Is health coaching the next panacea in healthcare reform?

2021 ◽  
Vol 32 (8) ◽  
pp. 323-326
Author(s):  
Catherine Best
Keyword(s):  
Chronic Disease ◽  
Healthcare Reform ◽  
Healthy Lifestyle ◽  
Communicable Disease ◽  
Essential Element ◽  
Health Coaching ◽  
Health Conditions ◽  
The Impact ◽  
Non Communicable Disease

Health coaching aims to empower patients to self-manage their long-term health conditions. Catherine Best explores the effect health coaching can have on patients and the shifts that are required to deliver it Non-communicable diseases now account for the vast majority of deaths globally. It is recognised that personalised care is key to managing non-communicable disease and health coaching is considered an essential element. Health coaching is a developing field of practice that encourages patients to adopt healthy lifestyle behaviours that can avert the impact of chronic disease. This article explores the effect health coaching can have on patients and the shifts that are required to deliver it.

scholarly journals Outcomes of decentralizing hypertension care from district hospitals to health centers in Rwanda, 2013–2014

2019 ◽  
Vol 9 (4) ◽  
pp. 142-147
Author(s):  
G. Ngoga ◽  
P. H. Park ◽  
R. Borg ◽  
G. Bukhman ◽  
E. Ali ◽  
...  
Keyword(s):  
Communicable Disease ◽  
Health Centers ◽  
Blood Pressure Targets ◽  
District Hospitals ◽  
Significant Difference ◽  
Stage 1 ◽  
To Receive ◽  
Non Communicable Disease

Setting: Three district hospitals (DHs) and seven health centers (HCs) in rural Rwanda.Objective: To describe follow-up and treatment outcomes in stage 1 and 2 hypertension patients receiving care at HCs closer to home in comparison to patients receiving care at DHs further from home.Design: A retrospective descriptive cohort study using routinely collected data involving adult patients aged 18 years in care at chronic non-communicable disease clinics and receiving treatment for hypertension at DH and HC between 1 January 2013 and 30 June 2014.Results: Of 162 patients included in the analysis, 36.4% were from HCs. Patients at DHs travelled significantly further to receive care (10.4 km vs. 2.9 km for HCs, P < 0.01). Odds of being retained were significantly lower among DH patients when not adjusting for distance (OR 0.11, P = 0.01). The retention effect was consistent but no longer significant when adjusting for distance (OR 0.18, P = 0.10). For those retained, there was no significant difference in achieving blood pressure targets between the DHs and HCs.Conclusion: By removing the distance barrier, decentralizing hypertension management to HCs may improve long-term patient retention and could provide similar hypertension outcomes as DHs.

The Impact of Hurricane Maria on Individuals Living with Non-Communicable Disease in Puerto Rico: The experience of 10 communities

2021 ◽  
Author(s):  
Elizabeth L. Andrade ◽  
Amalis Cordova Mustafa ◽  
Courtney Riggle-vanSchagen ◽  
Megan Jula ◽  
Carlos E. Rodriguez-Diaz ◽  
...  
Keyword(s):  
Puerto Rico ◽  
Natural Hazards ◽  
Structural Damage ◽  
Communicable Disease ◽  
Community Level ◽  
Morbidity And Mortality ◽  
Health Concern ◽  
Increased Risk ◽  
The Impact ◽  
Non Communicable Disease

