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Donahue KE, Tillman J, Halladay JR, Cené CW, Hinderliter A, Cummings DM, Miller C, Gizlice Z, Garcia BA, Wu JR, Quenum E, Bosworth HB, Keyserling TC, DeWalt D. Lessons Learned From Implementing Health Coaching in The Heart Healthy Lenoir Hypertension Study. Progress in community health partnerships : research, education, and action. 2016 Jan 1; 10(4):559-567.
BACKGROUND: Health coaching is increasingly important in patient-centered medical homes. OBJECTIVES: Describe formative evaluation results and lessons learned from implementing health coaching to improve hypertension self-management in rural primary care. METHODS: A hypertension collaborative was formed consisting of six primary care sites. Twelve monthly health coaching phone calls were attempted for 487 participants with hypertension. LESSONS LEARNED: Participant engagement was challenging; 58% remained engaged, missing fewer than three consecutive calls. Multivariate analyses revealed that older age (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.01-1.05), African American race (O,R 1.73; 95% CI, 1.15-2.60), greater number of comorbidities (OR, 1.17; 95% CI, 1.05-1.30) and receiving coaching closer to enrollment (OR, 5.03; 95% CI, 2.53-9.99) were correlated independently with engagement. Participants reported the coaching valuable; 96% would recommend health coaching to others. CONCLUSIONS: Health coaching in hypertension care can be successful strategy for engaging more vulnerable groups. A more tailored approach may improve engagement with counseling.