Whole Health Coaching for Homeless Veterans' Healthcare Needs

(PWHC Trial)

Recruiting in Palo Alto (17 mi)

+2 other locations

Overseen by David A. Smelson, PsyD

Age: Any Age

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: VA Office of Research and Development

Disqualifiers: Suicidal, Behavioral, Cognitive impairment

No Placebo Group

Approved in 1 Jurisdiction

Trial Summary

What is the purpose of this trial?

Use of acute care services (e.g., hospitalizations, Emergency Department visits) contributes substantially to the cost of healthcare for Veterans. Homelessness is a robust social determinant of super utilization of acute care. The goal of this project is to test if Peer Specialists trained in Whole Health Coaching can reduce homeless Veterans' frequent use of acute care.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Whole Health Coaching for Homeless Veterans' Healthcare Needs?

Research shows that peer-delivered Whole Health Coaching can help veterans with PTSD make progress on wellness goals, with high satisfaction and engagement. Additionally, a peer-led program improved mental health, quality of life, and reduced stress among veterans, suggesting that peer support and Whole Health concepts can enhance well-being and healthcare engagement. ^{1 2 3 4 5}

How is Peer Support-Whole Health Coaching different from other treatments for homeless veterans?

Peer Support-Whole Health Coaching is unique because it combines peer support with health coaching to address the holistic needs of veterans, focusing on what matters most to them. This approach is part of a broader Whole Health system that includes various complementary therapies, aiming to empower veterans to manage their health and well-being effectively. ^{1 6 7 8 9}

Research Team

Daniel M. Blonigen, PhD MA

Principal Investigator

VA Palo Alto Health Care System, Palo Alto, CA

David A. Smelson, PsyD

Principal Investigator

VA Bedford HealthCare System, Bedford, MA

Eligibility Criteria

This trial is for Veterans enrolled in a VA care team, listed on the VA's Homeless Registry, and have used acute care services frequently. It's not open to those with suicidal tendencies or severe cognitive impairments that prevent understanding of the study.

Inclusion Criteria

Veterans who had a hot spotter qualifying event in two or more quarters in the past year will be eligible for participation

Veterans who are enrolled on a Patient Aligned Care Team (or "PACT") at a study site

Veterans who are on VA's Homeless Registry, which comprises those who utilized any VA homeless programs and services in the past 2 years

Exclusion Criteria

I understand the study details and can consent on my own.

Veterans who have a suicidal and/or behavioral flag in their medical record

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants will meet with a Peer Specialist for 18 sessions over 24 weeks, receiving Whole Health Coaching to reduce acute care utilization

24 weeks

18 sessions

Follow-up

Participants are monitored for safety and effectiveness after treatment, including assessment of health outcomes and service engagement

9 months

Treatment Details

Interventions

• Peer Support-Whole Health Coaching (Behavioral Intervention)

Trial Overview The study tests if Peer Specialists trained as Whole Health Coaches can help reduce frequent use of emergency and hospital services among homeless Veterans by providing support and guidance.

Participant Groups

Group I: Peer Specialist - Whole Health Coaching (PS-WHC) Experimental Treatment 1 Intervention

Participants will meet with a Peer Specialist for 18 sessions over 24 weeks. The essential elements of this intervention include 1) general support provided via the core functions of a Peer Specialist, and 2) a structured Whole Health Coaching curriculum.

Group II: Enhanced Usual Care (EUC) Active Control 1 Intervention

Usual PACT care plus Hot Spotter Analytics (consists of access to field-based dashboard that allows PACTS to identify homeless Veterans on their panels who were super-utilizers, and the hot spotter manual).

Find a Clinic Near You

Research Locations Nearby Select from list below to view details:

Central Arkansas Veterans Healthcare System Eugene J. Towbin Healthcare Center, Little Rock, AR North Little Rock, AR

VA Palo Alto Health Care System, Palo Alto, CA Palo Alto, CA

VA Bedford HealthCare System, Bedford, MA Bedford, MA

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials

1691

Patients Recruited

3,759,000+

Findings from Research

In a study involving 15 primary care Veterans with PTSD, peer-delivered Whole Health Coaching showed high participant satisfaction and retention, with 11 out of 15 participants continuing in the program, indicating its potential effectiveness in supporting wellness goals.

The coaching was delivered with high fidelity by peers, and factors such as the flexibility of sessions and the peer-provider relationship were key to participant engagement, suggesting that peer support can be a valuable addition to primary care interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Engagement, experience, and satisfaction with peer-delivered whole health coaching for veterans with PTSD: A mixed methods process evaluation. Johnson, EM., Possemato, K., Khan, S., et al.[2022]

A pilot study involving 48 Veterans showed that a 9-week peer-led program, 'Taking Charge of My Life and Health' (TCMLH), significantly reduced perceived stress and improved mental health and quality of life, indicating its potential effectiveness in enhancing well-being.

The program also increased patient engagement, suggesting that empowering Veterans to explore their personal values and life goals can lead to better health outcomes, warranting further research and expansion of the program.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Examining the Impact of a Peer-Led Group Program for Veteran Engagement and Well-Being. Abadi, MH., Barker, AM., Rao, SR., et al.[2021]

In a study of 13,559 Veterans who screened positive for depression, those who used Whole Health services showed a decrease in their depression scores (PHQ-2) from 4.49 to 1.77, but this improvement was not significantly better than the conventional care group's decrease from 4.46 to 1.46.

Veterans with more complex health issues, such as PTSD and obesity, were more likely to use Whole Health services, indicating that while Whole Health may help in managing symptoms, it did not lead to a significantly better outcome compared to traditional care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Utilization of Whole Health and Longitudinal Outcomes After Screening Positive for Possible Depression Documented in Veterans Health Administration's Electronic Health Record. Reed, DE., Chen, C., Harvey, K., et al.[2023]

References

1. England pubmed.ncbi.nlm.nih.gov

An Innovation to Expand the Reach of Peer Support: A Feasibility and Acceptability Study. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

Engagement, experience, and satisfaction with peer-delivered whole health coaching for veterans with PTSD: A mixed methods process evaluation. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Examining the Impact of a Peer-Led Group Program for Veteran Engagement and Well-Being. [2021]

4. England pubmed.ncbi.nlm.nih.gov

Exploring kidney patients' experiences of receiving individual peer support. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Peer coaching to improve diabetes self-management: which patients benefit most? [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Utilization of Whole Health and Longitudinal Outcomes After Screening Positive for Possible Depression Documented in Veterans Health Administration's Electronic Health Record. [2023]

7. England pubmed.ncbi.nlm.nih.gov

The Untapped Power of Health and Wellness Coaching. [2023]

8. Switzerland pubmed.ncbi.nlm.nih.gov

Meeting the Needs of Rural Veterans: A Qualitative Evaluation of Whole Health Coaches' Expanded Services and Support during COVID-19. [2023]

9. United States pubmed.ncbi.nlm.nih.gov

What We Have Learned About the Implementation of Whole Health in the Veterans Administration. [2022]