Healthy Lifetime - Phase 2

Study Overview
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Brief Summary
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HealthyLifetime (HL) is a person-centered program that enables older adults to maximize health and optimize functioning - the necessary requisite to successfully remaining independent in their preferred home setting as long as possible, i.e., to age in place.

Detailed Description
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HL seeks to intervene early in the aging process when individuals have the best chance for longer term benefits of changing their health behavior, as a means to stave off functional decline, and minimize the onset or exacerbation of chronic conditions. And, for individuals who are experiencing any of the barriers described above, our HL program's Nurse Coaches are prepared and experienced in helping them achieve their highest level of functioning and self-care capacity, while integrating and collaborating with, but not duplicating, their medical services such as primary care, specialty care, and case management or medical social services. While the latter medically oriented services support clinical management, they do not focus on helping older adults maximize health and function by building self-care capacity, long term health behavior change capacity and the functional resilience necessary to sustain or regain independent living.

Official Title
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Healthy Lifetime - Sustainability and Quality Study - PHASE 2

Conditions
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Aging Well

Intervention / Treatment
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* Behavioral: Nurse-led health coaching


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Be able to read, speak English and hear - but may use glasses or hearing aids, if needed; Be able to tell us their age, their date of birth, address, and phone number, as well as write down and explain their health problems; Have their own computer or iPad (Tablet) with an Internet connection, a working camera and microphone. and Be able to use their computer/tablet to connect to video chat sessions like Zoom in a private space in their home or a private room. Exclusion Criteria: People who, in the last month, have used the Emergency Room (ER) or stayed in the hospital. Are not verified users of Medicaid Home Help services [we will check with the Michigan Department of Health and Human Service to verify that you receive these services using your name, date of birth, and Medicaid identification number]; Have a new major health problem that they are seeing a doctor about more than once per month; Have been told their illness is not curable; Cannot remember their name, date of birth or their health problems; Cannot use glasses or a hearing aid to see or hear well enough to read materials on the computer or talk to the nurse easily; and, Do not have, or cannot use, a computer, iPad or other device with the Internet at home to use Zoom (e.g., internet streaming).

