Abstract
Chronic multi-symptom illness (CMI) is characterized by persistent, difficult to treat symptoms that interfere with daily functioning, affecting approximately 30% of post-deployment Veterans. Clinicians often provide many recommendations with limited patient adherence. Emerging research suggests health coaching may be an effective intervention for individuals with CMI. Importantly, Veterans often report barriers to health care, thus, telehealth may be a practical solution. Nevertheless, research is limited on the effectiveness of this intervention using telehealth. This preliminary pilot study aimed to assess the feasibility of remotely implementing health coaching to support Veterans’ engagement with health goals. Following interdisciplinary medical evaluations, psychologically/medically stable participants were referred to the study. Health coaches incorporated clinical recommendations from the comprehensive evaluation, partnering with Veterans to create health goals, aligning clinical recommendations with Veterans’ values. Coaching sessions were delivered via telehealth. The primary outcome of the present study was the status of health goals. Veterans (N = 39) were 50.2 ± 8.4 years old, 77% male, well-educated, and predominantly white (82%). They identified 60 health goals related to physical activity (35%), mindset (20%), and diet (17%). After eight sessions, 37% and 58% of Veterans fully met and partially met their goals, respectively. After 17 sessions, 56% and 44% fully met and partially met their goals, respectively. These findings demonstrate the feasibility of remotely delivered health coaching to increase Veterans’ engagement in lifestyle changes. Use of telehealth to implement health coaching may reduce barriers to care and increase treatment adherence for Veterans with chronic, medically unexplained symptoms.
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References
Whole Health Implementation - Designation_Framework_for_WH_Implementation.pdf - All Documents. https://dvagov.sharepoint.com/sites/VHAOPCC/WH-Implementation/Shared%20Documents/Forms/AllItems.aspx?id=%2Fsites%2FVHAOPCC%2FWH%2DImplementation%2FShared%20Documents%2FDesignation%5FFramework%2FDesignation%5FFramework%5Ffor%5FWH%5FImplementation%2Epdf&parent=%2Fsites%2FVHAOPCC%2FWH%2DImplementation%2FShared%20Documents%2FDesignation%5FFramework. Accessed 14 Jan 2024
Purcell, N., Zamora, K., Bertenthal, D., Abadjian, L., Tighe, J., Seal, K.H.: How VA whole health coaching can impact veterans’ health and quality of life: a mixed-methods pilot program evaluation. Glob. Adv. Health Med. 10 (2021). https://doi.org/10.1177/2164956121998283
U.S. Department of Veterans Affairs, Veterans Health Administration: Passport to Whole Health (2020)
Bokhour, B.G., et al.: From patient outcomes to system change: evaluating the impact of VHA’s implementation of the Whole Health System of Care. Health Serv. Res. 57, 53–65 (2022). https://doi.org/10.1111/1475-6773.13938
Bokhour, B.G., Haun, J.N., Hyde, J., Charns, M., Kligler, B.: Transforming the Veterans Affairs to a Whole Health System of Care Time for Action and Research (2020)
Gierisch, J.M., et al.: The Effectiveness of Health Coaching Evidence-based Synthesis Program (ESP) Durham VA Healthcare System Durham, NC Co-Investigators: Medical Editor (2017)
Denneson, L.M., Trevino, A.Y., Kenyon, E.A., Ono, S.S., Pfeiffer, P.N., Dobscha, S.K.: Health coaching to enhance psychological well-being among veterans with suicidal ideation: a pilot study. J. Gen. Intern. Med. 34, 192–194 (2019). https://doi.org/10.1007/S11606-018-4677-2/TABLES/2
Rethorn, Z.D., Pettitt, R.W., Dykstra, E., Pettitt, C.D.: Health and wellness coaching positively impacts individuals with chronic pain and pain-related interference. PLoS One 15 (2020). https://doi.org/10.1371/journal.pone.0236734
Department of Veterans Affairs Fiscal Years 2022–28 Strategic Plan LETTER FROM THE SECRETARY
