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Improving Chronic Disease Self-Management by Older Home Health Patients through Community Health Coaching

Author

Listed:
  • Cheryl Dye

    (Institute for Engaged Aging, 2037 Barre Hall, Clemson University, Clemson, SC 29634, USA)

  • Deborah Willoughby

    (School of Nursing, 417 Edwards Hall, Clemson University, Clemson, SC 29634, USA)

  • Begum Aybar-Damali

    (Department of Recreation, Tourism and Therapeutic Recreation, Memorial Hall 119,Winona State University, Winona, MN 55987, USA)

  • Carmelita Grady

    (Walsh Center for Rural Health Analysis, NORC at the University of Chicago, 4350 East-West Hwy, Bethesda, MD 20814, USA)

  • Rebecca Oran

    (Walsh Center for Rural Health Analysis, NORC at the University of Chicago, 4350 East-West Hwy, Bethesda, MD 20814, USA)

  • Alana Knudson

    (Walsh Center for Rural Health Analysis, NORC at the University of Chicago, 4350 East-West Hwy, Bethesda, MD 20814, USA)

Abstract

The purpose of the study was to pilot test a model to reduce hospital readmissions and emergency department use of rural, older adults with chronic diseases discharged from home health services (HHS) through the use of volunteers. The study’s priority population consistently experiences poorer health outcomes than their urban counterparts due in part to lower socioeconomic status, reduced access to health services, and incidence of chronic diseases. When they are hospitalized for complications due to poorly managed chronic diseases, they are frequently readmitted for the same conditions. This pilot study examines the use of volunteer community members who were trained as Health Coaches to mentor discharged HHS patients in following the self-care plan developed by their HHS RN; improving chronic disease self-management behaviors; reducing risk of falls, pneumonia, and flu; and accessing community resources. Program participants increased their ability to monitor and track their chronic health conditions, make positive lifestyle changes, and reduce incidents of falls, pneumonia and flu. Although differences in the ED and hospital admission rates after discharge from HHS between the treatment and comparison group (matched for gender, age, and chronic condition) were not statistically significant, the treatment group’s rate was less than the comparison group thus suggesting a promising impact of the HC program (90 day: 263 comparison vs. 129 treatment; p = 0.65; 180 day 666.67 vs. 290.32; p = 0.19). The community health coach model offers a potential approach for improving the ability of discharged older home health patients to manage chronic conditions and ultimately reduce emergent care.

Suggested Citation

  • Cheryl Dye & Deborah Willoughby & Begum Aybar-Damali & Carmelita Grady & Rebecca Oran & Alana Knudson, 2018. "Improving Chronic Disease Self-Management by Older Home Health Patients through Community Health Coaching," IJERPH, MDPI, vol. 15(4), pages 1-23, April.
    • Handle: RePEc:gam:jijerp:v:15:y:2018:i:4:p:660-:d:139147
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    References listed on IDEAS

    as
    1. James, W.L., 2014. "All rural places are not created equal: Revisiting the rural mortality penalty in the United States," American Journal of Public Health, American Public Health Association, vol. 104(11), pages 2122-2129.
    2. Caldwell, J.T. & Ford, C.L. & Wallace, S.P. & Wang, M.C. & Takahashi, L.M., 2016. "Intersection of living in a rural versus urban area and race/ethnicity in explaining access to health care in the United States," American Journal of Public Health, American Public Health Association, vol. 106(8), pages 1463-1469.
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