Abstract Background Coinciding with the rising non-communicable disease (NCD) prevalence worldwide is the increasing frequency and severity of natural hazards. Protecting populations with NCDs against natural hazards is ever more pressing given their increased risk of morbidity and mortality in disaster contexts. Methods This investigation examined Hurricane Maria’s impact across 10 communities in Puerto Rico to determine whether and how disaster impact and community attributes affected NCD management. We conducted 40 qualitative interviews with mayors, first responders, faith leaders, community leaders, and municipal employees, with 4 interviews per selected municipality. Using QSR NVivo software, we coded interview transcripts and created categorical community-level impact variables based on participant responses. We undertook thematic analysis to characterize community-level impact and consequences for NCD management, and to identify convergent and divergent themes. Using a matrix coding query, we compared NCD management experiences across communities by impact variables and community attributes. Results The delivery of healthcare, pharmacy, and dialysis services was compromised due to facility structural damage and ineffective contingencies for electrical power and water supply. The challenges resulting from power outages were immediate, and individuals who were reliant on life-sustaining medical equipment, dialysis, or the refrigeration of medications were most vulnerable. Inaccessible roadways and the need to travel greater distances to locate operational health services were major impediments to transporting patients in need of NCD care, with those requiring dialysis and living in remote, mountainous communities at highest risk due to landslides and lengthy roadway obstruction. These barriers were compounded by limited communication to locate services and coordinate care. Two weeks post-hurricane, emerging challenges to NCD management included widespread diesel fuel shortages for generators, and shortages in medications, oxygen, and medical supplies. In the weeks to months post-hurricane, the emergence or exacerbation of mental health disorders was characterized as a pressing health concern. Conclusions Study findings identify contributors to morbidity and mortality among individuals with NCDs following Hurricane Maria. The degree to which these impacts were experienced across communities with different characteristics is discussed, offering important lessons regarding the impact of catastrophic disasters on NCD management for improve community disaster resilience.

scholarly journals Health coach online - health benefits on the citizens terms

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Kuitunen ◽  
A Cavrak
Keyword(s):  
Health Care ◽  
Healthy Lifestyle ◽  
Eating Habits ◽  
Hospital Costs ◽  
Diabetes Type 2 ◽  
Cost Effective ◽  
Health Coaching ◽  
Unhealthy Lifestyle ◽  
Lifestyle Habits ◽  
The Impact

Abstract In Sweden, we know that half of the women and two thirds of the men have one or more unhealthy lifestyle habits. We also know that 90% of all diabetes type 2, 80% of all heart attacks and 30% of all cancer can be prevented, if one has a healthy lifestyle. Consultative conversations have been proved very helpful while changing ones habits. The lifestyle habits of Swedes are similar to those of other countries in Europe, and by making our research available and the concept known to other countries, the overall health in Europe can improve. In August 2017 an online practice opened in a county in south west of Sweden, were we performed lifestyle interventions with people who applied and needed it. The practice specialized in eating habits, physical exercise, alcohol and tobacco use. We have 4-6 consultative meetings during 3 to 4 months, where we help our clients set realistic goals to reach, that work in their day to day life. While using coaching techniques and motivational interviewing, we have met over 200 people, and helped improve their lifestyle. We have seen that in regarding to self-assessed health (1-10), our clients score is higher after both completed health coaching and a year after completed coaching than at start. Calculating QALY, we can see that the impact the coach makes on our clients is cost effective and one person being coached saves the amount in hospital costs that we can use to coach 30 more. We have learned that online meetings are more cost effective and practical for this type of concept. Our clients feel more relaxed and open to the process at a location of their choosing and it saves time for them, time they might not have taken otherwise - therefore, we can help more people. Meetings online enables us to reach all over the Västra Götaland region, and not only the close proximity where the coaches are located. Key messages Online health coaching supports our health care and helps the citizens to improve their lifestyle habits and their overall health. The online method is cost effective and it saves money for both health care and society.

Recruitment to a trial of self-care skills training in long-term health conditions: Analysis of the impact of patient attitudes and preferences

2006 ◽  
Vol 27 (1) ◽  
pp. 49-56 ◽  
Author(s):  
Peter Bower ◽  
Anne Kennedy ◽  
David Reeves ◽  
Claire Gately ◽  
Victoria Lee ◽  
...  
Keyword(s):  
Self Care ◽  
Skills Training ◽  
Health Conditions ◽  
Patient Attitudes ◽  
The Impact

scholarly journals Prescribing a Healthy Lifestyle Polypill With High Therapeutic Efficacy in Many Shapes and Sizes

