Preliminary investigation of the student-delivered Community Outreach teleheAlth program for Covid education and Health promotion (COACH)

Michelle C Yang, Cam Clayton, Devin Harris, Chelsea Pelletier, Julia Schmidt, Jill G Zwicker, Brodie M Sakakibara, Michelle C Yang, Cam Clayton, Devin Harris, Chelsea Pelletier, Julia Schmidt, Jill G Zwicker, Brodie M Sakakibara

Abstract

Background: COVID-19 public health restrictions (i.e. physical distancing) compromise individuals' ability to self-manage their health behaviours and may increase the risks of adverse health events.

Objectives: To evaluate the student-delivered Community Outreach teleheAlth program for Covid education and Health promotion (COACH) on health-directed behaviour (self-management) among older adults (≥65 years of age, n = 75). Secondary objectives estimated the influence of COACH on perceived depression, anxiety, and stress; social support; health-related quality of life; health promotion self-efficacy; and other self-management domains.

Methods: COACH was developed to provide chronic disease management and prevention support among older adults via telephone or videoconferencing platforms (i.e. Zoom). In this single-group, pre-post study, our primary outcome was measured using the health-directed behaviour subscale of the Health Education Impact Questionnaire. Secondary measures included the Depression, Anxiety and Stress Scale, Medical Outcomes Study: Social Support Survey, MOS Short Form-36, and Self-Rated Abilities for Health Practices Scale. Paired sample t-tests were used to analyse outcome changes.

Results: Mean age of participants was 72.4 years (58.7% female; 80% ≥2 chronic conditions). Health-directed behaviour significantly improved after COACH (P < 0.001, d = 0.45). Improved health promotion self-efficacy (P < 0.001, d = 0.44) and decreased mental health were also observed (P < 0.001, d = -1.69).

Discussion: COACH likely contributed to improved health-directed behaviour and health promotion self-efficacy despite the diminished mental health-related quality of life during COVID-19. Our findings also highlight the benefits of using health professional students for the delivery of virtual health promotion programs.

Clinical trial information: ClinicalTrials.gov ID: NCT04492527.

Keywords: activities of daily living; chronic disease; health education; health promotion; self-management; telemedicine.

