Evaluation of the Texas Wellness Incentives and Navigation (WIN) Project
Condition: Chronic Mental Illness; Chronic Physical Illness
MeSH terms: Mental Disorders
Study type: Interventional

Summary: 
      The Wellness Incentives and Navigation (WIN) project is designed to help improve health
      self-management and reduce the incidence and consequences of chronic disease among
      non-elderly adult Medicaid Supplemental Security Income (SSI) beneficiaries. WIN targets SSI
      beneficiaries with behavioral health (mental health and substance abuse) diagnoses. Research
      demonstrates that these individuals are more likely to suffer chronic physical
      co-morbidities, experience debilitating chronic illnesses earlier in life and have elevated
      healthcare costs.

      WIN uses person-centered wellness planning and navigation facilitated by trained,
      professional health Navigators, dedicated specifically to the WIN project, who use
      Motivational Interviewing (MI) techniques, and a personal wellness account. Participants with
      more serious mental illnesses will be offered additional support in the form of Wellness
      Recovery Action Planning (WRAP) to enable them to take full advantage of person-centered
      wellness planning.
    

Detailed description: 
      The Texas based Wellness Incentives and Navigation (WIN) project uses a continuum of
      evidence-based "whole person" interventions that take into account clinical, environmental,
      and social risk factors and co-morbidities. Unlike more traditional didactic approaches to
      health management, WIN addresses individual behavioral, social, and economic barriers to
      health and wellness, and promotes continued engagement in achieving, internalizing, and
      maintaining healthy behaviors.

      The study is focused on non-dual eligible adult STAR+PLUS (a Texas Medicaid managed care
      program for people with chronic illnesses) members (ages 21-55) with a behavioral health
      disorder including serious mental illness (SMI - e.g., schizophrenia, bipolar disorder or
      major depressive disorder) or other behavioral health conditions (e.g., anxiety disorder or
      substance abuse). Key features of the program include the use of professional health
      navigators, working in collaboration with the three STAR+PLUS plans in the Harris Service
      Area (SA) (United-Evercare, Amerigroup, and Molina), the use of motivational interviewing
      (MI) techniques to help members develop and meet personal wellness goals, and a flexible
      wellness account for the participant to use in meeting his/her goals.
    

Intervention name(s): Patient-Directed Wellness Account; Health Navigator
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The intervention group (n=629) continue to receive usual care and receive a financial incentive to use in meeting their health goals.; The intervention group (n=629) will work with a health navigator on a monthly basis to develop and refine patient-centered health goals. Motivational interviewing techniques are used to establish the wellness goals.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Asthma; Cerebrovascular Disease; Intracranial Injury; Neoplasms; Heart Failure; HIV/AIDs; Hereditary and Degenerative Diseases of the Central Nervous System; Disorders of the Peripheral Nervous System; Rheumatoid Arthritis and Other Inflammatory Polyarthropathies; History of hepatitis C; Schizophrenia; Episodic Mood Disorders; Delusional Disorders; Other Non-Organic Psychoses; Organic Psychotic Conditions; Neurotic Disorders; Other Non-Psychotic Mental Disorders