2015 ◽  
Vol 11 (6) ◽  
pp. 476-478 ◽  
Author(s):  
Ross Arena ◽  
Carl J. Lavie ◽  
Marco Guazzi
Keyword(s):  
Therapeutic Efficacy ◽  
Healthy Lifestyle ◽  
European Heart Journal ◽  
Communicable Disease ◽  
Cardiovascular Prevention ◽  
Heart Association ◽  
Policy Statement ◽  
Unhealthy Lifestyle ◽  
Healthcare Model ◽  
Non Communicable Disease

The paradigm allowing for a lifestyle immersed in unhealthy behaviors to perpetuate to a point where a non-communicable disease (NCD) is eminent or manifests, and then initiating health care interventions, is deeply flawed, results in poor outcomes, and is unsustainable. This paradigm describes the current predominant healthcare model in many countries around the world and has resulted in the continual increase in unhealthy lifestyle patterns that have led to the global NCD epidemic. It is now broadly recognized that rapid integration of a new healthcare model, one heavily focused on primordial and primary NCD prevention, is needed. Being physically active, eating healthy and nutritious foods, not smoking and minimizing second-hand exposure, and maintaining an appropriate body weight are central to this new prevention model. Combined, these four characteristics can be viewed as the key ingredients for the “healthy lifestyle polypill”. Recently, the American Heart Association (AHA), European Society of Cardiology (ESC), European Association for Cardiovascular Prevention and Rehabilitation (EACPR), and American College of Preventive Medicine (ACPM) came together to publish, in both the Mayo Clinic Proceedings and European Heart Journal, a policy statement entitled “Healthy Lifestyle Interventions to Combat Non-Communicable Disease: A Novel Non-Hierarchical Connectivity Model for Key Stakeholders”. We hope the AHA-ESC-EACPR-ACPM healthy lifestyle policy statement prompts a massive increase in production of the healthy lifestyle polypill. Regulatory approval is not needed to start manufacturing and distributing this medication. The polypill can take many forms and have differing ingredients and dosages while still maintaining high therapeutic efficacy.

scholarly journals Peningkatan Pemahaman Risiko Penyakit Tidak Menular pada Remaja melalui Deteksi Dini dengan Pemeriksaan Komposisi Tubuh di SMK PGRI 2 Surakarta (Increased Understanding of the Risk of Non-Communicable Diseases in Adolescents through Early Detection by Examination of Body Composition in SMK PGRI 2 Surakarta)

2020 ◽  
Vol 2 (1) ◽  
pp. 11
Author(s):  
Aryanti Setyaningsih ◽  
Nastitie Cinintya Nurzihan
Keyword(s):  
Body Composition ◽  
Health Education ◽  
Early Detection ◽  
Healthy Lifestyle ◽  
Communicable Disease ◽  
Communicable Diseases ◽  
Non Communicable Diseases ◽  
Health Group ◽  
Obesity Hypertension ◽  
Non Communicable Disease