© The Author(s) 2022. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

References

    1. Wilder-Smith A, Freedman DO. Isolation, quarantine, social distancing and community containment: pivotal role for old-style public health measures in the novel coronavirus (2019-nCoV) outbreak. J Travel Med. 2020;27(2):taaa020.
    1. Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, Rubin GJ. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020;395(10227):912–920.
    1. Nussbaumer-Streit B, Mayr V, Dobrescu AI, Chapman A, Persad E, Klerings I, Wagner G, Siebert U, Christof C, Zachariah C, et al. . Quarantine alone or in combination with other public health measures to control covid-19: a rapid review. Cochrane Database Syst Rev. 2020;4(4):CD013574.
    1. Usher K, Bhullar N, Jackson D. Life in the pandemic: social isolation and mental health. J Clin Nurs. 2020;29(15–16):2756–2757.
    1. Valtorta NK, Kanaan M, Gilbody S, Hanratty B. Loneliness, social isolation and risk of cardiovascular disease in the English longitudinal study of ageing. Eur J Prev Cardiol. 2018;25(13):1387–1396.
    1. Diamond R, Willan J. Coronavirus disease 2019: achieving good mental health during social isolation. Br J Psychiatry. 2020:217(2):408–409.
    1. Darmon N, Drewnowski A. Does social class predict diet quality? Am J Clin Nutr. 2008;87(5):1107–1117.
    1. Saraiva MD, Apolinario D, Avelino-Silva TJ, De Assis Moura Tavares C, Gattás-Vernaglia IF, Marques Fernandes C, Rabel LM, Tavares Fernandes Yamaguti S, Karnakis T, Kalil-Filho R et al. . The impact of frailty on the relationship between life-space mobility and quality of life in older adults during the COVID-19 pandemic. J Nutr Health Aging. 2021;25(4):440–447.
    1. Martinez EZ, Silva FM, Morigi TZ, Zucoloto ML, Silva TL, Joaquim AG, Dall'Agnol G, Galdino G, Martinez MOZ, Silva WR. Physical activity in periods of social distancing due to COVID-19: a cross-sectional survey. Cien Saude Colet. 2020;25(suppl 2):4157–4168.
    1. Sepúlveda-Loyola W, Rodríguez-Sánchez I, Pérez-Rodríguez P, Ganz F, Torralba R, Oliveira DV, Rodríguez-Mañas L. Impact of social isolation due to COVID-19 on health in older people: mental and physical effects and recommendations. J Nutr Health Aging. 2020;24(9):938–947.
    1. Daly JR, Depp C, Graham SA, Jeste DV, Kim H, Lee EE, Nebeker C. Health impacts of the stay-at-home order on community-dwelling older adults and how technologies may help: focus group study. JMIR Aging. 2021;4(1):e25779.
    1. Sakakibara BM, Lear SA, Barr SI, Benavente O, Goldsmith CH, Silverberg ND, Yao J, Eng JJ. Development of a chronic disease management program for stroke survivors using intervention mapping: the stroke coach. Arch Phys Med Rehabil. 2017;98(6):1195–1202.
    1. Wagner EH, Austin BT, Davis C, Hindmarsh M, Schaefer J, Bonomi A. Improving chronic illness care: translating evidence into action. Health Aff. 2001;20(6):64–78.
    1. Barr VJ, Robinson S, Marin-Link B, Underhill L, Dotts A, Ravensdale D, Salivaras S. The expanded Chronic Care Model: an integration of concepts and strategies from population health promotion and the Chronic Care Model. Healthc Q. 2003;7(1):73–82.
    1. Michie S, Wood CE, Johnston M, Abraham C, Francis JJ, Hardeman W. Behaviour change techniques: the development and evaluation of a taxonomic method for reporting and describing behaviour change interventions (a suite of five studies involving consensus methods, randomised controlled trials and analysis of qualitative data). Health Technol Assess. 2015;19(99):1–188.
    1. Osborne RH, Elsworth GR, Whitfield K. The Health Education Impact Questionnaire (heiQ): an outcomes and evaluation measure for patient education and self-management interventions for people with chronic conditions. Patient Educ Couns. 2007;66(2):192–201.
    1. Elsworth GR, Osborne RH. Percentile ranks and benchmark estimates of change for the Health Education Impact Questionnaire: normative data from an Australian sample. SAGE Open Med. 2017;5:2050312117695716.
    1. Bell ML, Kenward MG, Fairclough DL, Horton NJ. Differential dropout and bias in randomised controlled trials: when it matters and when it may not. BMJ. 2013;346:e8668.
    1. Cramer H, Haller H, Dobos G, Lauche R. A systematic review and meta-analysis estimating the expected dropout rates in randomized controlled trials on yoga interventions. Evid Based Complement Alternat Med. 2016;2016:5859729.
    1. Groll DL, To T, Bombardier C, Wright JG. The development of a comorbidity index with physical function as the outcome. J Clin Epidemiol. 2005;58(6):595–602.
    1. Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995;33(3):335–343.
    1. Coker AO, Coker OO, Sanni D. Psychometric properties of the 21-item Depression Anxiety Stress Scale (DASS-21). Afr Res Rev. 2018;12(2):135–142.
    1. Sherbourne CD, Stewart AL. The MOS social support survey. Soc Sci Med. 1991;32(6):705–714.
    1. Lins L, Carvalho FM. SF-36 total score as a single measure of health-related quality of life: scoping review. SAGE Open Med. 2016;4:2050312116671725.
    1. Laucis NC, Hays RD, Bhattacharyya T. Scoring the SF-36 in orthopaedics: a brief guide. J Bone Joint Surg Am. 2015;97(19):1628–1634.
    1. Becker H, Stuifbergen A, Oh H, Hall S. Self-rated abilities for health practices: a health self-efficacy measure. Health Values. 1993;17(5):42–50.
    1. Whitlock EP, Orleans CT, Pender N, Allan J. Evaluating primary care behavioral counseling interventions: an evidence-based approach. Am J Prev Med. 2002;22(4):267–284.
    1. Gutnick D, Reims K, Davis C, Gainforth HL, Jay M, Cole S. Brief action planning to facilitate behavior change and support patient self-management. J Sci Commun. 2014;21(1):17–29.
    1. Page P. Beyond statistical significance: clinical interpretation of rehabilitation research literature. Int J Sports Phys Ther. 2014;9(5):726–736.
    1. BC COVID-19 Data. BC Centre for Disease Control [accessed 2021 June 27]. .
    1. Guo Y, Albright D. The effectiveness of telehealth on self-management for older adults with a chronic condition: a comprehensive narrative review of the literature. J Telemed Telecare. 2018;24(6):392–403.
    1. Chan SW. Chronic disease management, self-efficacy and quality of life. Nurs Res. 2021;29(1):e129.
    1. Lenzen SA, Daniëls R, van Bokhoven MA, van der Weijden T, Beurskens A. Disentangling self-management goal setting and action planning: a scoping review. PLoS One. 2017;12(11):e0188822.
    1. Seixas AA, Olaye IM, Wall SP, Dunn P. Optimizing healthcare through digital health and wellness solutions to meet the needs of patients with chronic disease during the COVID-19 era. Public Health Front. 2021;9:667654.
    1. Brown J, Lydecker JA, Turner T, Knackstedt RW, O’Neil PM. A novel approach to training students in delivering evidence-based obesity treatment. Fam Med. 2015;47(5):378–382.
    1. Janson SL, Cooke M, McGrath KW, Kroon LA, Robinson S, Baron RB. Improving chronic care of type 2 diabetes using teams of interprofessional learners. Acad Med. 2009;84(11):1540–1548.
    1. Suen J, Attrill S, Thomas JM, Smale M, Delaney CL, Miller MD. Effect of student-led health interventions on patient outcomes for those with cardiovascular disease or cardiovascular disease risk factors: a systematic review. BMC Cardiovasc Disord. 2020;20(1):332.
    1. Health Communication and Health Information Technology. Community Preventive Services Task Force. 2021. [accessed 2021 October 1]. .
    1. Maggi G, Baldassarre I, Barbaro A, Cavallo ND, Cropano M, Nappo R, Santangelo G. Mental health status of Italian elderly subjects during and after quarantine for the COVID-19 pandemic: a cross-sectional and longitudinal study. Psychogeriatrics. 2021;21(4):540–551.
    1. Mishra R, Park C, York MK, Kunik ME, Wung S, Naik AD, Najafi, B. Decrease in mobility during the COVID-19 pandemic and its association with increase in depression among older adults: a longitudinal remote mobility monitoring using a wearable sensor. Sensors. 2021;21(9):3090.
    1. van het Bolscher-Niehuis MJT, Marian JT, den Ouden MEM, de Vocht HM, Francke AL. Effects of self-management support programmes on activities of daily living of older adults: a systematic review. Int J Nurs Stud. 2016;61:230–247.

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