Whole Health Action Management
Whole Health Action Management (WHAM) is a peer-led intervention to facilitate self-management to reach whole health goals through peer coaching and support groups.{{cite book|author=SAMHSA-HRSA Center for Integrated Solutions|title=WHAM implementation manual for peer providers: A guide for successfully implementing the Whole Health Action Management (WHAM) program|date=29 August 2014|publisher=Author|location=Washington, DC|url=http://www.gmhcn.org/files/WHAM_Implementation_Manual_FINAL.pdf|accessdate=28 December 2016}} {{PD-notice}}{{cite web|title=Whole Health Action Management Training Program|url=https://www.thenationalcouncil.org/wp-content/uploads/2016/06/WHAM_One-Pager.pdf|publisher=National Council for Behavioral Health|accessdate=23 January 2017|date=27 June 2016}} It is a method of using peer support to support healthcare delivery,{{cite web|url=http://www.integration.samhsa.gov/health-wellness/wham|title=WHAM Overview|author=|date=|work=SAMHSA-HRSA Center for Integrated Health Solutions| accessdate=23 January 2017}} and to counter high rates of chronic physical health conditions such as diabetes, heart disease and obesity among those with behavioral health diagnoses.{{cite web|title=Whole Health Action Management|url=https://www.thenationalcouncil.org/training-courses/whole-health-action-management/|website=National Council for Behavioral Health|accessdate=23 January 2017}}
The SAMHSA-HRSA Center for Integrated Health Solutions (CIHS) developed the WHAM program to "encourage increased resiliency, wellness, and self-management of health and behavioral health among people with mental illnesses, substance use disorders, and chronic physical health conditions."See also the slightly different goal which omits chronic physical health conditions in {{cite web|url=http://www.integration.samhsa.gov/health-wellness/wham|title=WHAM Overview|author=|date=|work=SAMHSA-HRSA Center for Integrated Health Solutions| accessdate=23 January 2017}}
WHAM is based on a collaboration between peers and health professionals. Peers encourage clients to get routine health exams and comply with physician recommendations. They frequently discuss common health behaviors such as smoking cessation, physical exercise, stress reduction, and healthy food choices.{{cite news|last1=Vestal|first1=Christine|title='Peers' may ease mental health worker shortage under Obamacare|url=https://www.usatoday.com/story/news/nation/2013/09/11/stateline-mental-health/2798535/|accessdate=28 December 2016|work=USA Today|date=11 September 2013|ref=Vestal2013}} WHAM is very similar to Peer Support Whole Health and Resiliency{{cite web|last1=Lane|first1=Tom|title=Promoting Resiliency through Peer Support Whole Health|url=http://sites.magellanhealth.com/media/739584/promotingresiliency.pdf|publisher=Magellan Health Services|accessdate=23 January 2017|page=27|date=27 June 2013}}{{cite web |title=A Practice Guide for Peer-to-Peer Whole Health and Wellness Programs (Draft) |date=14 February 2013 |url=http://www.integration.samhsa.gov/pbhci-learning-community/Peer_to_Peer_Matrix.pdf |access-date=10 March 2017}}
WHAM facilitators participate in a 2-day training, which then enables them to train others in WHAM.{{cite web|url=http://www.integration.samhsa.gov/health-wellness/wham/wham-training|title=The WHAM Training|author=|date=|work=SAMHSA-HRSA Center for Integrated Health Solutions | accessdate=23 January 2017}} Participants receive six hours of instruction spread over up to three weeks, followed by an 8-week WHAM-focused support group as they work toward, achieve, and maintain whole health goals.
History
The WHAM model is based on a pilot program led by Larry Fricks when in 2013 Georgia received federal approval to bill Medicaid for peer support specialists to provide health coaching., as well as the earlier the chronic disease self-management Health and Recovery Peer (HARP) Program. Since then, Fricks and his colleagues have trained peers across the country on the model under the name Whole Health Action Management. In 2014, Spanish-language resources were produced to implement the program in the Latino community.{{cite web|url=http://www.integration.samhsa.gov/news/articles/2014/05/23/whole-health-action-management-wham-featured-in-nami-magazine-%C2%A1avanzamos|title=Whole Health Action Management (WHAM) featured in NAMI magazine ¡Avanzamos!|author=|date=|work=SAMHSA-HRSA Center for Integrated Health Solutions}}{{cite journal|last1=Mason|first1=Hannah|title=Mental Health from a Holistic Perspective: Whole Health Action Management (WHAM) Peer-support Training|journal=¡Avanzamos!|date=23 May 2014|volume=20|pages=16–18|url=http://www.integration.samhsa.gov/news/AVANZAMOS_Spring-2014.pdf|accessdate=23 January 2017|publisher=National Association for Mental Illness (NAMI)}}{{cite web |date=January 30, 2014 |title=WHAM Medidas de Autocontrol para la Salud Integral: Guía para Participantes Capacitación para ser Compañero-Líder de Apoyo |website=SAMHSA-HRSA Center for Integrated Health Solutions |url=http://www.integration.samhsa.gov/health-wellness/WHAM_Spanish_CIHS_Participant_Guide_final_press_10_29.pdf |language=Spanish }} Presbyterian Healthcare Services in New Mexico has trained over 600 of their staff in WHAM. Between 2012 and 2016, over 3000 people have been trained in the WHAM model.