Abstrak Remaja merupakan kelompok kesehatan prima namun rentan karena mengalami perubahan perilaku berisiko sehingga akan menentukan status kesehatan pada saat dewasa. Salah satu permasalahan kesehatan yang meningkat pada remaja adalah meningkatnya penyakit tidak menular pada remaja, misalnya obesitas, hipertensi, diabetes dan hiperkolesterolemia. Remaja perlu mendapatkan pemaparan mengenai penyakit tidak menular perlu diberikan kepada remaja guna meningkatkan kesadaran dan pemahaman remaja mengenai risiko, dampak, dan deteksi dini penyakit tidak menular pada remaja. Oleh karena itu, perlu diberikan pendidikan kesehatan sebagai dasar penerapan hidup sehat dan cara deteksi dini yang dapat dilakukan oleh remaja guna pencegahan penyakit tidak menular pada remaja. Kegiatan ini dilaksanakan di di SMK 2 PGRI Surakarta yang dilakukan selama 2 hari pada Bulan Juli 2019. Metode kegiatan adalah pendidikan kesehatan dan pemeriksaan komposisi tubuh dengan pengukuran indeks massa tubuh. Tiga puluh dua siswa mengikuti kegiatan ini. Hasil evaluasi menunjukkan peningkatan pengetahuan penyakit tidak menular dan kemampuan siswa dalam memahami status gizi mereka melalui pengukuran komposisi tubuh sebagai bagian dari deteksi dini penyakit tidak menular. Dengan demikian, dapat disimpulkan bahwa terdapat peningkatan pengetahuan dan kesadaran peserta kegiatan dalam melakukan pencegahan terhadap penyakit tidak menular remaja. �Kata kunci: Deteksi Dini; Pendidikan Kesehatan; Pengetahuan; PTM; Remaja�Abstract Adolescents are a prime health group but are vulnerable because they experience changes in risky behavior that will determine their health status as adults. One of the increasing health problems in adolescents is the increase in non-communicable diseases in adolescents, such as obesity, hypertension, diabetes, and hypercholesterolemia. Adolescents need to get exposure to non-communicable diseases to increase awareness and understanding of the risks, impacts, and early detection of non-communicable diseases in adolescents. Therefore, it is necessary to provide health education as a basis for implementing a healthy lifestyle and early detection that can be done by adolescents to prevent non-communicable diseases in adolescents. This activity was carried out at SMK 2 PGRI Surakarta which was conducted for 2 days in July 2019. The method of the activity was health education and examination of body composition by measuring body mass index. Thirty-two students participated in this activity. Evaluation results show an increase in knowledge of non-communicable diseases and the ability of students to understand their nutritional status through measurement of body composition as part of early detection of non-communicable diseases. Thus, it can be concluded that there is an increase in the knowledge and awareness of participant activities in the prevention of adolescent non-communicable diseases.�Keywords: Early Detection; Health Education; Knowledge; Non-Communicable Disease; Adolescent

scholarly journals Chronic Disease Stigma, Skepticism of the Health System, and Socio-economic Fragility: Qualitative Assessment of Factors Impacting Receptiveness to Group Medical Visits and Microfinance for Non-Communicable Disease Care in Rural Kenya

2020 ◽  
Author(s):  
Rae Dong ◽  
Claudia Leung ◽  
Mackenzie N. Naert ◽  
Violet Naanyu ◽  
Peninah Kiptoo ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Health System ◽  
Health Workers ◽  
Care Delivery ◽  
Communicable Disease ◽  
Qualitative Assessment ◽  
East African Community ◽  
Group Medical Visits ◽  
Medical Visits ◽  
The Impact

Abstract Background: Non-communicable diseases (NCDs) are the leading cause of mortality in the world, and innovative approaches to NCD care delivery are being actively developed and evaluated. Combining the group-based experience of microfinance and group medical visits is a novel approach to NCD care delivery that has demonstrated beneficial impact in previous pilot studies. However, the contextual factors, facilitators, and barriers impacting wide-scale implementation of these approaches within a low- and middle-income country setting are not well known.Methods: Two types of qualitative group discussion were conducted: 1) mabaraza (singular, baraza), a traditional East African community gathering used to discuss and exchange information in large group settings; and 2) focus group discussions (FGDs) among rural clinicians, community health workers, microfinance group members, and patients with NCDs. Trained research staff members led the discussions using structured question guides. Content analysis was performed with NVivo using deductive and inductive codes that were then grouped into themes.Results: We conducted 5 mabaraza and 16 FGDs. A total of 205 individuals (113 men and 92 women) participated in the mabaraza, while 162 individuals (57 men and 105 women) participated in the FGDs. Participants expressed interest in participating in microfinance and group medical visits, but cited several key challenges: 1) stigma of chronic disease, 2) earned skepticism of the health system, and 3) socio-economic fragility.Conclusions: Our qualitative study revealed and illuminated actionable factors that could impact the success of implementation of group medical visits and microfinance initiatives for NCD care. While several challenges were highlighted, participants also felt that planned interventions could address and mitigate the impact of these dynamic factors. We anticipate that our approach and analysis provides new insights and methodological techniques that will be relevant to other low-resource settings worldwide.Trial Registration: Clinicaltrials.gov, NCT02501746, registration date: July 17, 2015

scholarly journals Chronic Disease in the Community (CDCom) Program: Hypertension and non-communicable disease care by village health workers in rural Uganda