The Lewin Group: VA/DoD Clinical Practice Guideline for the Management of Chronic Multisymptom Illness The Management of Chronic Multisymptom Illness Work Group With support from (2021)
Afari, N., et al.: Psychological trauma and functional somatic syndromes: a systematic review and meta-analysis. Psychosom. Med. 76, 2–11 (2014). https://doi.org/10.1097/PSY.0000000000000010
Clauw, D.: Fibromyalgia associated syndromes. J. Musculoskelet. Pain 201–214 (2002). https://doi.org/10.1300/J094v10n01_16
Mohanty, A.F., McAndrew, L.M., Helmer, D., Samore, M.H., Gundlapalli, A.V.: Chronic multisymptom illness among Iraq/Afghanistan-deployed US veterans and their healthcare utilization within the veterans health administration. J. Gen. Intern. Med. 33, 1419–1422 (2018). https://doi.org/10.1007/s11606-018-4479-6
McAndrew, L.M., Helmer, D.A., Phillips, L.A., Chandler, H.K., Ray, K., Quigley, K.S.: Iraq and Afghanistan Veterans report symptoms consistent with chronic multisymptom illness one year after deployment. J. Rehabil. Res. Dev. 53, 59–70 (2016). https://doi.org/10.1682/JRRD.2014.10.0255
Porter, B., Long, K., Rull, R.P., Dursa, E.K.: Prevalence of chronic multisymptom illness/gulf war illness over time among millennium cohort participants, 2001 to 2016. J. Occup. Environ. Med. 62, 4 (2020). https://doi.org/10.1097/JOM.0000000000001716
Stonerock, G.L., Blumenthal, J.A.: Role of counseling to promote adherence in healthy lifestyle medicine: strategies to improve exercise adherence and enhance physical activity. Prog. Cardiovasc. Dis. 59, 455 (2017). https://doi.org/10.1016/J.PCAD.2016.09.003
U.S. Department of Veterans Affairs: War Related Illness and Injury Study Center
Hermens, H., op den Akker, H., Tabak, M., Wijsman, J., Vollenbroek, M.: Personalized Coaching Systems to support healthy behavior in people with chronic conditions (2014). https://doi.org/10.1016/j.jelekin.2014.10.003
Elnitsky, C.A., Andresen, E.M., Clark, M.E., McGarity, S., Hall, C.G., Kerns, R.D.: Access to the US Department of Veterans Affairs health system: self-reported barriers to care among returnees of Operations Enduring Freedom and Iraqi Freedom (2013)
RURAL VETERANS - Office of Rural Health. https://www.ruralhealth.va.gov/aboutus/ruralvets.asp. Accessed 20 Jan 2024
Zulman, D.M., et al.: Making connections: Nationwide implementation of video telehealth tablets to address access barriers in veterans. JAMIA Open 2, 323–329 (2019). https://doi.org/10.1093/jamiaopen/ooz024
Joo, J.Y., Liu, M.F.: A Scoping Review of Telehealth-Assisted Case Management for Chronic Illnesses (2022). https://doi.org/10.1177/01939459211008917
Ngo, V., Hammer, H., Bodenheimer, T.: Health coaching in the teamlet model: a case study. J. Gen. Intern. Med. 25, 1375–1378 (2010). https://doi.org/10.1007/s11606-010-1508-5
VA Video Connect
Department of Veterans Affairs VHA, U.: Personal Health Inventory (2010)
Cornis-Pop, M., Reddy, K.P.: Integrative medicine and health coaching in polytrauma. Rehabilitation (2019). https://doi.org/10.1016/j.pmr.2018.08.007
Kligler, B., Khung, M., Schult, T., Whitehead, A.: What we have learned about the implementation of whole health in the veterans administration. J. Integr. Complement. Med. 29, 774–780 (2023). https://doi.org/10.1089/jicm.2022.0753
Sforzo, G.A., Kaye, M.P., Faber, A., Moore, M.: Dosing of Health and Wellness Coaching for Obesity and Type 2 Diabetes: Research Synthesis to Derive Recommendations (2023). https://doi.org/10.1177/15598276211073078
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This study was supported by WRIISC.
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Summers, A.C. et al. (2024). Distance-Based Lifestyle Medicine for Veterans with Chronic Multi-symptom Illness (CMI): Health Coaching as Behavioral Health Intervention for Clinical Adherence. In: Schmorrow, D.D., Fidopiastis, C.M. (eds) Augmented Cognition. HCII 2024. Lecture Notes in Computer Science(), vol 14695. Springer, Cham. https://doi.org/10.1007/978-3-031-61572-6_16
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