The Force for Health — Evidence & References

How our programs are built on evidence

Each ingredient of the Force for Health model is independently supported by high-quality research. Here is what the evidence shows for each.

Structured self-management educationHigh

8-step Journey & Prepared Patient course

Structured, curriculum-based education improves knowledge, glycemic/respiratory control, and reduces hospital use.

Asthma self-management: hospitalizations ↓ (RR 0.64)

Sources: R01, R02, R03, R04, R05

Demonstrated competency (teach-back)High

Step 6 Skills Lab sign-off (PPEC)

Confirming understanding by having the patient show/explain improves adherence and lowers 30-day readmission.

Discharge teach-back: 30-day readmissions ↓ (OR 0.55)

Sources: R06, R07

Family / care-partner engagementHigh

Care-partner track

Involving a family member/caregiver (dyadic care) improves outcomes and cuts caregiver burden and cost.

Heart-failure dyadic care: mortality RR 0.58

Sources: R08, R09, R10, R11, R12

Behavioral incentivesHigh

Healthy Coins reward system

Well-designed incentives improve adherence and health behaviors; reward framing drives uptake.

Medication adherence: effect size d 0.77

Sources: R13, R14, R15

GamificationHigh

Bingo, games, streaks & coins

Game mechanics with social/competitive elements increase activity and learning outcomes.

Physical activity: +~1,600 steps/day (g 0.42)

Sources: R16, R17, R18, R19

Community health workers / peer support / team-based careHigh

PPEC certifier, Ambassador/Advocate peers

CHW, peer, and team-based delivery improve BP/glycemic control and are cost-effective.

BP control +8.5–17.6 pts; <$18k per QALY

Sources: R20, R21, R22, R23, R24, R25

Patient navigationHigh

PPEC navigation function

Navigation raises preventive-screening completion, especially in under-served groups.

Colorectal screening: RR 1.64

Sources: R26, R27

Patient-portal engagementModerate

Portal step (results, messaging)

Portal use (esp. secure messaging) improves preventive care, adherence, and engagement; clinical outcomes mixed.

Secure messaging → glycemic control (OR 1.43)

Sources: R28, R29

Self-monitoring with supportHigh

Pulse, pulse-ox & home-BP skills

Self-measured BP with support lowers blood pressure; pulse-ox taught as recognition/escalation (evidence mixed).

Self-measured BP: −3 to −6 mmHg

Sources: R30, R31, R32, R33

Health-literacy designHigh

Plain-language & reading-level layers

Designing for literacy reaches those at highest risk; low literacy predicts worse outcomes.

Low literacy → mortality HR 1.52

Sources: R34, R35

Published modules & their evidence

Every module links to the design principles above plus its own condition guideline. We add live links here as modules publish at theforce.health.

