{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T05:04:59Z","timestamp":1789535099201,"version":"build-2803163510"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,9,15]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">The Veterans Affairs New York Harbor Healthcare System is 1 of 50 Veterans Affairs sites participating in the Veterans Affairs Lipid Optimization Reimagined Quality Improvement Project. Veterans Affairs sites worked with an American Heart Association quality improvement consultant to develop and deploy a plan to achieve low\u2010density lipoprotein cholesterol (LDL\u2010C) &lt;70\u2009mg\/dL in &gt;30% of veterans with atherosclerotic cardiovascular disease and uncontrolled LDL\u2010C (LDL\u2010C \u226570\u2009mg\/dL), and meaningful LDL\u2010C lowering.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">In this pre\u2010post designed project, health coaches applied a root\u2010cause analysis framework, used medication possession ratio to assess adherence, and used motivational interviewing principles to improve medication adherence and lifestyle habits. Health coaches tailored interventions to address adherence barriers (if medication possession ratio &lt;0.8) or facilitated medication intensification (if medication possession ratio \u22650.8). To evaluate the impact of health coaches on outcomes, we compared baseline and follow\u2010up data pre\u2010post to evaluate LDL\u2010C lowering and assess LDL\u2010C control.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Among 152 engaged veterans, 57.9% had LDL\u2010C between 70\u2009and 100\u2009mg\/dL at baseline, 41.4% had LDL\u2010C \u2265100\u2009mg\/dL, and 0.7% had no data in the past year. Median (interquartile range) baseline LDL\u2010C was 92.0 (81.0\u2013118.0) mg\/dL, and follow\u2010up was 75.0 (54.5\u201398.0) mg\/dL. Mean LDL\u2010C change from baseline was \u221222.7\u2009mg\/dL (Wilcoxon signed rank test,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). The proportion with controlled LDL\u2010C was 42.6% (binomial test,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.001). All specialties, except geriatrics, lowered LDL\u2010C significantly and exceeded the 30% goal. LDL\u2010C control rates did not statistically differ by specialty (Fisher exact test,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.091).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Health coach\u2013delivered interventions to improve medication adherence and encourage lifestyle modifications led to significant LDL\u2010C reduction, with 42.6% achieving control, surpassing the 30% program benchmark, and lowered LDL\u2010C level.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.047697","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T14:47:06Z","timestamp":1788965226000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["A Health Coach\u2013Based Multilevel Personalized Strategy Lowers Low\u2010Density Lipoprotein Cholesterol and Enhances Lipid Control in Veterans With Atherosclerotic Cardiovascular Disease"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-5560-2369","authenticated-orcid":false,"given":"Tina","family":"Chen","sequence":"first","affiliation":[{"name":"VA New York Harbor Healthcare System","place":["New York"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2472-9264","authenticated-orcid":false,"given":"Diana","family":"Ingerman","sequence":"additional","affiliation":[{"name":"VA New York Harbor Healthcare System","place":["New York"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7635-7398","authenticated-orcid":false,"given":"Leah","family":"Haley","sequence":"additional","affiliation":[{"name":"VA New York Harbor Healthcare System","place":["New York"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priscilla","family":"Salovaara","sequence":"additional","affiliation":[{"name":"VA New York Harbor Healthcare System","place":["New York"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3307-5207","authenticated-orcid":false,"given":"Andrew","family":"Nicholson","sequence":"additional","affiliation":[{"name":"VA New York Harbor Healthcare System","place":["New York"]},{"name":"New York University Grossman School of Medicine","place":["New York"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4967-0390","authenticated-orcid":false,"given":"Nicholas","family":"Illenberger","sequence":"additional","affiliation":[{"name":"VA New York Harbor Healthcare System","place":["New York"]},{"name":"New York University Grossman School of Medicine","place":["New York"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6737-1995","authenticated-orcid":false,"given":"Sundar","family":"Natarajan","sequence":"additional","affiliation":[{"name":"VA New York Harbor Healthcare System","place":["New York"]},{"name":"New York University Grossman School of Medicine","place":["New York"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000678"},{"key":"e_1_3_2_3_2","volume-title":"Endotext [Internet]","author":"Feingold KR","year":"2000","unstructured":"Feingold KR. 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