Health Coach Curriculum

Purpose

The curriculum will be used as a guide for those who are assisting the community based medical home teams with integration of care management for complex patients with chronic disease. The intention is to incorporate recognized and modeled standards of care into the core training requirements for medical assistants being trained as health coaches.

Background and Scope

In a community-based medical home that is patient-centered, the health care team works with the patient to ensure that comprehensive care, age-appropriate prevention, acute care, chronic care and health management coordination are incorporated into a personal health plan. These efforts are based on the patient’s health status, his or her readiness to make lifestyle changes, and educational and social background. To improve outcomes patients must understand the importance of treatments and be proactive in self-care. Health coaching has been one model in the chronic care continuum which facilitates the collaboration between the patient and the medical home in managing chronic illness.

Trainings and certifications vary according to approach adopted by individual medical homes. A consistent set of national standards and guidelines for training is a challenge that is being addressed at the state and federal level for developing and integrating this model into medical homes. Training programs are in place in several states, with different required hours of training for certification. Unfortunately, these certification programs are specific to the states where the curriculum is offered and are collaborated with local community or secondary educational systems. For programs that offer a patient navigator or health coach curriculum as short term- intensive training, the cost is a barrier for primary care centers in West Virginia to utilize these programs as training resources. It is noted however, that there a number of on-line training modules and resource manuals available with permissions to use in a patient navigation training curriculum locally.

In West Virginia, Maternal Infant Health Outreach Worker (MIHOW) program, was used as the basic training for the patient navigator pilot curriculum under the Health Resources and Services Administration (HRSA)-funded program “Patient Navigator Outreach and Chronic Disease Prevention Demonstration Program”. This was a collaboration project with New River Health Association, Inc., Cabin Creek Health System, Inc., and FamilyCare HealthCenter from 2010 to 2012. The Community Health Worker (CHW) curriculum components were supplemented with specialized trainings to expand the CHW role for integration into the medical home primary care teams as patient navigators. These trainings included patient navigation, chronic disease risk factors, prevention and early intervention, in-depth training on specific targeted chronic diseases with emphasis on diabetes,

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Analysis of strengths, opportunities, and challenges of the original trainings was performed in March and April 2013. Information was gathered from the previous trainers, current health coaches at FamilyCare currently employed as patient navigators, and FamilyCare administrative and clinical staff. Research involved literature review from the Benedum grant application research documentation, along with internet research, web-based learning, and workshop attendance.

The curriculum standards are based upon several national training models and include elements from CDC sponsored CHW Sourcebook: A Training Manual for Heart Disease and Stroke, AHRQ’s Health Literacy Universal Precautions Toolkit, along with Wagner’s model of Chronic Care and Freeman’s Patient Navigation core standards. Comprehensive classroom training is delivered in conjunction with on-line trainings, skills practice sessions, and on the job experiential learning opportunities. Training incorporates current FamilyCare health coaches as mentors, along with education provided by Social Services and Registered Dietician/Certified Diabetes Educator. The components of this training can be modified and expanded upon based on individual medical home needs, participant evaluation, and identification of further learning needs. At FamilyCare the training has been followed with bi-weekly health coach meetings as this position is being integrated into 4 of the primary care sites to allow for case sharing and skills practice opportunities.

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