Skip to main content

Main menu

  • Home
  • Current Issue
  • Content
    • Current Issue
    • Early Access
    • Multimedia
    • Podcast
    • Collections
    • Past Issues
    • Articles by Subject
    • Articles by Type
    • Supplements
    • Plain Language Summaries
    • Calls for Papers
  • Info for
    • Authors
    • Reviewers
    • Job Seekers
    • Media
  • About
    • Annals of Family Medicine
    • Editorial Staff & Boards
    • Sponsoring Organizations
    • Copyrights & Permissions
    • Announcements
  • Engage
    • Engage
    • e-Letters (Comments)
    • Subscribe
    • Podcast
    • E-mail Alerts
    • Journal Club
    • RSS
    • Annals Forum (Archive)
  • Contact
    • Contact Us
  • Careers

User menu

  • My alerts

Search

  • Advanced search
Annals of Family Medicine
  • My alerts
Annals of Family Medicine

Advanced Search

  • Home
  • Current Issue
  • Content
    • Current Issue
    • Early Access
    • Multimedia
    • Podcast
    • Collections
    • Past Issues
    • Articles by Subject
    • Articles by Type
    • Supplements
    • Plain Language Summaries
    • Calls for Papers
  • Info for
    • Authors
    • Reviewers
    • Job Seekers
    • Media
  • About
    • Annals of Family Medicine
    • Editorial Staff & Boards
    • Sponsoring Organizations
    • Copyrights & Permissions
    • Announcements
  • Engage
    • Engage
    • e-Letters (Comments)
    • Subscribe
    • Podcast
    • E-mail Alerts
    • Journal Club
    • RSS
    • Annals Forum (Archive)
  • Contact
    • Contact Us
  • Careers
  • Follow annalsfm on Twitter
  • Visit annalsfm on Facebook
Research ArticleOriginal ResearchA

Health Coaching by Medical Assistants to Improve Control of Diabetes, Hypertension, and Hyperlipidemia in Low-Income Patients: A Randomized Controlled Trial

Rachel Willard-Grace, Ellen H. Chen, Danielle Hessler, Denise DeVore, Camille Prado, Thomas Bodenheimer and David H. Thom
The Annals of Family Medicine March 2015, 13 (2) 130-138; DOI: https://doi.org/10.1370/afm.1768
Rachel Willard-Grace
1Department of Family and Community Medicine, University of California San Francisco, San Francisco, California
MPH
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: willardr@fcm.ucsf.edu
Ellen H. Chen
1Department of Family and Community Medicine, University of California San Francisco, San Francisco, California
2Silver Avenue Family Health Center, San Francisco Department of Public Health, San Francisco, California
MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Danielle Hessler
1Department of Family and Community Medicine, University of California San Francisco, San Francisco, California
PhD, MS
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Denise DeVore
1Department of Family and Community Medicine, University of California San Francisco, San Francisco, California
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Camille Prado
1Department of Family and Community Medicine, University of California San Francisco, San Francisco, California
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Thomas Bodenheimer
1Department of Family and Community Medicine, University of California San Francisco, San Francisco, California
MD, MPH
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
David H. Thom
1Department of Family and Community Medicine, University of California San Francisco, San Francisco, California
MD, PhD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • eLetters
  • Info & Metrics
  • PDF
Loading

Abstract

PURPOSE Health coaching by medical assistants could be a financially viable model for providing self-management support in primary care if its effectiveness were demonstrated. We investigated whether in-clinic health coaching by medical assistants improves control of cardiovascular and metabolic risk factors when compared with usual care.

METHODS We conducted a 12-month randomized controlled trial of 441 patients at 2 safety net primary care clinics in San Francisco, California. The primary outcome was a composite measure of being at or below goal at 12 months for at least 1 of 3 uncontrolled conditions at baseline as defined by hemoglobin A1c, systolic blood pressure, and low-density lipoprotein (LDL) cholesterol. Secondary outcomes were meeting all 3 goals and meeting individual goals. Data were analyzed using χ2 tests and linear regression models.

RESULTS Participants in the coaching arm were more likely to achieve both the primary composite measure of 1 of the clinical goals (46.4% vs 34.3%, P = .02) and the secondary composite measure of reaching all clinical goals (34.0% vs 24.7%, P = .05). Almost twice as many coached patients achieved the hemoglobin A1c goal (48.6% vs 27.6%, P = .01). At the larger study site, coached patients were more likely to achieve the LDL cholesterol goal (41.8% vs 25.4%, P = .04). The proportion of patients meeting the systolic blood pressure goal did not differ significantly.

CONCLUSIONS Medical assistants serving as in-clinic health coaches improved control of hemoglobin A1c and LDL levels, but not blood pressure, compared with usual care. Our results highlight the need to understand the relationship between patients’ clinical conditions, interventions, and the contextual features of implementation.

