Restricted accessResearch articleFirst published online 2017-8
Preparing Home Health Aides to Serve as Health Coaches for Home Care Patients With Chronic Illness: Findings and Lessons Learned From a Mixed-Method Evaluation of Two Pilot Programs
This article highlights findings from a mixed-method evaluation of two pilot programs that utilized Home Health Aides (HHAs) as health coaches for home care patients with chronic illness, including (1) a dedicated health coaching program for patients with heart failure and (2) an integrated program for HHAs working with chronically ill patients. Interviews were conducted with HHAs and staff to understand their experiences implementing program activities. Data from clinical assessments and surveys were employed to examine the characteristics and outcomes of patients. HHAs viewed health coaching positively and described it as an informative process that is dependent on patient motivation and willingness to change. Patients in both programs reported improvement in self-care maintenance. Patients in the chronic illness program also reported improved quality-of-life.
BercovitzAMossAJSenguptaM. An Overview of Home Health Aides: United States, 2007. Hyattsville, MD: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics; 2011.
2.
U.S. Department of Labor, Bureau of Labor Statistics. (STATISTICS UBOL). Employment status of the civilian noninstutional population by age, sex, and race. 2016. https://www.bls.gov/cps/demographics.htm
3.
StoneRI.The direct care worker: the third rail of home care policy. Annu Rev Public Health. 2004;25:521-537.
4.
StoneRHarahanMF.Improving the long-term care workforce serving older adults. Health Aff. 2010;29(1):109-115.
5.
GatesARudowitzRGuyerJ.An Overview of Delivery System Reform Incentive Payment (DSRIP) Waivers. New York, NY: Kaiser Family Foundation; 2014.
6.
AuerbachJChangDIHesterJMagnanS.Opportunity Knocks: Population Health in State Innovation Models. Washington, DC: Institute of Medicine; 2013.
7.
HuffmanM.Health coaching: a new and exciting technique to enhance patient self-management and improve outcomes. Home Healthc Nurse. 2007;25(4):271-274; quiz 275-276.
8.
PalmerSTubbsIWhybrowA.Health coaching to facilitate the promotion of healthy behaviour and achievement of health-related goals. Int J Health Promot Educ. 2003;41(3):91-93.
9.
GhorobA.Health coaching: teaching patients how to fish. Fam Pract Manag. 2013;20(3):40-42.
10.
CaspiJ.Coaching and social work: challenges and concerns. Soc Work. 2005;50(4):359-362.
11.
JerantAKravitzRMoore-HillMFranksP.Depressive symptoms moderated the effect of chronic illness self-management training on self-efficacy. Med Care. 2008;46(5):523-531.
12.
McGloinHTimminsFCoatesVBooreJ.A case study approach to the examination of a telephone-based health coaching intervention in facilitating behaviour change for adults with Type 2 diabetes. J Clin Nurs. 2015;24(9-10):1246-1257.
13.
PludwinskiSAhmadFWayneNRitvoP.Participant experiences in a smartphone-based health coaching intervention for type 2 diabetes: a qualitative inquiry. J Telemed Telecare. 2016;22(3):172-178.
14.
RiceKGJumamilRBJabourSMChengJK.Role of health coaches in pediatric weight management: patient and parent perspectives. Clin Pediatr (Phila). 2017;56(2):162-170.
15.
WolffJLStarfieldBAndersonG.Prevalence, expenditures, and complications of multiple chronic conditions in the elderly. Arch Intern Med. 2002;162(20):2269-2276.
16.
MurtaughCPengTTottenACostelloBMooreSAykanH.Complexity in geriatric home healthcare. J Healthc Qual. 2009;31(2):34-43.
17.
MusichSWangSSHawkinsKYehCS.Homebound older adults: prevalence, characteristics, health care utilization and quality of care. Geriatr Nurs. 2015;36(6):445-450.
18.
OrnsteinKALeffBCovinskyKE. Epidemiology of the homebound population in the United States. JAMA Intern Med. 2015;175(7):1180-1186.
19.
ShaoHPengTRBruceMLBaoY.Diagnosed depression among Medicare home health patients: national prevalence estimates and key characteristics. Psychiatr Serv. 2011;62(5):538-540.
20.
FlanneryM.Creating and sustaining an effective coaching culture in home care: one organization’s performance improvement related to aides and aide retention. Home Healthc Nurse. 2011;29(5):275-281.
21.
RiegelBJaarsmaTStrömbergA.A middle-range theory of self-care of chronic illness. ANS Adv Nurs Sci. 2012;35(3):194-204.
22.
RabinRCharroF.EQ-5D: a measure of health status from the EuroQol Group. Ann Med. 2001;33(5):337-343.
23.
GudexCDolanPKindPWilliamsA.Health state valuations from the general public using the visual analogue scale. Qual Life Res. 1996;5(6):521-531.
24.
RiegelBDicksonVVFaulknerKM.The situation-specific theory of heart failure self-care: revised and updated. J Cardiovasc Nurs. 2016;31(3):226-235.
25.
RosenfeldPRussellD.A review of factors influencing utilization of home and community-based long-term care: trends and implications to the nursing workforce. Policy Polit Nurs Pract. 2012;13(2):72-80.
26.
KangoviSCarterTCharlesD. Toward a scalable, patient-centered community health worker model: adapting the IMPaCT intervention for use in the outpatient setting. Popul Health Manag. 2016;19(6):380-388.
RussellDOberlinkMRShahSEvansLBassukK. 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 [published online ahead of print March1, 2017]. J Public Health Manag Pract. doi:10.1097/PHH.0000000000000545.
29.
GusmanoMKThompsonFJ.An examination of Medicaid delivery system reform incentive payment initiatives under way in six states. Health Aff. 2015;34(7):1162-1169.
30.
WoleverRQCaldwellKLWakefieldJP. Integrative health coaching: an organizational case study. Explore. 2011;7(1):30-36.
31.
SmithLLLakeNHSimmonsLAPerlmanAWrothSWoleverRQ.Integrative health coach training: a model for shifting the paradigm toward patient-centricity and meeting new national prevention goals. Glob Adv Health Med. 2013;2(3):66-74.