Content
WHAM facilitators are trained in teaching skills to promote health factors utilizing a "whole health perspective". These skills target the following health factors:
- Stress management
- Healthy eating
- Physical activity
- Restful sleep
- Service to others
- Support network
- Optimism based on positive expectations
- Cognitive skills to avoid negative thinking
- Spiritual beliefs and practices
- A sense of meaning and purpose{{cite web | title=Whole Health and Resiliency Factors | website=SAMHSA-HRSA Center for Integrated Health Solutions | url=http://www.integration.samhsa.gov/health-wellness/wham/whole-health-and-resiliency-factors | accessdate=23 January 2017}} {{PD-notice}}
Peer specialists are trained to help clients:
- Elicit the relaxation response to manage stress
- Engage in cognitive skills to avoid negative thinking
- Identify strengths and supports in 10 science-based whole health and resiliency factors
- Know basic whole health screenings and prepare for them
- Participate in peer support to create new health behavior
- Write a concise and achievable whole health goal and weekly action plans as part of a person-centered planning process
- Use shared decision-making skills and tools for engaging with doctors{{cite web | title=Skills Learned | website=SAMHSA-HRSA Center for Integrated Health Solutions | url=http://www.integration.samhsa.gov/health-wellness/wham/skills-learned | accessdate=23 January 2017}} {{PD-notice}}
Research Findings
A recent study explored the longitudinal effectiveness of the Whole Health Action Management (WHAM) program, specifically targeting adults with serious mental illness (SMI) and co-occurring general medical conditions. The research focused on whether peer-delivered interventions could improve health management and related outcomes. Participants were drawn from community mental health centers in Georgia and Illinois and were randomly assigned to either the WHAM intervention group (N=68) or a control group receiving standard care (N=71).{{Cite journal |last=Cook |first=Judith A. |last2=Jonikas |first2=Jessica A. |last3=Burke-Miller |first3=Jane K. |last4=Hamilton |first4=Marie |last5=Powell |first5=Ike G. |last6=Tucker |first6=Sherry Jenkins |last7=Wolfgang |first7=Jacqueline B. |last8=Fricks |first8=Larry |last9=Weidenaar |first9=Joni |last10=Morris |first10=Elliott |last11=Powers |first11=Destiny L. |date=2020-10-01 |title=Whole Health Action Management: A Randomized Controlled Trial of a Peer-Led Health Promotion Intervention |url=https://psychiatryonline.org/doi/10.1176/appi.ps.202000012 |journal=Psychiatric Services |language=en |volume=71 |issue=10 |pages=1039–1046 |doi=10.1176/appi.ps.202000012 |issn=1075-2730}}
Over six months, the study measured a range of outcomes, revealing meaningful improvements among WHAM participants.
= Key Insights from the Study =
- Enhanced Patient Activation
Participants in the WHAM program demonstrated significantly improved ability and confidence in managing their health care responsibilities. This result underscores the value of peer-supported models in empowering individuals to take active roles in their health management.
- Improved General Health
Self-reported health outcomes were notably better for WHAM participants compared to the control group. Over 63% of participants in the intervention reported that their overall health had improved since joining the program.
- Increased Optimism and Confidence
A striking improvement in hopefulness and optimism was observed among the WHAM group. This suggests that the program not only addresses physical health but also fosters mental well-being and positive future outlooks.
- Increased Employment Outcomes
WHAM participants were more likely to secure paid employment during the study period compared to the control group, indicating a potential link between the program’s interventions and broader life opportunities.
- High Participant Satisfaction
The program received overwhelmingly positive feedback. Approximately 97% of WHAM participants expressed satisfaction, highlighting its acceptability and the perceived benefits of the program.
= Conclusion and Implications =
The study’s findings suggest that WHAM is an effective, peer-delivered self-management education model. It shows promise in enhancing patient activation, physical and mental health, and socioeconomic outcomes, particularly for individuals with SMI and chronic health conditions. The results advocate for broader adoption of such programs in community health settings, emphasizing the value of peer-led support in improving holistic health outcomes.
This evaluation demonstrates WHAM's potential as a scalable, impactful intervention that bridges mental health care and general medical care.
See also
References
{{Reflist}}
External links
- [http://www.integration.samhsa.gov/health-wellness/wham WHAM Home page] at the SAMHSA-HRSA Center for Integrated Health Solutions
- "health activation" on Wiktionary
- [http://www.integration.samhsa.gov/health-wellness/wham/WHAM_Participant_Guide_April_2015.pdf WHAM Participant Guide]
- {{cite web |first=Ginger |last=Lerner-Wren |author-link=Ginger Lerner-Wren |title=The Need for Health Activism in the Criminal Justice System |website=The Huffington Post |date=30 May 2015 |url=http://www.huffingtonpost.com/ginger-lernerwren/the-need-for-health-activ_b_6965274.html }}
- {{cite web|title=Appalachian Consulting Group|url=http://www.gmhcn.org/ACG/index.html|website=Georgia Mental Health Consumer Network|accessdate=24 January 2017|archiveurl=https://web.archive.org/web/20101022065932/http://www.gmhcn.org/ACG/index.html|archivedate=22 October 2010}}