  • medical assistants
  • allied health personnel
  • vulnerable populations
  • chronic disease management
  • health education
  • motivation
  • primary care
  • practice-based research
  • Received for publication June 25, 2014.
  • Revision received October 6, 2014.
  • Accepted for publication October 15, 2014.
  • © 2015 Annals of Family Medicine, Inc.
View Full Text
PreviousNext
Back to top

In this issue

The Annals of Family Medicine: 13 (2)
The Annals of Family Medicine: 13 (2)
Vol. 13, Issue 2
March/April 2015
  • Table of Contents
  • Index by author
  • Back Matter (PDF)
  • Front Matter (PDF)
  • In Brief
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on Annals of Family Medicine.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Health Coaching by Medical Assistants to Improve Control of Diabetes, Hypertension, and Hyperlipidemia in Low-Income Patients: A Randomized Controlled Trial
(Your Name) has sent you a message from Annals of Family Medicine
(Your Name) thought you would like to see the Annals of Family Medicine web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
2 + 4 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
Citation Tools
Health Coaching by Medical Assistants to Improve Control of Diabetes, Hypertension, and Hyperlipidemia in Low-Income Patients: A Randomized Controlled Trial
Rachel Willard-Grace, Ellen H. Chen, Danielle Hessler, Denise DeVore, Camille Prado, Thomas Bodenheimer, David H. Thom
The Annals of Family Medicine Mar 2015, 13 (2) 130-138; DOI: 10.1370/afm.1768

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Get Permissions
Share
Health Coaching by Medical Assistants to Improve Control of Diabetes, Hypertension, and Hyperlipidemia in Low-Income Patients: A Randomized Controlled Trial
Rachel Willard-Grace, Ellen H. Chen, Danielle Hessler, Denise DeVore, Camille Prado, Thomas Bodenheimer, David H. Thom
The Annals of Family Medicine Mar 2015, 13 (2) 130-138; DOI: 10.1370/afm.1768
Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Abstract
    • INTRODUCTION
    • METHODS
    • RESULTS
    • DISCUSSION
    • Acknowledgments
    • Footnotes
    • References
  • Figures & Data
  • eLetters
  • Info & Metrics
  • PDF

Related Articles

  • PubMed
  • Google Scholar

Cited By...

  • Primary Care Practice Characteristics Associated With Medical Assistant Staffing Ratios
  • Effectiveness of non-pharmacological strategies in the management of type 2 diabetes in primary care: a protocol for a systematic review and network meta-analysis
  • Lay Health Coaching to Increase Appropriate Inhaler Use in COPD: A Randomized Controlled Trial
  • Advanced practice nurses, registered nurses and medical practice assistants in new care models in Swiss primary care: a focused ethnography of their professional roles
  • Making Inroads in Addressing Population Health in Underserved Communities With Type 2 Diabetes
  • Barriers and Facilitators to Expanding Roles of Medical Assistants in Patient-Centered Medical Homes (PCMHs)
  • Delivery of Health Coaching by Medical Assistants in Primary Care
  • A Qualitative Study of How Health Coaches Support Patients in Making Health-Related Decisions and Behavioral Changes
  • What Happens After Health Coaching? Observational Study 1 Year Following a Randomized Controlled Trial
  • Impact of Medical Assistants as Health Coaches
  • In This Issue: Developing and Amplifying the Effectiveness of the Primary Care Workforce
  • Google Scholar

More in this TOC Section

  • Treatment of Chlamydia and Gonorrhea in Primary Care and Its Patient-Level Variation: An American Family Cohort Study
  • Performance-Based Reimbursement, Illegitimate Tasks, Moral Distress, and Quality Care in Primary Care: A Mediation Model of Longitudinal Data
  • Adverse Outcomes Associated With Inhaled Corticosteroid Use in Individuals With Chronic Obstructive Pulmonary Disease
Show more Original Research

Similar Articles

Subjects

  • Domains of illness & health:
    • Chronic illness
  • Person groups:
    • Vulnerable populations
  • Methods:
    • Quantitative methods
  • Other research types:
    • Professional practice
  • Other topics:
    • Organizational / practice change

Keywords

  • medical assistants
  • allied health personnel
  • vulnerable populations
  • chronic disease management
  • health education
  • motivation
  • primary care
  • practice-based research

Content

  • Current Issue
  • Past Issues
  • Early Access
  • Plain-Language Summaries
  • Multimedia
  • Podcast
  • Articles by Type
  • Articles by Subject
  • Supplements
  • Calls for Papers

Info for

  • Authors
  • Reviewers
  • Job Seekers
  • Media

Engage

  • E-mail Alerts
  • e-Letters (Comments)
  • RSS
  • Journal Club
  • Submit a Manuscript
  • Subscribe
  • Family Medicine Careers

About

  • About Us
  • Editorial Board & Staff
  • Sponsoring Organizations
  • Copyrights & Permissions
  • Contact Us
  • eLetter/Comments Policy

© 2025 Annals of Family Medicine