C102-11 Patient Experience of Health Coaching: Secondary Analysis From a Randomized Controlled Trial

Rationale Lay health coaches, acting as extenders of pulmonary specialists, can help to improve receipt of guideline-based care for chronic obstructive pulmonary disease and asthma in primary care. Yet the success of the model depends in large part on acceptance by patients and scalability of support. We sought to understand the ways in which health coaches supported patients and the patient’s perceptions of health coaching support. Methods This study was conducted in the context of a randomized-controlled trial of 16 weeks of health coach-facilitated pulmonary consultation and support for implementing recommendations versus usual care for adult English- or Spanish-speaking patients. Study sites served low income, publicly insured individuals. We tracked support that health coaches provided to patients through an interaction log. Patient perceptions of health coaching were captured through a survey administered at the end of the intervention. Results Of the 165 people assigned to health coaching, 125 took part in the post-intervention survey, for a response rate of 76%. Of those, 96% (120) reported having interacted with a health coach). Patient ratings of trust in their health coach were high, with 92% (109) rating the trust at a 9 or 10, the highest ratings on the 0-10 scale. When asked about impacts of health coaching, 97% agreed or strongly agreed that they knew more about how their breathing condition affects their body, 93% that they were more able to manage their shortness of breath, 95% that they were able to use their inhalers more effectively, and 91% that they were more able to prevent exacerbations by managing their triggers. When examining the most common topics covered by health coaching with their patients based on activity logs, these included taking new medications recommended by the pulmonary specialist (88%), improving inhaler technique (85%), understand the basics of asthma/COPD and their impact on the body (84%), recognizing signs of and seeking help for exacerbations (75%), and practicing breathing techniques (72%). Conclusions Lay health coaches acting as extenders for pulmonary specialists appeared to be well accepted by patients, who rated the intervention as impactful and reported that they would recommend it to friends or family. Health coaches supported medication optimization, awareness of symptoms, and self-management. This intervention offers a scalable approach to improve access to pulmonary specialty care support and uptake of clinical guidelines in resource-limited primary care practices where most asthma and COPD care occurs.