Changing the Conversation: Technology Enabled Nurse Coaching

Thursday, April 23, 2015: 4:15 PM
Sarina Fazio, RN, BSN, MS, PhD Student , Betty Irene Moore School of Nursing, UC Davis Health System, Sacramento, CA
Sheridan Miyamoto, PhD, FNP, RN , Betty Irene Moore School of Nursing, UC Davis Health System, Sacramento, CA
Madan Dharmar, MBBS, PhD , Pediatrics & Betty Irene Moore School of Nursing, UC Davis Health System, Sacramento, CA
Yajarayma Tang-Feldman, MA , Internal Medicine & Betty Irene Moore School of Nursing, UC Davis Health System, Sacramento, CA
Matthew Lang, PhD , Institute for Wireless Health and Wellness, UC Davis Health System, Sacramento, CA
Jay Han, MD , Physical Medicine & Rehabilitation, UC Davis Health System, Sacramento, CA
Heather Young, PhD, RN, FAAN , Betty Irene Moore School of Nursing, UC Davis Health System, Sacramento, CA
Purpose: The purpose of this project is to describe how the integration of mobile health (mHealth) technology informs nurse health coaching for individuals with chronic conditions, such as diabetes mellitus.

Background: Traditional approaches to diabetes management have proven insufficient as the incidence of both diabetes mellitus and the resulting complications continue to grow. Significant advances have been made in improving chronic disease and diabetes outcomes by utilizing Motivational Interviewing, an evidence-based health coaching intervention focused on patient motivations, goal setting, and attainment. Patients have also voiced that implementation of mHealth technology, sensor tracking, and health coaching can help to facilitate positive health conversations with their providers.  Incorporating mHealth technologies with evidence-based nurse coaching interventions has the potential to achieve improved health and sustainable behavior change among patients with diabetes.

Approach: This project uses a comprehensive approach to develop a mHealth technology informed nurse coaching intervention that involves patients, providers, and technology experts.  These team members offer ongoing input in project design and development of intuitive, customizable, and trustworthy digital platforms that integrate with existing electronic health records and mobile technology.  For the mHealth coaching intervention, patients are given a Fitbit, a wireless wearable sensor device to track accurate, real-time physical activity and sleep quality data. The activity and sleep data allows coaches to perform meaningful analysis of patient generated data and correlate data with patient health behaviors to provide timely and personal feedback based on their health goals.

Outcomes Achieved: The use of mHealth technology platforms to gather data related to physical activity and sleep quality provides actionable data in which nurse health coaches can use real-time data to evaluate goal progression, identify barriers to behavior change, deliver targeted feedback, recognize opportunities for behavior change, and reinforce positive health activities.

Conclusions and Implications: Integrating patient generated real-time activity data into nurse health coaching provides a fuller understanding of the patient’s experience outside of traditional clinic offices by gaining insight into daily health behaviors and their effect on quality of life and disease management.  If future research can confirm the benefits of mHealth technology enabled nurse health coaching, this intervention may be scaled up and utilized to achieve outcomes in larger populations with various health challenges.