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CDC and Kaiser Permanente announce structured evaluation of the Wellness Coaching and Gestational Diabetes Programs
Section:  Nursing

“Kaiser Permanente Northern California (KPNC) Division of Research is assessing the effectiveness of 2 health plan-initiated programs to prevent the onset of diabetes in patients at high risk. The first study evaluates a telephonic health-coaching program that provides counseling on healthful eating, active living, and weight loss to KPNC members. The second evaluation examines a postpartum glucose screening and educational diabetes prevention program for women with gestational diabetes mellitus that KPNC implemented in 2006. Identifying effective approaches to preventing diabetes will be of value to health care systems, policy makers, and public health officials seeking to understand the roles systems and employers can play in preventing chronic illness.”

 

“Wellness Coaching Program Evaluation

KPNC’s Regional Health Education Department launched a telephonic Wellness Coaching Center in January 2010 targeted at members interested in healthy behaviors and employers who want to encourage healthy lifestyles among their employees. Wellness Coaching is designed to help members set and reach goals in 5 key areas (healthful eating, physical activity, weight management, smoking cessation, and stress management) to reduce health risk and increase health-related quality of life. Coaches are trained in motivational interviewing (12), a patient-centered behavioral health approach that assists patients in addressing self-management and multiple health risks and behaviors. This approach to health coaching has been effective in improving patient physical and mental health status (12). A typical coaching engagement consists of 1 initial session (30 minutes) and up to 3 short (5 to 15 minutes) follow-up contacts. Wellness Coaching is available to all KPNC members, and the program recruits participants through mechanisms that include partnerships with employers and direct risk assessment and outreach.”

Gestational Diabetes Program Evaluation

Within KPNC, the Regional Perinatal Service Center offers supplemental care via telephone counseling for women with pregnancies at high risk for adverse outcomes (such as preterm birth), including pregnancies complicated by GDM. Referral to the centers has been associated with decreased risk of macrosomia (excessive birth weight) and increased postpartum screening for diabetes (23). Beginning in 2006, the center has used a step-wise approach to ensure that all patients have a glucose test (standard oral glucose tolerance test [OGTT]) and appropriate educational and referral follow-up if postpartum glucose levels are elevated (diagnostic for IFG, impaired glucose tolerance, or diabetes). These increases in screening and the shift to the more sensitive OGTT should lead to greater detection of prediabetes and earlier detection of type 2 diabetes. We will evaluate whether the incidence of diabetes is decreasing because of these earlier detection and prevention efforts and because of treatment efforts launched after detection. We will compare the cohort of women with GDM who gave birth during 2001 through 2006 with the cohort who gave birth during 2006 through 2010 for subsequent diabetes incidence. For each cohort, follow-up begins at childbirth and continues until the diagnosis of diabetes, to the end of the study period (5 years follow-up for each person), or censoring because of leaving the health plan.”

Reference:

“Health-Plan and Employer-Based Wellness Programs to Reduce Diabetes Risk: The Kaiser Permanente Northern California NEXT-D Study”

Authors:Schmittdiel JA, Brown SD, Neugebauer R, Adams SR, Adams AS, Wiley D, et al. Health-Plan and Employer-Based Wellness Programs to Reduce Diabetes Risk: The Kaiser Permanente Northern California NEXT-D Study.

Prev Chronic Dis 2013;10:120146. DOI: http://dx.doi.org/10.5888/pcd10.120146

http://www.cdc.gov/pcd/issues/2013/12_0146.htm

 

MEMBER COMMENTS
Re: CDC and Kaiser Permanente announce structured evaluation of the Wellness Coaching and Gestational Diabetes Programs

I'd like to know who is providing the wellness coaching. I'm a certified coach through Wellcoaches, and perhaps I'm biased but training someone in MI is only one small piece of coaching. It's sort of like training someone to use a glucometer, and then calling them a diabetes educator.

Re: CDC and Kaiser Permanente announce structured evaluation of the Wellness Coaching and Gestational Diabetes Programs

I really do understand your concern,Lyn. I hope we are not entering an era where highly credentialed health professionals are bypassed in favor of low cost alternatives that appear to suffice.

Re: CDC and Kaiser Permanente announce structured evaluation of the Wellness Coaching and Gestational Diabetes Programs

MA is in the process of formalizing the Community Health Worker, with policy changes.  I can't wait to see how many people come out to fight this.  I'll keep you posted !