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Health Coaches Hypertension Control Program

Health Coaches for Hypertension ControlHealth Coaches for Hypertension Control (HCHC) was designated in 2018 by the Administration for Community Living/Administration on Aging (ACL/AoA) as an evidence-based program making it eligible for funding through Older Americans Act (OAA) Title III-D funding and also through CDC 1815 funding.

HCHC consists of eight weekly sessions averaging 1.5 hours each which can be led by lay educators trained by Master Trainers. Master Trainers will learn how to train lay educators in adult learning theory, behavior change strategies, and hypertension self-management. The Master Training includes skill development in using a scripted manual, participant workbook, and posters for implementing the eight sessions.

An organization wishing to implement HCHC will sign a “License to Use” agreement and return to Dr. Cheryl Dye, Clemson University Institute for Engaged Aging, 2037 Barre Hall, Clemson University. Dr. Dye will then train organization representatives who have credentials in health education or healthcare and have experience working with older adults to be Master Trainers. Master Trainers will receive electronic versions of the training curriculum, scripted manual, participant notebooks, evaluation instruments, and posters which can then be used to train lay educators from local communities. The cost for training Master Trainers is $950 per person and training will occur at Clemson University, Clemson, SC. 29634. Arrangements can be made to provide on-site training for an additional fee of $1000 to cover the trainer’s travel time in addition to travel costs.  For more information, contact Dr. Cheryl Dye at tcheryl@clemson.edu

Health Coaches News

Dr. Cheryl Dye and colleagues have trained community volunteers as Health Coaches to support coordination of patient care at several points of care transition with the goal of improving chronic condition self-management and health outcomes while reducing costs. Trained Health Coaches have provided services to older adults in two different models tested in federally funded projects: one-on-one case management and small group instruction.

A project developed with nursing faculty member, Dr. Deborah Willoughby, in collaboration with Oconee Medical Center funded by HRSA, D04RH06789-03-00, called, “Helping Rural Elders Transition from Home Health to Chronic Disease Self-Management through Paraprofessional Outreach” received accolades as a cost-effective approach to health promotion and chronic disease self-management.  The HRSA Office of Performance Review described it as a “Leading Practice” as part of its effort to disseminate information about leading practices implemented within HRSA-funded programs in the areas of clinical practice, outreach, cultural competence, and administration.  In the project, volunteer community Health Coaches helped patients transition from home health care to self-care by teaching them to manage chronic illnesses like diabetes and heart disease with techniques such as medication management, healthy eating and physical activity and to access community resources. As compared to patients matched by diagnosis, gender and age without Health Coaches, patients mentored by Health Coaches had fewer readmissions related to their chronic condition and fewer new admissions for falls, pneumonia and flu.  The training curriculum developed by Dr. Dye and Dr. Willoughby incorporates core competencies for community health workers and health coaches with health literacy strategies. Findings are published in:

Dye C; Willoughby D; Aybar-Damali B; Grady C; Oran R; Knudson A. “ Improving Chronic Disease Self-Management by Older Home Health Patients through Community Health Coaching”. International Journal of Environmental Research and Public Health. 15(4), 660; doi:10.3390/ijerph15040660. 2018.

Another project developed with Public Health Sciences faculty member, Dr. Joel Williams, “Health Coaches for Hypertension Control (HCHC)” was funded by two federal grants: HRSA 1 D04RH12726-01-00 and USDA Award: 2012-46100-20122.   It was recently designated as an Evidence-based Program by the Administration on Aging making it eligible for Title III-D funding to agencies serving older adults who implement the program. It is also featured in the HRSA toolkit “Community Health workers Evidence-Based Models Toolkit” (page 19).  As of 4-2018, organizations from eight states have contacted Dr. Dye about becoming trained as Health Coaches. Over 300 residents of rural Oconee County, South Carolina aged 45 years and above have participated in the program which consists of eight core sessions and eight additional sessions in physical activity and nutrition. In the 16-sesssion version of the program, there were statistically significant decreases in systolic BP, weight, BMI, waist circumference, fasting triglycerides, and glucose. In the 8-session version, participants achieved statistically significant improvements in readiness and perceived competence for hypertension self-management behaviors.   Research findings are published in:  

Dye, CJ, Williams JE, Evatt JH. “Improving Hypertension Self-Management with Community Health Coaches”. Health Promotion Practice. DOI:10.1177/1524839914533797. 5-16-2014.

Dye C, Williams J, Evatt JH. “Activating Patients for Sustained Chronic Disease Self-Management: Thinking Beyond Clinical Outcomes”. Journal of Primary Care and Community Health. 2016. DOI:10.1177/2150131915626562. 

Dr. Dye and colleagues have also trained healthcare providers in health coaching skills.  She and Dr. Windsor Sherrill, Public Health Sciences,trained VA staff in the use of health coaching skills as part of VA efforts to improve patient outcomes through transitioning to person-center care in the funded project, Developing Wellness through Focused Health Coaching”, Veterans Affairs, Office of Patient Centered Care and Cultural Transformation (2011 – 2012).

From 2011 to 2018, Dr. Dye was invited by 11 different organizations to train healthcare providers and social workers in health coaching skills. Organizations included: Greenville Health System, Roper St. Francis Hospital, AnMed Health, South Carolina Hospital Association, South Carolina Office of Rural Health, South Carolina Department of Health and Environmental Control, South Carolina Organization of Nurse Leaders, SC Chapter of American Society of Healthcare Risk Management, SC Association for Healthcare Quality, Carolina Center for Behavioral Health, and AccessHealth South Carolina. 

From 1999 to 2015, Dr. Dye trained healthcare and social service providers in using strategies to overcome patient Health Literacy challenges with the program, “Health Literacy in Older Adults: a Faculty Development Program”.  Dr. Dye developed this full-day training in collaboration with nursing faculty, Dr. Julie Eggert,who also helped provide the training in 1999-2000. Dr. Dye then later developed an on-line version of the training for undergraduate students and another one for the upstate Area Health Education Center (AHEC) for use with healthcare providers and social workers.

Dr. Dye is currently collaborating with Greenville Health System in a three-year project (2016-2019) funded by the Administration on Aging, Administration for Community Living to train family caregivers of those with dementia with an evidence-based program, RCI –REACH (Rosalyn Carter Institute – Resources for Enhancing Alzheimer’s Caregiver’s Health.  She has also been trained in the evidence-based program, Powerful Tools for Caregivers, which she has implemented with family caregivers. The goals of these programs are to enable family caregivers to effectively provide care to their care recipient with dementia with dementia without compromising their own health.  She also has funding from the Duke Endowment through a grant to GHS to evaluate the GHS Memory Health program and its expansion to Oconee County.

Dr. Dye and PRTM faculty member, Dr. Marieke Van Puymbroeck, and Public Health Science faculty member, Dr. Karen Kemper, received funding in 2018 in collaboration with GHS clinician, Dr. Scott Sasser, to implement a fall prevention program with Oconee county residents called “Ready for STEADI?”.  As part of this effort, Dr. Dye became a Master Trainer in the evidence-based program, A Matter of Balance, making her eligible to offer the small-group based program and to also train community members to implement it.  Ready for STEADI? includes a referral protocol developed by the CDC for use by clinicians treating older patients, and a therapeutic yoga intervention in which study participants will enroll after they complete A Matter of Balance.


Funding for Health Coaches for Hypertension Control was provided by:
Health Resources and Services Administration
Rural Health Services Outreach Grant # D04RH12726

US Department of Agriculture – National Institute of Food and Agriculture
Award #2012-46100-20122