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Activity Coaching: A treatment
program for increasing activity ACHIEV meeting July 2014
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Purpose of today’s presentation
Background on Activity coaching
Update on pilot progress
Next steps
Feedback from ACHIEV
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What is a Activity Coaching?
Trained coach works with patients to promote
healthy behavior change
• exercise
• activity participation
• motivational and behavioral techniques
• Worker sets own goals
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Goals of PGAP™
Reduce psychosocial barriers to rehabilitation
progress
Promote re-integration into life-role activities
Increase quality of life
Facilitate return-to-work
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PGAP™
Structured therapist manual, client workbook,
introductory DVD
Can be delivered either in person or via
telephone
Maximum 10 sessions
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PGAP™ at L&I
Pilot project started January 2012
19 trained coaches – all PTs and OTs
Initially only within COHE areas
– Now statewide
Added 4 Spanish-speaking coaches in March
>40 interpreters oriented to program
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Cost of PGAP
10 session maximum
Approx. $1700 total
Paid at PT/OT level
Not part of daily PT cap
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Referral criteria
– Off work greater than 4 weeks
– No surgery planned
– No drug/alcohol problem
– Work hardening
– PGAP screening score of greater than 5 on
one or more of the screening tools
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PGAP Assessment Tools
Short-form McGill Pain Questionnaire (MPQ)
Patient Health Questionnaire (PHQ-8)
Disability Index (GPDI)
FFQ – Chr
– Fear – symptom exacerbation, re-injury
– Fatigue
CIEQ – Chr
– Catastrophic thinking – negative thought reactions
– Perceived injustice - unfairness
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Challenge – Cumbersome referral process
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Referrals to PGAP
135 referred to coaches
90 started coaching
Approximately 50 completed
– 70% at work or ready for work
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Average Number of Visits
8 visits for those who completed coaching
4 visits for those who stopped coaching
without completing
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Challenge – Non-English speakers
Language Number of referrals
Spanish 24
Arabic 2
Albanian 1
Punjabi 1
Swahili 1
Vietnamese 1
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Between first, middle and last sessions
Statistically significant decreases in all scales
Scores improved for 50% – 80% of workers
Changes in assessment scores
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Role of UW
Analysis of workers in program
Assessment scores
– Statistically significant changes
Matching group
– Cost comparison
– Due in August
Small numbers
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Next Steps
Interviews with coaches and providers
Internal workgroup
– Should PGAP require preauthorization from the
claim manager?
– Referral process
– Screening criteria
– Who is best to provide PGAP?
Recommendations to Steering Committee
Decision this fall on pilot future
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Feedback from ACHIEV
How available should we make PGAP?
– Restricted group of coaches?
When in the claim should it be available?
What kind of worker should be sent to PGAP?