{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:36:19Z","timestamp":1792787779031,"version":"4.5.0"},"reference-count":19,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"West Virginia Department of Health, Division of Health Promotion and Chronic Disease via Centers for Disease Control and Prevention","award":["CDC-RFA-DP-23-0004"],"award-info":[{"award-number":["CDC-RFA-DP-23-0004"]}],"id":[{"id":"https:\/\/ror.org\/042twtr12","id-type":"ROR","asserted-by":"crossref"}]},{"name":"National Cardiovascular Health Program. Assistance Listing Number","award":["93.426"],"award-info":[{"award-number":["93.426"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Prim Care Community Health"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Rural Appalachian communities experience a high burden of cardiometabolic disease and barriers to preventive and wellness services. This study retrospectively evaluated documented program participation and cardiometabolic outcomes among active participants in Prescription for Your Health (P4YH), a rural hospital-based wellness program in West Virginia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective evaluation used data collected during routine operation of P4YH. The analytic cohort included 585 active participants as of March 2026. The hospital-curated dataset included demographic and program participation information and available clinical and wellness measures. Duration of participation was summarized for the full cohort, and changes in available paired cardiometabolic measures were examined using matched pairs\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      -tests. Exploratory subgroup analyses included participants with diabetes and metabolic syndrome.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 585 active participants, duration of documented program participation varied, with many participants maintaining a connection with P4YH over time. In paired analyses, waist circumference decreased by 0.19 inches (95% CI, \u22120.34 to \u22120.03;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .0174), and diastolic blood pressure decreased by 3.38 mmHg (95% CI, \u22124.54 to \u22122.21;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .0001). Among participants with diabetes and paired HbA1c measurements (n = 56), mean HbA1c decreased by 0.25 percentage points (95% CI, \u22120.44 to \u22120.06;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .0106), with a larger decrease among those with initial HbA1c \u22657.0% (n = 23; \u22120.65 percentage points; 95% CI, \u22121.00 to \u22120.29;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .0010). Other overall paired cardiometabolic outcomes did not change significantly.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This retrospective evaluation found longitudinal program participation and favorable changes in selected cardiometabolic measures among P4YH participants. Although the observational design does not allow these changes to be attributed directly to the program, the findings provide real-world evidence from a locally developed rural hospital-based wellness model and support continued evaluation of its potential role in supporting long-term engagement and cardiometabolic health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21501319261494557","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T21:15:11Z","timestamp":1791494111000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cardiometabolic Outcomes and Program Participation in Prescription for Your Health: A Rural Hospital-Based Wellness Program in Appalachia"],"prefix":"10.1177","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8993-3680","authenticated-orcid":false,"given":"Adam","family":"Baus","sequence":"first","affiliation":[{"name":"West Virginia University School of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Yeager","sequence":"additional","affiliation":[{"name":"Roane General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Carr","sequence":"additional","affiliation":[{"name":"Roane General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecil","family":"Pollard","sequence":"additional","affiliation":[{"name":"West Virginia University School of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Elza","sequence":"additional","affiliation":[{"name":"West Virginia University School of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Tanner","sequence":"additional","affiliation":[{"name":"Roane General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Bentz","sequence":"additional","affiliation":[{"name":"Roane General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"key":"e_1_3_9_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001412"},{"key":"e_1_3_9_3_2","first-page":"1","article-title":"Prevalence of total, diagnosed, and undiagnosed diabetes in adults: United States, August 2021\u2013August 2023","volume":"516","author":"Gwira JA","year":"2024","unstructured":"Gwira JA, Cho P, Gu Q, et al. Prevalence of total, diagnosed, and undiagnosed diabetes in adults: United States, August 2021\u2013August 2023. NCHS Data Brief. 2024;516:1-8.","journal-title":"NCHS Data Brief"},{"key":"e_1_3_9_4_2","unstructured":"Centers for Disease Control and Prevention. Adult Obesity Prevalence Maps. Published December 3 2025. Accessed May 12 2026."},{"issue":"2","key":"e_1_3_9_5_2","first-page":"90","article-title":"Continuing challenges in rural health in the United States","volume":"5","author":"Coughlin SS","year":"2019","unstructured":"Coughlin SS, Clary C, Johnson JA, et al. Continuing challenges in rural health in the United States. 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