for people ages 18 years and up (full criteria)
at San Francisco, California and other locations
study started
estimated completion
Rachel Willard-Grace, MPH



The Pulmonary Specialist-Health Coach Consultation (PuSHCon) study examines the implementation of health coach-assisted consultations to improve access to specialist care and implementation of specialist recommendations for patients with COPD, asthma, and asthma COPD overlap syndrome (ACOS) for low-income and vulnerable patients seen at public health clinics. A limited number of patients (50) from two clinics will be enrolled in the pilot study; 25 patients from one clinic will receive a pulmonary consultation under usual care and 25 patients from the other clinic will receive the PuSHCon model.

Official Title

Pulmonary Specialist-Health Coach Consult (PuSHCon) Model to Improve Access to Specialist Consultation and Receipt of Recommended Evidence-based Care for Vulnerable Patients With Chronic Obstructive Pulmonary Disease (COPD) and Asthma


While evidence-based care for chronic obstructive pulmonary disease (COPD) and asthma can substantially reduce disease burden and prevent emergency visits and hospitalizations, it is estimated that 55% of patients with COPD do not receive all recommended care and that less than 50% of patients with asthma are well controlled.

The proposed study is a one-year cluster randomized controlled pilot trial comparing the Pulmonary specialist-health coach (PuSHCon) model to usual care for primary care patients referred for a consultation with a pulmonary specialist. This study is intended to prepare the way for a larger randomized controlled trial comparing the PuSHCon model to usual care for primary care patients referred for a consultation with a pulmonary specialist.

The investigators will use a combination of quantitative and qualitative methods to assess the implementation the PuSHCon model and measurement of patient-centered outcomes (Specific Aim 1) and the impact of PuSHCon model on patient reported quality of care, satisfaction, and patient receipt of care recommended by the pulmonary specialist (Specific Aim 2). The results of the current study will provide initial enrollment for a subsequent 5 year randomized controlled trial.


COPD Asthma Health coaching COPD Asthma Access to specialty care Pulmonary Disease, Chronic Obstructive PushCon Model


You can join if…

Open to people ages 18 years and up

  • English or Spanish speaking
  • At last 18 years of age
  • Diagnosed with asthma or COPD
  • Referred to see a pulmonary specialist

You CAN'T join if...

  • Do not plan to attend primary care clinic for at least 3 months
  • Already engaged in pulmonary specialty care (defined as at least one visit in last 12 months)
  • Cognitive dysfunction that would prevent interaction with a health coach
  • Not having a phone at which the participant can be reached


  • Ocean Park Health Center accepting new patients
    San Francisco California 94122 United States
  • Silver Avenue Family Health Center accepting new patients
    San Francisco California 94134 United States

Lead Scientist

  • Rachel Willard-Grace, MPH
    Rachel Willard-Grace is the Director of the Center for Excellence in Primary Care (CEPC). CEPC identifies, develops, tests, and disseminates promising innovations in primary care to improve the patient experience, enhance population health and health equity, reduce the cost of care, and restore joy and satisfaction in the practice of primary care.


accepting new patients
Start Date
Completion Date
University of California, San Francisco
Study Type
Last Updated