An Emory University study published recently in the Journal of the American Heart Association finds that a personalized, goal‐directed lifestyle intervention delivered by a health partner significantly improved the cardiovascular health of participants over a two-year period.
The Emory/Georgia Tech Predictive Health Institute (PHI), conducted the study through its Center for Health Discovery and Well Being, enrolling 711 university employees in a novel program that paired each participant with a trained Health Partner (HP). Sixty-six percent of the participants were women and 22.5 percent were African Americans.
The HP, in partnership with the participant, generated a personalized plan aimed at meeting ideal health metrics for each person. The plans were based on comprehensive evaluations using laboratory, physical activity and body measurements performed at baseline and at six months, one year, and two years of follow‐up.
Physical measurements included vital signs, height, blood pressure and weight. Blood samples were collected for a complete serum metabolic panel and lipid profile. Participants completed questionnaires to obtain detailed information about dietary intake and physical activity.
"Each participant received individualized attention and a comprehensive medical evaluation periodically throughout the program," says Arshed A. Quyyumi, MD, professor of medicine (cardiology), Emory University School of Medicine and co-director of the Emory Clinical Cardiovascular Research Institute.
"This goal‐directed Health Partner intervention helped significantly improve the cardiometabolic risk profile and metrics of cardiovascular health, which include important markers such as cholesterol, blood pressure and BMI. These effects were evident at the first six-month visit and were sustained for the two-year duration of the study," says Quyyumi, the study’s lead investigator.
Compared to baseline, at each of the six‐month, one‐year, and two‐year follow‐up visits, systolic blood pressure was lower by 3.6, 4.6, and 3.3 mm Hg, total cholesterol decreased by 5.3, 6.5, and 6.4 mg/dL, body mass index declined by 0.33, 0.45, and 0.38 kg/m2, and the percentage of smokers decreased by 1.3 percent, 3.5 percent, and 3.5 percent, respectively. Changes were greater in those with greater abnormalities at baseline.
Finally, the American Heart Association "Life's Simple 7" ideal cardiovascular health score increased by 0.28, 0.40, and 0.33 at six months, one year, and two years, respectively, compared to baseline visit.
Each HP was specifically trained to utilize subjects’ data profiles and collaboratively generate health goals and a personalized action plan at each visit. The health action plans were self‐generated by participants and included strategies aimed at improving metrics related to physical activity, body weight, cholesterol, fasting glucose, stress reduction, dietary patterns and smoking habits.
The HP advised subjects on specific tactical approaches for reaching their goals, and subjects were offered HP interim support in the form of weekly to monthly e‐mail or phone contact. Subjects met with their HP after each visit, and the action plan was recalibrated based on review of data and overall progress. The HP remained in contact with the participant by e‐mail or telephone at intervals according to the formulated action plan on the initial visit.
Quyyumi says conclusions about whether the Health Partner intervention improves long‐term morbidity and mortality and is cost‐effective need further investigation.
Aside from Quyyumi’s study analyzing the effects of the PHI’s health partner model among Emory employees, the model is being applied to a large audience as part of the general education requirement in personal health for Emory College students.
Known as the Health 1,2,3 Program, the foundational course, Health 100, is required of all first-year students. It relies on Peer Health Partners™ — trained upperclassmen supervised by faculty — who educate and support the students as they conduct health self-assessments, identify their existing strengths through journaling, and set concrete, realistic goals around stress reduction, nutrition, physical activity and time management.
"The program helps students engage with all aspects of their health at a crucial time when they are beginning to set life-long habits and patterns," says study co-author Michelle Lampl, MD, co-director of the Predictive Health Institute and founder and director of the Center for the Study of Human Health in Emory College of Arts and Sciences.