59 of 59 modules

Module	Condition	Body system	Guideline cited	Status	Link
Your ADHD Journey FFH-PPJ-001 · Prepared Patient	ADHD	Neurodevelopmental	AAP ADHD Clinical Practice Guideline AAP HealthyChildren.org	Released	Coming soon
Your Adrenal Disorders Journey FFH-PPJ-002 · Prepared Patient	Adrenal Disorders	Endocrine / Metabolic	Endocrine Society Clinical Practice Guidelines Hormone Health Network / Endocrine Society	Released	Coming soon
Your Allergic Rhinitis Journey FFH-PPJ-003 · Prepared Patient	Allergic Rhinitis	Allergy / Immune	Joint Task Force Rhinitis Practice Parameter AAAAI patient site (aaaai.org)	Released	Coming soon
Your Anxiety Journey FFH-PPJ-004 · Prepared Patient	Anxiety	Mental & Behavioral	APA Practice Guideline; USPSTF anxiety screening (2023) NIMH (nimh.nih.gov)	Released	Coming soon
Your Aortic Aneurysm Journey FFH-PPJ-005 · Prepared Patient	Aortic Aneurysm	Cardiovascular	ACC/AHA Aortic Disease Guideline (current edition) American Heart Association (heart.org)	Released	Coming soon
Your Aortic Valve Disease Journey FFH-PPJ-006 · Prepared Patient	Aortic Valve Disease	Cardiovascular	ACC/AHA Valvular Heart Disease Guideline (current edition) American Heart Association (heart.org)	Released	Coming soon
Your Asthma Journey FFH-PPJ-007 · Prepared Patient	Asthma	Respiratory	Joint Task Force practice parameters; GINA report (current edition) NHLBI / AAAAI patient site	Released	Coming soon
Your Atherosclerosis Journey FFH-PPJ-008 · Prepared Patient	Atherosclerosis	Cardiovascular	ACC/AHA Primary Prevention / Cholesterol Guidelines (current edition) American Heart Association (heart.org)	Released	Coming soon
Your Atrial Fibrillation Journey FFH-PPJ-009 · Prepared Patient	Atrial Fibrillation	Cardiovascular	2023 AF Guideline American Heart Association (heart.org)	Released	Coming soon
Your Autism Journey FFH-PPJ-010 · Prepared Patient	Autism	Neurodevelopmental	AAP Clinical Reports on Autism AAP HealthyChildren.org / CDC	Released	Coming soon
Your Breast Cancer Survivor Journey FFH-PPJ-011 · Prepared Patient	Breast Cancer Survivor	Cancer Survivorship	ASCO Survivorship Guidelines; NCCN Survivorship ASCO Cancer.Net / NCI Cancer.gov	Released	Coming soon
Your Heart Failure (CHF) Journey FFH-PPJ-012 · Prepared Patient	Heart Failure (CHF)	Cardiovascular	ACC/AHA/HFSA Heart Failure Guideline (current edition) American Heart Association (heart.org)	Released	Coming soon
Your COPD Journey FFH-PPJ-013 · Prepared Patient	COPD	Respiratory	GOLD Report (current edition) ATS Patient Information Series (thoracic.org)	Released	Coming soon
Your COVID 19 Journey FFH-PPJ-014 · Prepared Patient	COVID 19	Infectious	IDSA COVID-19 Guidelines CDC COVID-19 (cdc.gov)	Released	Coming soon
Your Cardiomyopathy Journey FFH-PPJ-015 · Prepared Patient	Cardiomyopathy	Cardiovascular	ACC/AHA cardiomyopathy guidelines (current edition) American Heart Association (heart.org)	Released	Coming soon
Your Chronic Kidney Disease Journey FFH-PPJ-016 · Prepared Patient	Chronic Kidney Disease	Renal	KDIGO 2024 CKD Guideline National Kidney Foundation (kidney.org)	Released	Coming soon
Your Cirrhosis Journey FFH-PPJ-017 · Prepared Patient	Cirrhosis	Digestive / Liver	AASLD Practice Guidance (cirrhosis/complications) AASLD (aasld.org)	Released	Coming soon
Your Colorectal Cancer Survivor Journey FFH-PPJ-018 · Prepared Patient	Colorectal Cancer Survivor	Cancer Survivorship	ASCO Survivorship Guidelines; NCCN Survivorship ASCO Cancer.Net / NCI Cancer.gov	Released	Coming soon
Your Congenital Heart Defects Journey FFH-PPJ-019 · Prepared Patient	Congenital Heart Defects	Cardiovascular	ACC/AHA Adult Congenital Heart Disease Guideline (current edition) American Heart Association (heart.org)	Released	Coming soon
