHCP) in addition to usual care in the emergency department at enrollment.

Behavioral: Health Coaching

Usual Care

NO INTERVENTION

Patients randomized to the control arm receive usual care in the emergency department at enrollment.

Interventions

Health Coaching BEHAVIORAL

The Alameda County Health Coach program pairs patients with a language-concordant health coach for six months following an ED visit. Health coaches are young adults from the local community employed through Alameda County and trained for three months in topics such as self-management support and motivational interviewing. Health coaches work one-on-one with participants in order to develop an action plan in order to achieve patient-identified health goals. Communication between the health coach and participant includes text messages (weekly), phone calls (twice a month), face-to-face visits (at least once), and accompaniment to a primary care visit (at least once). Health coaches may also assist participants in accessing community resources as related to the individualized action plan.

Health Coaching

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Willing to work with a health coach
• Plans to reside in Alameda County for the next year
• Has a reliable phone number
• Speaks English or Spanish
• years of age or older
• Meets at least one of the following three criteria: (1) Low medication adherence defined as a continuous medication gap of at least 1 month in the past year OR a new diagnosis of diabetes and/or hypertension; (2) No patient-identified primary care provider (PCP) or no visit to PCP in 1 year; (3) One or more visits to the ED in the last 6 months.

You may not qualify if:

• Life-expectancy less than 1 year
• Poorly controlled psychiatric illness
• Homeless
• Active and frequent use of illicit substances
• Currently incarcerated
• Already enrolled in a program for patients with high rates of hospitalization and/or emergency department visits
• Unable to consent due to an unstable condition or serious emotional or neurologic condition
• Admitted or anticipated to be admitted to the hospital from the ED

Sponsors & Collaborators

• Alameda County Medical Center: lead
• University of California, Berkeley: collaborator
• Robert Wood Johnson Foundation: collaborator

Study Sites (1)

Highland Hospital - Alameda Health System

Oakland, California, 94602, United States

Location

MeSH Terms

Conditions

Diabetes Mellitus; Hypertension

Condition Hierarchy (Ancestors)

Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases; Endocrine System Diseases; Vascular Diseases; Cardiovascular Diseases

Study Officials

• Jocelyn Freeman-Garrick, MD

  Highland Hospital - Alameda Health System

  PRINCIPAL INVESTIGATOR

• Berenice Perez, MD

  Highland Hospital - Alameda Health System

  PRINCIPAL INVESTIGATOR

• Harrison Alter, MD

  Highland Hospital - Alameda Health System

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Chair for Research, Department of Emergency Medicine, Highland Hospital

Study Record Dates

• First Submitted: February 14, 2015
• First Posted: March 12, 2015
• Study Start: February 6, 2015
• Primary Completion: December 10, 2018
• Study Completion: December 10, 2018
• Last Updated: December 19, 2018

Record last verified: 2018-12

Locations

US (1)