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Collaborative Learning to Examine the Feasibility and Uptake of Whole Health Coaching for Rural-Residing Veterans
David B Coultas1,2, Leslie Tadei3, Kristen Saxton4
1Division of Hospital and Specialty Medicine, VA Portland Health Care System, Portland, Oregon, USA.
Journal of Integrative and Complementary Medicine
|July 25, 2025
Summary
Health coaching for rural Veterans with multiple chronic conditions (MCC) showed low engagement. Integrating remote patient monitoring improved uptake, highlighting the need for tailored interventions to address rural health disparities.
Area of Science:
- Health Services Research
- Rural Health
- Chronic Disease Management
Background:
- Rural communities face increasing numbers of individuals with multiple chronic conditions (MCC).
- These populations often experience significant unmet healthcare needs.
- Innovative interventions are crucial to address these challenges.
Purpose of the Study:
- To assess the feasibility and uptake of a Whole Health System (WHS) health coaching program.
- To evaluate this support for rural-residing Veterans with MCC.
- To identify factors influencing engagement with health coaching interventions.
Main Methods:
- Prospective qualitative case study design.
- Two intervention arms: health coach alone vs. health coach with remote patient monitoring-home telehealth (RPM-HT).
- Formative evaluation using the Mi-PARIHS toolkit.
Main Results:
- Health coach alone: 10.7% engagement (6/56 Veterans).
- Health coach plus RPM-HT: 37.5% engagement (12/32 Veterans).
- Limited engagement attributed to system, clinician, and patient-level factors.
Conclusions:
- Implementing WHS health coaching for rural Veterans with MCC presents complex challenges.
- RPM-HT integration shows potential for improving intervention uptake.
- Addressing identified barriers is critical for future person-centered care implementation in rural settings.
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