Your Coronary Artery Disease Journey FFH-PPJ-020 · Prepared Patient	Coronary Artery Disease	Cardiovascular	ACC/AHA Chronic Coronary Disease Guideline (current edition) American Heart Association (heart.org)	Released	Coming soon
Your Cystic Fibrosis Journey FFH-PPJ-021 · Prepared Patient	Cystic Fibrosis	Genetic / Respiratory	CF Foundation Clinical Care Guidelines Cystic Fibrosis Foundation (cff.org)	Released	Coming soon
Your Deep Vein Thrombosis Journey FFH-PPJ-022 · Prepared Patient	Deep Vein Thrombosis	Cardiovascular	ASH VTE Guidelines; CHEST Antithrombotic Guidelines American Society of Hematology (hematology.org) / CDC	Released	Coming soon
Your Dementia Journey FFH-PPJ-023 · Prepared Patient	Dementia	Neurological	AAN Dementia Guidelines Alzheimer's Association (alz.org)	Released	Coming soon
Your Depression Journey FFH-PPJ-024 · Prepared Patient	Depression	Mental & Behavioral	APA Practice Guideline; VA/DoD MDD (2022); USPSTF screening (2023) NIMH (nimh.nih.gov)	Released	Coming soon
Your Down Syndrome Journey FFH-PPJ-025 · Prepared Patient	Down Syndrome	Genetic / Developmental	AAP Health Supervision for Children with Down Syndrome AAP HealthyChildren.org / CDC	Released	Coming soon
Your Endometriosis / PCOS Journey FFH-PPJ-026 · Prepared Patient	Endometriosis / PCOS	Reproductive	ACOG guidance; ESHRE International PCOS Guideline ACOG Patient FAQs (acog.org)	Released	Coming soon
Your Epilepsy Journey FFH-PPJ-027 · Prepared Patient	Epilepsy	Neurological	AAN Epilepsy Practice Guidelines Epilepsy Foundation (epilepsy.com)	Released	Coming soon
Your Falls Prevention Journey FFH-PPJ-028 · Prepared Patient	Falls Prevention	Musculoskeletal	USPSTF; AGS/BGS; CDC STEADI CDC STEADI (cdc.gov/steadi)	Released	Coming soon
Your GERD Journey FFH-PPJ-029 · Prepared Patient	GERD	Digestive	ACG & AGA GERD Guidelines ACG / AGA patient education	Released	Coming soon
Your HIV Journey FFH-PPJ-030 · Prepared Patient	HIV	Infectious	NIH HIV/OI Guidelines (clinicalinfo.hiv.gov) CDC HIV (cdc.gov/hiv)	Released	Coming soon
Your Heart Attack Journey FFH-PPJ-031 · Prepared Patient	Heart Attack	Cardiovascular	2025 Acute Coronary Syndromes Guideline American Heart Association (heart.org)	Released	Coming soon
Your Hepatitis B/C Journey FFH-PPJ-032 · Prepared Patient	Hepatitis B/C	Digestive / Infectious	AASLD-IDSA HCV Guidance; AASLD HBV Guidance CDC Viral Hepatitis (cdc.gov/hepatitis)	Released	Coming soon
Your Hip Fracture Journey FFH-PPJ-033 · Prepared Patient	Hip Fracture	Musculoskeletal	AAOS Hip Fracture Guideline; see 2026 JAMA review on screening OrthoInfo (orthoinfo.aaos.org)	Released	Coming soon
Your Hyperlipidemia Journey FFH-PPJ-034 · Prepared Patient	Hyperlipidemia	Cardiovascular	ACC/AHA Blood Cholesterol Guideline (current edition) American Heart Association (heart.org)	Released	Coming soon
Your Hypertension Journey FFH-PPJ-035 · Prepared Patient	Hypertension	Cardiovascular	2025 AHA/ACC High Blood Pressure Guideline American Heart Association (heart.org)	Released	Coming soon
Your Inflammatory Bowel Disease Journey FFH-PPJ-036 · Prepared Patient	Inflammatory Bowel Disease	Digestive	ACG & AGA IBD Guidelines ACG / AGA patient education	Released	Coming soon
Your Maternal Health Journey FFH-PPJ-037 · Prepared Patient	Maternal Health	Reproductive	ACOG & SMFM Guidance; CDC Hear Her ACOG Patient FAQs / CDC Hear Her	Released	Coming soon
Your Menopause Journey FFH-PPJ-038 · Prepared Patient	Menopause	Endocrine / Reproductive	Menopause Society Position Statements The Menopause Society (menopause.org)	Released	Coming soon
Your Multiple Sclerosis Journey FFH-PPJ-039 · Prepared Patient	Multiple Sclerosis	Neurological	AAN Multiple Sclerosis Guidelines AAN Brain & Life (brainandlife.org)	Released	Coming soon
Your Orthostatic Hypotension Journey FFH-PPJ-040 · Prepared Patient	Orthostatic Hypotension	Cardiovascular	AHA Scientific Statement on Orthostatic Hypotension (2024) American Heart Association (heart.org)	Released	Coming soon
