We want to share news about ongoing research in the division of general internal medicine. Recently Gene Oddone told us about an interesting behavioral health study that’s coming to a close this fall. He has collaborated with Laura Damschroder from Ann Arbor, Michigan, to investigate whether patients with risky behaviors such as smoking or obesity would choose prevention programs and change behaviors if they first participated in Shared Decision Making.
Last month the research team finalized recruitment of 416 Veterans from the Durham VAMC, Greenville NC Veterans Health Center, and Ann Arbor VA Medical Center. The final outcome assessment will be completed December, 2016.
Here is the project summary:
Project Name: Does a shared decision making approach to Health Risk Assessment enhance patient activation and engagement in prevention services?
Project Acronym or Short Title: ACTIVATE
Funding Agency: VA Health Services Research
PI(s): Eugene Z. Oddone, MD, MHSc, and Laura Damschroder, MS, MPH (Ann Arbor)
Project Staff: Felicia McCant, MPH (Project Coordinator), Jennifer Gierisch, PhD (Director Health Coaching), Maren Olsen, PhD (Biostatistician), Linda Sanders MStat (Biostatistician), Avi Alkon (Programmer)
Brief Description: The VA has committed to disseminate a web-based Health Risk Assessment tool and use it as the cornerstone of a personalized prevention plan to engage Veterans to improve their health behaviors that lead to high health risk. Health Risk Assessments done in isolation, however, do not generally lead to behavior change. ACTIVATE will test the effectiveness of a Shared Decision Making intervention designed to activate Veterans to enroll in effective prevention programs. The intervention will be conducted over the telephone, by a prevention coach, and will be linked to the patients’ primary care team (see figure). The co-primary outcomes will be patient activation and patient enrollment in prevention programs; we will also measure 10-year risk of major cardiac events.
ACTIVATE Intervention: Veterans randomized to the intervention receive two telephone calls from trained health coaches. In the first call, the coach and patient use the results of the Health Risk Assessment to choose a risk factor to address (obesity, smoking, and/or physical inactivity). The coach then guides the Veteran to an approved prevention program (either inside or outside the VA) and has them set a SMART goal for enrolling in that program. The second call either congratulates the patient for enrollment, or offers them a second coaching session designed to re-engage them in a prevention program. Usual care patients do not get the coach calls.
You can take the VA’s Healthy Living Assessment by registering on the VA’s main health website (MyHealtheVet): Veterans are interviewed by telephone at 1 month and in person 6 months after randomization.
Outcomes: The main outcomes of ACTIVATE include whether Veterans (1) identify and enroll in a structured prevention program to address a cardiovascular disease risk factor; (2) improve 10-year Framingham Risk Score.
The team completed recruitment of 416 Veterans from the Durham VAMC, Greenville NC Veterans Health Center, and Ann Arbor VA Medical Center in May 2016. Final outcome assessment will be complete December, 2016.
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