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

NCT ID: NCT02386540

Last Updated: 2018-12-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

295 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-02-06

Study Completion Date

2018-12-10

Brief Summary

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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.

Detailed Description

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Patients will be recruited by health coaches from the Highland Hospital Emergency Department. Eligible patients who agree to participate will be randomized to the control and experimental groups in a 2:1 ratio respectively because experimental group size is limited by health coach availability and greater loss-to-follow up is expected among the control group. Repeated measures analysis will be used to compare each outcome over the study period. In addition, subgroup analyses will be performed in order to stratify by baseline survey measures or amount of ED visits in the pre-observation period.

Conditions

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Diabetes Mellitus Hypertension

Keywords

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

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Health Coaching

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.

Group Type EXPERIMENTAL

Health Coaching

Intervention Type 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.

Usual Care

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

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Health Coaching

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.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* 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
* 18 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.

Exclusion Criteria

* 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
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of California, Berkeley

OTHER

Sponsor Role collaborator

Robert Wood Johnson Foundation

OTHER

Sponsor Role collaborator

Alameda County Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Harrison J. Alter

Associate Chair for Research, Department of Emergency Medicine, Highland Hospital

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jocelyn Freeman-Garrick, MD

Role: PRINCIPAL_INVESTIGATOR

Highland Hospital - Alameda Health System

Berenice Perez, MD

Role: PRINCIPAL_INVESTIGATOR

Highland Hospital - Alameda Health System

Harrison Alter, MD

Role: PRINCIPAL_INVESTIGATOR

Highland Hospital - Alameda Health System

Locations

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Highland Hospital - Alameda Health System

Oakland, California, United States

Site Status

Countries

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United States

Other Identifiers

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IRB 14-08123E

Identifier Type: -

Identifier Source: org_study_id