Your Osteoporosis Journey FFH-PPJ-041 · Prepared Patient	Osteoporosis	Musculoskeletal	ACOG CPG No.1 Osteoporosis Screening (2021) & No.2 Management (2022) Bone Health & Osteoporosis Foundation (bonehealthandosteoporosis.org)	Released	Coming soon
Your PTSD Journey FFH-PPJ-042 · Prepared Patient	PTSD	Mental & Behavioral	APA & VA/DoD PTSD Guidelines NIMH (nimh.nih.gov)	Released	Coming soon
Your Parkinsons Disease Journey FFH-PPJ-043 · Prepared Patient	Parkinsons Disease	Neurological	AAN Parkinson's Disease Guidelines AAN Brain & Life (brainandlife.org)	Released	Coming soon
Your Peripheral Artery Disease Journey FFH-PPJ-044 · Prepared Patient	Peripheral Artery Disease	Cardiovascular	ACC/AHA PAD Guideline (current edition) American Heart Association (heart.org)	Released	Coming soon
Your Prostate Cancer Survivor Journey FFH-PPJ-045 · Prepared Patient	Prostate Cancer Survivor	Cancer Survivorship	ASCO Survivorship Guidelines; NCCN Survivorship ASCO Cancer.Net / NCI Cancer.gov	Released	Coming soon
Your Pulmonary Embolism Journey FFH-PPJ-046 · Prepared Patient	Pulmonary Embolism	Respiratory / Vascular	ASH VTE Guidelines; CHEST Antithrombotic Guidelines American Society of Hematology (hematology.org) / CDC	Released	Coming soon
Your Pulmonary Fibrosis Journey FFH-PPJ-047 · Prepared Patient	Pulmonary Fibrosis	Respiratory	IPF Clinical Practice Guideline Pulmonary Fibrosis Foundation (pulmonaryfibrosis.org)	Released	Coming soon
Your Sarcopenia Journey FFH-PPJ-048 · Prepared Patient	Sarcopenia	Musculoskeletal	EWGSOP2 & AWGS Consensus on Sarcopenia American Geriatrics Society (healthinaging.org)	Released	Coming soon
Your Sepsis Journey FFH-PPJ-049 · Prepared Patient	Sepsis	Infectious / Critical	Surviving Sepsis Campaign 2026 International Guidelines CDC Sepsis (cdc.gov/sepsis)	Released	Coming soon
Your Sleep Apnea Journey FFH-PPJ-050 · Prepared Patient	Sleep Apnea	Respiratory	AASM Clinical Practice Guidelines AASM SleepEducation.org	Released	Coming soon
Your Stroke Journey FFH-PPJ-051 · Prepared Patient	Stroke	Neurological	AHA/ASA Stroke Guidelines + 2024 AHA/Red Cross First Aid (lay recognition) American Stroke Association (stroke.org)	Released	Coming soon
Your Substance Use Disorder Journey FFH-PPJ-052 · Prepared Patient	Substance Use Disorder	Mental & Behavioral	ASAM National Practice Guideline SAMHSA (samhsa.gov) / 988 Lifeline	Released	Coming soon
Your Sudden Cardiac Arrest Journey FFH-PPJ-053 · Prepared Patient	Sudden Cardiac Arrest	Cardiovascular	AHA CPR & ECC + 2024 AHA/Red Cross First Aid Guidelines AHA CPR (cpr.heart.org)	Released	Coming soon
Your TIA / Carotid Stenosis Journey FFH-PPJ-054 · Prepared Patient	TIA / Carotid Stenosis	Neurological	AHA/ASA Secondary Stroke Prevention & Carotid Guidelines American Stroke Association (stroke.org)	Released	Coming soon
Your Thyroid Disease Journey FFH-PPJ-055 · Prepared Patient	Thyroid Disease	Endocrine / Metabolic	ATA Clinical Guidelines American Thyroid Association (thyroid.org)	Released	Coming soon
Your Tuberculosis Journey FFH-PPJ-056 · Prepared Patient	Tuberculosis	Respiratory / Infectious	CDC/ATS/IDSA TB Guidelines CDC Tuberculosis (cdc.gov/tb)	Released	Coming soon
Your Type 1 Diabetes Journey FFH-PPJ-057 · Prepared Patient	Type 1 Diabetes	Endocrine / Metabolic	ADA Standards of Care in Diabetes (current edition) ADA (diabetes.org)	Released	Coming soon
Your Type 2 Diabetes Journey FFH-PPJ-058 · Prepared Patient	Type 2 Diabetes	Endocrine / Metabolic	ADA Standards of Care in Diabetes (current edition) ADA (diabetes.org)	Released	Coming soon
Your Vestibular Disorders Journey FFH-PPJ-059 · Prepared Patient	Vestibular Disorders	Neurological	AAO-HNS BPPV Guideline; Bárány Society criteria Vestibular Disorders Association (vestibular.org)	Released	Coming soon

