{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T06:36:35Z","timestamp":1793082995200,"version":"4.5.0"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","license":[{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Caring for someone with heart failure takes an emotional and physical toll. Engaging in self-care may decrease stress and improve the health of informal caregivers. We conducted a randomized controlled trial testing the efficacy of a virtual health coaching intervention, compared with health information alone, on the self-care, stress, coping, and health status of heart failure caregivers.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>We enrolled 250 caregivers providing care at least 8 hours\/week, reporting poor self-care, and able to use technology. All received a tablet device programmed with websites providing vetted information on heart failure and caregiving. Half were randomized to also receive 10 synchronous support sessions virtually with a health coach over 6 months. Data on self-care, stress, coping, and health status were collected at baseline and 3 and 6 months. Linear mixed-effects models were used to assess the interaction between time and treatment group.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              The sample was majority female (85.2%), White (62.2%), spouses (59.8%), and aged 55\u00b113.6 years. Many were employed full time (41.8%). They had been caring for the patient 8 hours\/day for a median of 3.25 years. In the intention-to-treat analysis, caregivers who received the health coach intervention had statistically and clinically greater improvement across 6 months compared with the control group in the primary outcome of self-care maintenance (5.05\u00b11.99;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.01) and stress (\u22124.50\u00b11.00;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.0001). Self-care neglect declined significantly (\u22120.65\u00b10.32;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.04), but the difference between the treatment arms disappeared when the results were adjusted for multiple comparisons. Mental health status improved statistically but not clinically (3.35\u00b11.61;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.04). Active coping improved in both groups but not significantly more in the intervention group (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.10). Physical health status was unchanged (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.27).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>This virtual health coaching intervention was effective in improving self-care and stress in heart failure caregivers.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circheartfailure.123.011475","type":"journal-article","created":{"date-parts":[[2024,6,21]],"date-time":"2024-06-21T09:00:39Z","timestamp":1718960439000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":22,"title":["Health Coaching Improves Outcomes of Informal Caregivers of Adults With Chronic Heart Failure: A Randomized Controlled Trial"],"prefix":"10.1161","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0970-136X","authenticated-orcid":true,"given":"Barbara","family":"Riegel","sequence":"first","affiliation":[{"name":"School of Nursing (B.R., R.Q., K.B.H., G.T., M.A.S., K.H.B.), University of Pennsylvania, Philadelphia."},{"name":"Center for Home Care Policy &amp; Research, VNS Health, New York, NY (B.R., K.H.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2988-0633","authenticated-orcid":true,"given":"Ryan","family":"Quinn","sequence":"additional","affiliation":[{"name":"School of Nursing (B.R., R.Q., K.B.H., G.T., M.A.S., K.H.B.), University of Pennsylvania, Philadelphia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4886-7765","authenticated-orcid":true,"given":"Karen B.","family":"Hirschman","sequence":"additional","affiliation":[{"name":"School of Nursing (B.R., R.Q., K.B.H., G.T., M.A.S., K.H.B.), University of Pennsylvania, Philadelphia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9569-8700","authenticated-orcid":true,"given":"Gladys","family":"Thomas","sequence":"additional","affiliation":[{"name":"School of Nursing (B.R., R.Q., K.B.H., G.T., M.A.S., K.H.B.), University of Pennsylvania, Philadelphia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4664-009X","authenticated-orcid":true,"given":"Rebecca","family":"Ashare","sequence":"additional","affiliation":[{"name":"Department of Psychology, University at Buffalo, NY (R.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0710-7639","authenticated-orcid":true,"given":"Michael A.","family":"Stawnychy","sequence":"additional","affiliation":[{"name":"School of Nursing (B.R., R.Q., K.B.H., G.T., M.A.S., K.H.B.), University of Pennsylvania, Philadelphia."},{"name":"Penn Medicine Princeton Health, Princeton, NJ (M.A.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7740-5725","authenticated-orcid":true,"given":"Kathryn H.","family":"Bowles","sequence":"additional","affiliation":[{"name":"School of Nursing (B.R., R.Q., K.B.H., G.T., M.A.S., K.H.B.), University of Pennsylvania, Philadelphia."},{"name":"Center for Home Care Policy &amp; Research, VNS Health, New York, NY (B.R., K.H.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8300-1484","authenticated-orcid":true,"given":"Subhash","family":"Aryal","sequence":"additional","affiliation":[{"name":"School of Nursing, Johns Hopkins University, Baltimore, MD (S.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joyce W.","family":"Wald","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Perelman School of Medicine (J.W.W.), University of Pennsylvania, Philadelphia."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","unstructured":"National Association of Chronic Disease Directors. 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