As part of the Medical Center's push for preventive medicine, a promising intervention study will examine the efficacy of strategic health planning upon the well-being of patients at risk for major disease.
The one-year study will implement the concepts of health care coaches--who will help patients make changes in their lives--and mindfulness--being more aware of one's body and surroundings.
"At the core of intervention is a piece of mindfulness," said Dr. Eugene Oddone, chief of the Division of General Internal Medicine and a principal investigator. He added that allowing patients to understand what factors are causing barriers to improving their health will aid them to overcome their problems.
Dr. Tracy Gaudet, director of the Duke Center for Integrative Medicine and the other principal investigator, developed the intervention design and specifically formulated the concept of mindfulness.
"We as a culture have lost the ability to tune in to our bodies," Gaudet said. She emphasized that such a process would help each person make wiser, healthier decisions.
Researchers hope in the long run that the collaboration between the Centers for Medicare and Medicaid Services and the Medical Center will spur further, more comprehensive, investigations.
"We're hoping that through the study, we can help people make changes in life that will reduce long-term risk and [help them] feel better in the short term," added Gaudet, who is also an assistant clinical professor of obstetrics and gynecology.
Although disseminating the results will take an extra six months, promising outcomes may lead to a longer study.
"This is a small step along the way," said Oddone, an associate professor who also serves as the director for the Center for Health Services Research in Primary Care at the Durham Veterans Affairs Medical Center.
The researchers said the study is the first to delve into the psyche of individuals with its emphasis on mindfulness.
Gaudet described the study as strategic health planning, surpassing what doctors traditionally call preventive medicine.
To determine the success of the intervention, researchers assessed standard psychosocial qualities such as anxiety, depression or other risk factors at various times throughout the period of the intervention, Oddone said. He added that rather than actual heart attacks, the study will look for intermediate variables to measure success.
The study, which just began recruiting volunteers, will involve about 200 people, 100 of whom will be in the intervention group, with the remaining half in the control group, Oddone said.
The study is seeking Duke employees 45 years of age or older who have at least one of the main risk factors that cause cardiovascular problems: high cholesterol, high blood pressure, above-average weight, diabetes or a smoking habit. Gaudet said the reasoning behind the selection of these factors revolved around their being modifiable.
"What we are looking at is reducing the risk for the four major health concerns--[heart attack], stroke, cancer and diabetes," Gaudet said.
Health care coaches serve an integral function within the parameters of the study. Coaches are knowledgeable about health care issues and are trained to motivate people and help them set priorities, Oddone said.
Ruth Quillian, assistant clinical professor of medical psychiatry, is in charge of implementing the intervention, which will be divided into three 16-week partitions, and will run the study on a day-to-day basis. In the first 16 weeks, interaction between health care coaches and the intervention group is heavy. A group of no more than 12 individuals will meet with a health care coach, who will also conduct personal motivational sessions with each individual.
As the second 16-week period progresses, group meetings will occur biweekly, and health care coaches will talk to individual members in the off weeks. In the final weeks, group meetings will occur monthly, with even fewer phone conversations.
Quillian explained that each group session will concentrate on training in mindfulness. In addition, nutrition, physical activity, wellness education and self-care are just a few of the topics that will be covered during group meetings.
Once the year is over, Quillian said classes will be provided for the control group to learn about mindfulness and personal strategic health planning.
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