Roy Brad, Roberts Pam, Lisowski Cathy, Kaye Miranda P, Sforzo Gary A
Summit Medical Fitness Center at Kalispell Regional Medical Center, Kalispell, Montana (BR, PR, CL).
Clearinghouse for Military Family Readiness at Penn State, State College, Pennsylvania (MPK).
Am J Lifestyle Med. 2017 Sep 5;14(3):326-334. doi: 10.1177/1559827617728025. eCollection 2020 May-Jun.
Medical fitness and health/wellness coaching (HWC) are emerging health care trends but potential synergistic effects are yet to be studied.
To determine the impact of integrating HWC within a community-based medical fitness program for patients with chronic health conditions.
A before and after clinical trial, examining 3 frequency levels of coaching sessions, with Journey-to-Wellness (J2W) participants (N = 1306) who were predominately female (76%), aged 12 to 87 years (mean ± SD = 53.54 ± 14.34 years), and referred by their health care provider. Over 3 months, J2W emphasized HWC, exercise, nutrition counseling, and group/interactive events. HWC averaged 4.4 ± 2.5 sessions and was analyzed at 3 levels (0-3; 4-6; 6+ sessions). Pre-post measures were Patient Health Questionnaire (PHQ-9), Positivity, General Anxiety Disorder (GAD-7), Dartmouth Quality of Life (QoL), Lifestyle Nutrition Behavior (LNB), Pain, exercise minutes, weight, waist circumference, and systolic/diastolic blood pressures.
J2W intervention significantly (P < .01) improved all outcomes. Between 20% and 43% improvements were observed for PHQ-9, GAD-7, QoL while LNB improved 7.5%, and biometrics between 1% and 2.2%. Greater frequency of HWC enhanced J2W effect for PHQ-9 and QoL with weight and GAD approaching significance.
J2W programming produced measurable improvement in health metrics, with greater HWC frequency adding to these beneficial effects, providing a powerful community-based health intervention.
医疗健康与健康/ Wellness教练指导（HWC）是新兴的医疗保健趋势，但潜在的协同效应尚未得到研究。
确定将HWC纳入基于社区的慢性健康状况患者医疗健身计划的影响。
一项前后对照临床试验，研究3种指导课程频率水平，对象为“健康之旅”（J2W）参与者（N = 1306），他们主要为女性（76%），年龄在12至87岁之间（平均±标准差 = 53.54 ± 14.34岁），由其医疗保健提供者转诊而来。在3个月的时间里，J2W强调HWC、运动、营养咨询以及团体/互动活动。HWC平均进行4.4 ± 2.5次课程，并在3个水平（0 - 3次；4 - 6次；6次以上课程）进行分析。前后测量指标包括患者健康问卷（PHQ - 9）、积极情绪、广泛性焦虑障碍（GAD - 7）、达特茅斯生活质量（QoL）、生活方式营养行为（LNB）、疼痛、运动分钟数、体重、腰围以及收缩压/舒张压。
J2W干预显著（P <.01）改善了所有结果。PHQ - 9、GAD - 7、QoL的改善幅度在20%至43%之间，而LNB改善了7.5%，生物指标改善了1%至2.2%。更高频率的HWC增强了J2W对PHQ - 9和QoL的效果，体重和GAD接近显著水平。
J2W计划在健康指标方面产生了可测量的改善，更高频率的HWC增强了这些有益效果，提供了一种强大的基于社区的健康干预措施。
