Study Examines a New Model for Older Adult Wellness

Community-based wellness instructors can provide tailored wellness care to older adults, according to researchers at Columbia University Mailman School of Public Health. A randomized controlled trial assessing whether community self-management with wellness coaching could improve participants’ overall wellbeing was the foundation to outline the components of a new model of community-based wellness called the Person-Centered Wellness Home (PCWH). The PCWH helps patients manage chronic diseases and maintain wellness. Findings were published in a special issue on aging and public health in Innovation in Aging, a publication of the Gerontological Society of America.

The researchers enrolled 121 participants over the age of 55 with two or more chronic diseases from New York City Housing Authority communities in the South Bronx. All participants completed a six-week workshop in which trained community lay leaders encouraged self-management skills for diseases such as arthritis, diabetes, HIV, chronic pain, and cancer that are highly prevalent in the South Bronx. Participants in the treatment arm received a wellness self-coaching program that guided them to set health goals aligning with their needs.

“There was an improvement in self-reported physical functioning by the wellness coaching group,” says first author Thelma J. Mielenz, PhD, assistant professor of epidemiology. She noted that people with better physical functioning often have an easier time being physically active. The wellness coaches and participants maintained their social connection.

The study also examined the benefits of patient health information availability in wellness care, including providing patients and their caregivers/coaches with personalized health records. Researchers found this measure encourages patients to familiarize themselves with their health information so they can set goals and track their progress. Together, the availability of community-based wellness programs and the provision of transparent wellness records empowers older adults to take control of their health in a community setting along with the support of wellness program instructors.

“By establishing personalized wellness care within the community, older adults can easily access and frequently take advantage of services that promote healthy lifestyle changes,” says Mielenz. “In underserved areas where gaps exist between the clinic and community, the Person-Centered Wellness Home model may start to provide the needed support for a patient in the community and improve overall health outcomes.”

Co-authors are Melissa Tracy, University of Albany, Rennsselaer; Haomiao Jia and Laura L. Durbin at the Columbia Mailman School; John P. Allegrante, PhD, Teachers College, Columbia University; Guedy Armiella, Family Health Center of Harlem; and Julie A. Sorensen, Bassett Healthcare Network.

This study was funded by the Patient-Centered Outcomes Research Institute, located in Washington, DC.