Distance-Based Lifestyle Medicine for Veterans with Chronic Multi-symptom Illness (CMI): Health Coaching as Behavioral Health Intervention for Clinical Adherence

Chronic multi-symptom illness (CMI) is characterized by persistent, difficult to treat symptoms that interfere with daily functioning, affecting approximately 30% of post-deployment Veterans. Clinicians often provide many recommendations with limited patient adherence. Emerging research suggests health coaching may be an effective intervention for individuals with CMI. Importantly, Veterans often report barriers to health care, thus, telehealth may be a practical solution. Nevertheless, research is limited on the effectiveness of this intervention using telehealth. This preliminary pilot study aimed to assess the feasibility of remotely implementing health coaching to support Veterans’ engagement with health goals. Following interdisciplinary medical evaluations, psychologically/medically stable participants were referred to the study. Health coaches incorporated clinical recommendations from the comprehensive evaluation, partnering with Veterans to create health goals, aligning clinical recommendations with Veterans’ values. Coaching sessions were delivered via telehealth. The primary outcome of the present study was the status of health goals. Veterans (N = 39) were 50.2 ± 8.4 years old, 77% male, well-educated, and predominantly white (82%). They identified 60 health goals related to physical activity (35%), mindset (20%), and diet (17%). After eight sessions, 37% and 58% of Veterans fully met and partially met their goals, respectively. After 17 sessions, 56% and 44% fully met and partially met their goals, respectively. These findings demonstrate the feasibility of remotely delivered health coaching to increase Veterans’ engagement in lifestyle changes. Use of telehealth to implement health coaching may reduce barriers to care and increase treatment adherence for Veterans with chronic, medically unexplained symptoms.