Preventing Disability Through Community-Based Health Coaching

The California Public Employees Retirement System (CalPERS) Health Matters program is a randomized controlled trial of a community‐based health coaching program operating in Sacramento, California, since January 2001. It is modeled after the Health Enhancement Program and Senior Wellness Program of Seattle, Washington. Like the Health Enhancement Program, this program incorporates a menu of disability‐prevention strategies, with health coaching, patient education on the self‐management of chronic illness, and fitness forming the program's core. Unlike the Health Enhancement Program, the Health Matters program focuses as much attention on linking participants to existing community, health plan, and self‐directed programming as it does encouraging them to participate in programming developed especially for the project. All participants and controls continue to receive their usual medical care from their managed care providers. Eligibility criteria for the program include having one or more qualifying chronic health conditions, being aged 65 and older, being a member of a participating health plan, and being accepted into CalPERS' Long Term Care Insurance Program. Baseline exclusions include being cognitively impaired or qualifying for long‐term care insurance benefits due to deficiencies in two or more activities of daily living. The project has been successful in its enrollment strategy. It has also been successful in recruiting participants into project‐sponsored, community‐based, and self‐directed disability‐prevention programming. This is particularly true for programming related to diet, exercise, and various aspects of disease management.