Montana Journey to Wellness Consortium is using its Direct Services grant to expand and refine the Summit Medical Fitness Center’s existing program to more underserved, rural communities. The Journey to Wellness program targets individuals looking to make lasting changes in their lifestyle and overall wellness.
The Georgia Health Policy Center recently spoke to Brad Roy, the director of the Summit Medical Fitness Center in Kalispell, Montana, and Catherine Lisowski, the clinical program manager at Kalispell Regional Healthcare.
To date, what has been the biggest accomplishment or an early win in your Rural Health Services grant program?
Brad: One of the initial wins for us was the establishment of the Montana Journey to Wellness consortium that brought together two rural critical access hospitals with our program here — training their staff and building those relationships. This success has opened the opportunity to further expand to other rural communities across Montana. That has been very positive for the program.
Cathy: We acknowledge that the struggles are real in all areas, whether urban or rural. Bringing together like minds where you can really try to collaborate, and cross utilize the resources that exist within and among the organizations helps to facilitate better wellness throughout the community.
What is a tip or early learning that you would share with an organization launching a similar wellness program?
Cathy: To quantify how people are doing, we have a very comprehensive set of assessments that we do with each of our members. This is something that they aren’t really excited about in the beginning. However, once they complete the program, they can see so many changes. You can really point to improvements in sleep quality, quality of life, anxiety, or functional level of fitness. We have a really wonderful statistician who put together a Qualtrics database that helps keep all of that in one place.
Brad: One of the challenges we had in the very beginning was that all of our data collection assessments were paper based. You get a lot of errors. People don’t answer all of your questions or may enter out-of-range numbers, and scoring is laborious. There also can be transcription errors when you enter that information into a database. This grant allowed us to move all our assessments and other data collection to an electronic platform. Now, our participants can no longer leave a question blank. This provides us with better data integrity and is critical because those outcome measures are not only important to the participants but also are important for us going forward into the sustainability period, to be able to show providers, insurers, and others that the program really does make a difference for people and that there is a reason to support it. So, our tip would be that as you are preparing your grant proposal, think through the data side very carefully. What are the outcomes you want to measure? What is truly meaningful, and what will you do with that information? That really needs to be planned out ahead of time.
How does your Federal Office of Rural Health Policy grant fit into your broader health improvement efforts?
Cathy: We created the Journey to Wellness program a number of years ago when we came to the realization, why do you have to create a separate program for every single chronic condition? The basic platform really is the same — it’s diet, exercise, stress management, restorative sleep, and the social connections and interactions that people need to maintain. That is really the basis of the program, which is health and wellness coaching based.
Brad: Even though we are located in a rural Montana community, our health care system is a regional provider. We provide a lot of services and outreach out to Critical Access Hospitals in other areas of the state. This grant provided an opportunity to take preventative programming to communities that do not have adequate resources for that. While we didn’t have the resources to implement programs there, the grant, insights, and technical advice that we received from the Georgia Health Policy Center was very, very helpful as we journeyed through that path of modifying our program to fit into a small, rural Critical Access Hospital community. This was a critical first step to get established in two communities. Our goal now is to continue this progress by progressively expanding the consortium project to other communities in Montana.
Cathy: It is expensive to create program infrastructure remotely. This grant provided the financial support that we would not have otherwise been able to obtain — facilitating the process. It also allowed us to update our telehealth equipment for remote coaching, interactive presentations, and support to those sites. Now that the infrastructure is in place and solid in those two sites, the process will be less extensive to extend to other sites.
What will your organization be doing more of or differently to emerge stronger from the pandemic?
Brad: We were challenged trying to get follow-up assessment data from program cohorts that were still out there when COVID hit. We were able to continue getting data because we had moved to the electronic platform, and we had telehealth in place. One important lesson is that you can never be over-prepared. Anything might happen, and you have to take it as it comes, not panic, but figure out ways to move forward.
We had an acute pandemic with COVID-19, but we really were in a syndemic. We have a pandemic of diabetes, obesity, heart disease, etc. Those conditions actually kill more people than the acute COVID pandemic does over time — and they are all interrelated. People with those conditions do worse with COVID. So, the lesson learned is that it comes back to lifestyle and those lifestyle behaviors. Our coaching is a key health behavior change piece, especially since most medical providers just don’t have the time or training to do it. The COVID experience really reemphasizes the importance of programs like this to be out there, meeting and working with people where they’re at.
We had an acute pandemic with COVID-19, but we really were in a syndemic. We have a pandemic of diabetes, obesity, heart disease, etc. Those conditions actually kill more people than the acute COVID pandemic does over time — and they are all interrelated. People with those conditions do worse with COVID. So, the lesson learned is that it comes back to lifestyle and those lifestyle behaviors. Our coaching is a key health behavior change piece, especially since most medical providers just don’t have the time or training to do it. The COVID experience really reemphasizes the importance of programs like this to be out there, meeting and working with people where they’re at.
For more information on the outcomes associated with the Journey to Wellness program, see “Integrating Health Coaching With a Medical Fitness Program to Treat Chronic Health Conditions,” published in the American Journal of Lifestyle Medicine.