Ages Eligible for Study
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Minimum Age: 30 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: HealthyLifetime Group<br>This project is designed to prepare and equip the participant for improved self-care capacity, motivational insight, health-related problem solving and decision-making. | Behavioral: Nurse-led health coaching<br>* This project is an 6-month program providing an initial 2-month intensive evaluation and personalized virtual individual health coaching experience that is designed to prepare and equip the participant for improved self-care capacity, motivational insight, health-related problem solving and decision-making. This intensive period will then be followed by monthly 30-minute Nurse Coach assessment and individual coaching 'check-in' virtual visits, continued use of the electronic platform tools and health tracking system, and access to group 'virtual coaching' on tailored topics of interest to the cohort.<br>* Other names: HealthyLifetime;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Participant Self- rated health score | Participants perception of their health on a scale of 1= Excellent to 5 = Poor | At 0, 8 and 20 weeks after study enrollment. | 
| Change in Self-efficacy in ability to continue essential life activities score | Confidence of the participant in doing certain activities on a scale of 1= Not at all confident to 10 = Totally Confident. For the purposes of answering these questions, confidence is defined as the belief in the participant's chances of being able to do and/or complete an activity (e.g., hobbies and recreation, social visits, chores, errands, etc.) or task (e.g., hobbies and recreation, social visits, chores, errands, etc.) successfully however the participant defines it. | At 0, 8 and 20 weeks after study enrollment. | 
| Change in Independent self-care agency score | Confidence in doing certain activities, e.g., stick to behavior changes, meet goals, and improve health, on a scale of 1= Not at all confident to 10 = Totally Confident | At 0, 8 and 20 weeks after study enrollment. | 
| Change in Health Habits score | Activities that participants engage in that affect health in a negative or positive way, e.g., smoking (yes or no), alcohol (number of drinks per week), exercise (0 = none to 4= more than 3 hours/week), food choices (seldom or never to 2 or more times a day) | At 0, 8 and 20 weeks after study enrollment. | 
| Change in Goal attainment score | Health goals (up to 3) of participants and importance of goal (1= Not at all important now to 10 = highest importance now) and confidence in achieving goal (1= Not confident at all to 10 = Completely Confident) | At 0, 8 and 20 weeks after study enrollment. | 
| Change in Quality of Life score | Questions about how participant experiences their quality of life. Covers six areas and includes how satisfied they are with these areas, and how important they are to them. Uses a scale where 0 = Do not agree at all and 4 = Agree completely | At 0, 8 and 20 weeks after study enrollment. | 
| Change in Lifestyle Habits | Questions about tobacco and alcohol use: Do participants use alcohol and/or tobacco, and, if so, how much | At 0, 8 and 20 weeks after study enrollment. | 
| Change in Food Consumption | Participants report how frequently they eat foods from different food groups, e.g., vegetables, fruits, grains, dairy, sugary, etc. | At 0, 8 and 20 weeks after study enrollment. | 
| Change in Exercise and Activities | DURING THE PAST 7 DAYS, even if it was not a typical week for participants, how much total time (for the entire week) did they spend on each of various exercises or activities, e.g., walking, swimming, bicycling, etc. | At 0, 8 and 20 weeks after study enrollment. | 
| Change in Vigorous Activity | Number of days out of the past seven did participants do vigorous or moderate activities at work, as part of their house and yard work, to get from place to place, and in their spare time for recreation, exercise, or sport. | At 0, 8 and 20 weeks after study enrollment. | 
| Change in Level of independence in household activities score | Ability to do daily living activities such as shopping, cooking, managing medications, etc. on a scale where 1 = Not at all Confident to 10 = Totally Confident | At 0, 8 and 20 weeks after study enrollment. | 
| Change in Health Impact | Using a 1 to 10 scale where 1 = Almost never and 10 = Almost totally, participant selects ONE number which best represents how much their health impacts their ability to do or participate in an activity AT THE PRESENT TIME. | At 0, 8 and 20 weeks after study enrollment. | 
| Change in Confidence in ability to manage symptoms score | How confident the is participant that they can keep health symptoms/problems from interfering with the things they want to do, e.g., fatigue, physical discomfort, emotional distress, etc. on a scale where 1 = Not at all Confident to 10 = Totally Confident | At 0, 8 and 20 weeks after study enrollment. | 
| Change in Level of Symptomatology score | Frequency with which participants experience symptoms such as physical discomfort, pain, fatigue, etc. on a scale where 0 = Never to 5 = Always | At 0, 8 and 20 weeks after study enrollment. | 
| Change in Other Symptoms | Questions ask how often a participant is bothered by psychological and emotional symptoms such as feeling nervous, worry, anxiety, sadness, etc. On a scale from 0 Not at All to 3 Nearly Every Day. | At 0, 8 and 20 weeks after study enrollment. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Higher values of primary measures at 8 weeks: persistence at 20 weeks | Are effects of program noted at 8 weeks still present at 20 weeks. | 20 weeks after study enrollment | 
| Change in Self-reported medical visits | Number of unplanned medical visits with doctor or primary medical provider in past 2 months (0/none to 10), emergency room visits (0/none to10), overnight stay in hospital (0\none to 10). | At 0, 8 and 20 weeks after study enrollment. | 
| Change in Social Network and Support score | Number of friends and relatives participants interact with/rely on. Scale from None to Nine or more. | At 0, 8 and 20 weeks after study enrollment. | 
| Change in type and source of At-home Support | Do the type (healthcare, chores, meals, etc) and source (Medicare, Medicaid, other insurance, etc.) of help received by participants indicated in answers to survey questions change over course of study. | At 0, 8 and 20 weeks after study enrollment. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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aging, nurse coaching, motivational interviewing