Health coach-delivered interventions to improve medication adherence and encourage lifestyle modifications led to significant LDL-C reduction, with 42.6% achieving control, surpassing the 30% program benchmark, and lowered LDL-C level.
Median LDL-C decreased significantly from baseline to follow-up among veterans with atherosclerotic cardiovascular disease engaged by health coaches.
The proportion of veterans achieving controlled LDL-C (<70 mg/dL) was 42.6%, surpassing the program benchmark of 30%.
At baseline, the majority of engaged veterans had moderately to severely elevated LDL-C levels.
LDL-C was significantly lowered across almost all specialty care groups, with no statistically significant difference in LDL-C control rates between specialties.
Health coaches used a multilevel, personalized strategy incorporating root-cause analysis, medication possession ratio assessment, and motivational interviewing to address barriers to lipid control.
This research describes a quality improvement project at a Veterans Affairs healthcare system in New York that used health coaches to help veterans with heart disease lower their 'bad' cholesterol (LDL-C). The health coaches used structured conversations and motivational techniques to identify why each veteran was struggling to control their cholesterol — whether it was difficulty taking their medications consistently or a need for stronger medications — and then tailored their support accordingly. The study compared cholesterol levels before and after the health coach program among 152 veterans who participated. This research suggests that the health coach approach produced meaningful results: average LDL-C dropped by about 22.7 mg/dL, and 42.6% of participants achieved a target LDL-C below 70 mg/dL, which exceeded the program's goal of getting at least 30% of participants to that level. The reductions were seen across nearly all types of medical specialty care involved, and the program's success did not differ significantly depending on which specialty was involved. This research suggests that embedding health coaches into cardiovascular care — with a structured, personalized framework — can be an effective strategy for helping patients with heart disease achieve better cholesterol control. This is significant because uncontrolled LDL-C in people with existing heart disease substantially raises the risk of heart attacks and strokes, and many patients face real-world barriers to taking medications as prescribed or making lifestyle changes. The use of a practical, scalable model within an existing healthcare system like the VA may offer a template for other health systems seeking to improve cholesterol management at a population level.
Chen T, Ingerman D, Haley L, Salovaara P, Nicholson A, Illenberger N, et al.. (2026). A Health Coach-Based Multilevel Personalized Strategy Lowers Low-Density Lipoprotein Cholesterol and Enhances Lipid Control in Veterans With Atherosclerotic Cardiovascular Disease.. Journal of the American Heart Association. https://doi.org/10.1161/JAHA.125.047697