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247464
Author(s):  
Joseph H. Stephens ◽  
Aravind Addepalli ◽  
Shombit Chaudhuri ◽  
Abel Niyonzima ◽  
Sam Musominali ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Health Workers ◽  
District Hospital ◽  
Communicable Disease ◽  
Sub Saharan Africa ◽  
Hypertension Prevalence ◽  
Village Health Workers ◽  
Sub Saharan ◽  
Village Health ◽  
Non Communicable Disease

Background Although hypertension, the largest modifiable risk factor in the global burden of disease, is prevalent in sub-Saharan Africa, rates of awareness and control are low. Since 2011 village health workers (VHWs) in Kisoro district, Uganda have been providing non-communicable disease (NCD) care as part of the Chronic Disease in the Community (CDCom) Program. The VHWs screen for hypertension and other NCDs as part of a door-to-door biannual health census, and, under the supervision of health professionals from the local district hospital, also serve as the primary providers at monthly village-based NCD clinics. Objective/Methods We describe the operation of CDCom, a 10-year comprehensive program employing VHWs to screen and manage hypertension and other NCDs at a community level. Using program records we also report hypertension prevalence in the community, program costs, and results of a cost-saving strategy to address frequent medication stockouts. Results/Conclusions Of 4283 people ages 30–69 screened for hypertension, 22% had a blood pressure (BP) ≥140/90 and 5% had a BP ≥ 160/100. All 163 people with SBP ≥170 during door-to-door screening were referred for evaluation in CDCom, of which 91 (59%) had repeated BP ≥170 and were enrolled in treatment. Of 761 patients enrolled in CDCom, 413 patients are being treated for hypertension and 68% of these had their most recent blood pressure below the treatment target. We find: 1) The difference in hypertension prevalence between this rural, agricultural population and national rates mirrors a rural-urban divide in many countries in sub-Saharan Africa. 2) VHWs are able to not only screen patients for hypertension, but also to manage their disease in monthly village-based clinics. 3) Mid-level providers at a local district hospital NCD clinic and faculty from an academic center provide institutional support to VHWs, stream-line referrals for complicated patients and facilitate provider education at all levels of care. 4) Selective stepdown of medication doses for patients with controlled hypertension is a safe, cost-saving strategy that partially addresses frequent stockouts of government-supplied medications and patient inability to pay. 5) CDCom, free for village members, operates at a modest cost of 0.20 USD per villager per year. We expect that our data-informed analysis of the program will benefit other groups attempting to decentralize chronic disease care in rural communities of low-income regions worldwide.

scholarly journals Caregivers’ Mental Health and Somatic Symptoms During COVID-19

2020 ◽  
Author(s):  
Sung S Park
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Negative Binomial ◽  
Somatic Symptoms ◽  
Health Conditions ◽  
Group Differences ◽  
Short Term ◽  
The Impact ◽  
Mental And Physical Health

Abstract Objectives This study examines differences in the mental and physical health of the U.S. population during the early stages of the COVID-19 pandemic among 3 groups: noncaregivers, short-term caregivers (1 year or less), and long-term caregivers (greater than 1 year). Methods Data from the Understanding America Study are used to describe group differences in reports of psychological distress and somatic symptoms. Logistic and negative binomial regression models are used to examine whether these differences persist after adjusting for demographic, socioeconomic, and prepandemic health conditions. To understand within-group differences in caregiving demands, the intensity of care provided by short-term and long-term caregivers, as well as selected patients’ health conditions are summarized. Results Adults’ mental and physical health varied substantially by caregiver status. Caregivers continued to fare worse than noncaregivers in terms of mental health and fatigue, and long-term caregivers were more likely to report headache, body aches, and abdominal discomfort than both short-term caregivers and noncaregivers, net of controls. The nature of caregiving differed between short-term and long-term caregivers, with the latter more likely to provide greater hours of care, and to be looking after patients with permanent medical conditions. Discussion Efforts to understand and mitigate the impact of the pandemic on population health should include caregivers, whose mental and physical health were already vulnerable before COVID-19.

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