https://doi.org/10.1177/1084822317706080 Home Health Care Management & Practice 1–8 © The Author(s) 2017 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/1084822317706080 journals.sagepub.com/home/hhc Article Introduction Home health aides (HHAs) provide personal care and func- tional assistance to frail elderly homebound patients. Compared with the overall workforce in the United States, HHAs tend to be older and disproportionately female—57% are 45 years or older (compared with 44% of all U.S. work- ers) and 95% are women (47% of all U.S. workers are female). 1,2 HHAs face many job-related challenges including physically demanding work and irregular hours. 1 HHAs also have limited opportunities for career advancement—an issue that underlies high turnover and worker shortages observed across the industry. 3 Calls have been made for the develop- ment of workforce initiatives that tailor the roles and respon- sibilities of direct care workers to meet the needs of diverse clients as well as address the demands of new service deliv- ery models. 4 Policy reforms at the federal, state, and local levels have also refocused health care systems toward com- munity-based models that emphasize integrated, engaged, and holistic approaches to patient wellness. 5,6 Consistent with this approach, health coaching moves beyond tradi- tional educational approaches by engaging patients to iden- tify their unique concerns that may hinder adoption of healthy behaviors and disease management skills. 7,8 The pur- pose of this article is to describe findings from an evaluation of two pilot programs designed to prepare and utilize HHAs as health coaches for older home care patients who struggle with chronic disease self-management. Health coaches “teach patients how to fish” by assisting them with setting goals and gaining the knowledge, skills, tools, and confidence they need to participate in their own 1 Visiting Nurse Service of New York, New York City, NY, USA 2 NYU Langone Medical Center, New York City, NY, USA 3 The Rogosin Institute, New York City, NY, USA Corresponding Author: David Russell, Center for Home Care Policy & Research, Visiting Nurse Service of New York, 1250 Broadway, 7th Floor, New York, NY 10001, USA. Email: david.russell@vnsny.org Preparing Home Health Aides to Serve as Health Coaches for Home Care Patients With Chronic Illness: Findings and Lessons Learned From a Mixed-Method Evaluation of Two Pilot Programs David Russell, PhD 1 , Ana Mola, PhD, RN, ANP-BC 2 , Nicole Onorato, BS 1 , Sheniqua Johnson, RN 1 , Jessica Williams, LMSW 1 , Mark Andaya, MS, RN 3 , and Marki Flannery, MA 1 Abstract This article highlights findings from a mixed-method evaluation of two pilot programs that utilized Home Health Aides (HHAs) as health coaches for home care patients with chronic illness, including (1) a dedicated health coaching program for patients with heart failure and (2) an integrated program for HHAs working with chronically ill patients. Interviews were conducted with HHAs and staff to understand their experiences implementing program activities. Data from clinical assessments and surveys were employed to examine the characteristics and outcomes of patients. HHAs viewed health coaching positively and described it as an informative process that is dependent on patient motivation and willingness to change. Patients in both programs reported improvement in self-care maintenance. Patients in the chronic illness program also reported improved quality-of-life. Keywords home health aides, paraprofessional workforce, health coaching, chronic illness, self-management, program evaluation, home care 706080HHC XX X 10.1177/1084822317706080Home Health Care Management & PracticeRussell et al research-article 2017