📊 For partners & reviewers: download the master reference base — FFH Evidence Library (Excel) — one row per module, one row per citation, plus the design principles that connect them.

Full reference list

Every source below was retrieved and read from its origin; findings are quoted as reported. The list grows as we expand across the catalog.

References (35)

R01. Chrvala CA, Sherr D, Lipman RD. Diabetes self-management education for adults with type 2 diabetes mellitus: a systematic review of the effect on glycemic control. Patient Educ Couns. 2016;99(6):926-943. High link
R02. Sun J, Fan Z, Kou M, Wang X, Yue Z, Zhang M. Impact of nurse-led self-management education on type 2 diabetes: a meta-analysis. Front Public Health. 2025. Moderate link
R03. Gibson PG, Powell H, Coughlan J, et al. Self-management education and regular practitioner review for adults with asthma. Cochrane Database Syst Rev. 2002;(3):CD001117. High link
R04. Schrijver J, Lenferink A, Brusse-Keizer M, et al. Self-management interventions for people with COPD. Cochrane Database Syst Rev. 2022;(1):CD002990. High link
R05. Lenferink A, Brusse-Keizer M, van der Valk PDLPM, et al. Self-management interventions including action plans for exacerbations versus usual care in COPD. Cochrane Database Syst Rev. 2017;(8):CD011682. High link
R06. Talevski J, Wong Shee A, Rasmussen B, Kemp G, Beauchamp A. Teach-back: a systematic review of implementation and impacts. PLoS One. 2020;15(4):e0231350. High link
R07. Oh EG, Lee HJ, Yang YL, Kim YM. Effectiveness of discharge education with the teach-back method on 30-day readmission: a systematic review. J Patient Saf. 2021;17(4):305-310. Moderate link
R08. Yu DSF, et al. Effects of dyadic care interventions for heart failure on patients' and caregivers' outcomes: a systematic review, meta-analysis and meta-regression. Int J Nurs Stud. 2024;157:104829. High link
R09. Teli M, Thato R, Hasan F, Rias YA. Effectiveness of family-based diabetes management intervention on glycated haemoglobin among adults with type 2 diabetes: a systematic review and meta-analysis of RCTs. Biol Res Nurs. 2024;26(2):315-333. Moderate link
R10. Kebebew T, et al. Family-based interventions on self-management behaviours and blood pressure control in individuals with hypertension: a systematic review and meta-analysis. BMC Public Health. 2026. