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Health Coaches Enhance Participants’ Walk With Ease Experience
State: Iowa Submitted Date: 2019
Problem Statement

Arthritis is a major public health problem in the United States.  It affects over 54 million American adults and will increase to 78 million by 2040.  The condition limits 24 million people from performing their daily tasks.  Specific to Iowa, the state had an age-adjusted arthritis prevalence of 23.1% in 2016.

Project Objective(s)

Funding Community Health Partners (CHP) is helping NACDD to achieve the following project objective: By 9/29/19, three national or regional partner organizations will be recruited to receive HUB mini-grants to deliver Walk With Ease (WWE) self-directed or group program to adults with arthritis.

Program Action

Studies have found walking to be a safe and effective way to manage arthritis.  In 2018-2019, the National Association of Chronic Disease Directors awarded a mini-grant to Community Health Partners (CHP) in Des Moines, Iowa, for the purpose of engaging 3,000 participants in Walk With Ease (WWE), an arthritis appropriate evidence-based intervention.  WWE is offered in either a group or self-directed format.

CHP has been supporting NACDD’s WWE efforts for multiple years, initially as a partner of the Iowa Physical Therapy Association when IPTA was awarded funding from NACDD, then as a direct recipient of NACDD mini-grant funding.

CHP is a community-based organization that focuses on a continuum of care across the spectrum of prevention; one of CHP’s three pillars is self-management coaching and education.  CHP has a unique and valuable partnership with Iowa State University (ISU) that enables trained health coaches to support self-directed WWE participants (called the “enhanced self-directed” version of WWE).  Participants in the enhanced self-directed version of WWE are guided through the program using personalized (telephonic) health coaching based on motivational interviewing, “a collaborative conversation style for strengthening a person’s own motivation and commitment to change.”

Data/Other Information Collected

CHP collects data on the number of enrollees and completers in both WWE formats, as well as select pre and post data; a 6-month follow-up survey is planned for participants who complete the enhance self-directed version. 

Impact / Accomplishment

The CHP/ISU partnership has created a unique and meaningful model of supporting WWE self-directed participants.  They have successfully formalized a health coaching model in which health coaches follow a documented format and complete a standard summary of each participant session.

As of 09/13/19, CHP has had 46 participants enroll and 28 participants complete the WWE self-directed program, 10 participants are currently progressing through the program, representing a completion rate of 72%.  Each participant was engaged by a health coach on a weekly basis during the course of their WWE enrollment.       

In a telephonic conversation with one enhanced self-directed participant, she noted, “having a health coach was motivation.”  She elaborated by sharing that having a health coach to talk to was a big help.  The coach kept her motivated to keep up with the program and keep walking in a way that she may not have otherwise.  The participant rated her fatigue “around a 7” when she started, citing it’s “down to a 1-2”; she’s walking around a mile now, which has helped her take less pain medication and improved her outlook.]

Next Steps

CHP plans to continue using ISU-trained health coaches to support WWE self-directed participants.  

CHP and ISU have also submitted an R01 application to the National Institutes of Health proposing to address a fundamental gap in health care by testing ways to integrate community-based physical activity programming into clinical care.  They are specifically interested in systematically evaluating the programmatic factors that enhance individual-level outcomes as well as the impact of organizational factors on the delivery and implementation of WWE by community-based organizations.

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