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Health Coaching: A Preliminary Report on the Effects in Traumatic Brain Injury/Polytrauma Patients

Background: Failure to adhere to treatment recommendations has significant impact on the health outcomes of the individual and health care systems. Health coaching is a promising care model that has gained interest in the medical field. This study focused on the impact of health coaching on health behaviors that may have direct impact on successful patient outcomes. Primary Study Objective: The objective of this study was to assess the impact of health coaching administered through the Polytrauma Integrative Medicine Initiative (PIMI). Methods/Design: This study was a quasiexperimental cohort study. Setting: This study occurred at a specialized polytrauma rehabilitation center. Participants: Participants were divided into 3 cohorts: (1) 33 patients who served through PIMI enrollment, (2) 22 patients who declined PIMI, and (3) a control cohort of 30 random patients who were not referred to PIMI. Patients were primarily male active duty or veteran military personnel. Intervention: The intervention consisted of personalized health coaching by trained, certified personnel. Primary Outcome Measures: Outcome measures included the following (1) Self-assessment: utilizing the Personal Health Inventory (PHI) at enrollment and at 3 mo; (2) treatment adherence: the percentage of scheduled appointments fulfilled by patients; and (3) post hoc analysis: for no-show and cancellation rates; 2-tailed paired t tests for PHI data and post hoc within groups; 2-tailed independent samples t tests for treatment adherence percentages and post hoc between groups. Results: There was no significant difference in treatment adherence rates between the 3 cohorts (all P > .45). PIMI patients had significantly higher cancellation rates than no-show rates for both clinical, 20.8%/5%, and coaching appointments, 17.3%/7.5%, (P < .05). PIMI patients had significantly lower no-show rates, 5%, than control patients, 15.8% (P = .007). PHI data suggest PIMI patients believe they are making improvements in many areas of health coaching focus. Conclusion: Low cohort numbers are a concern. There was no difference for treatment adherence rates for health coaching compared with no health coaching. Select variables such as cancellation and no-show appointment rates may better capture the impact of health coaching on patient behavior and clinical resource utilization.

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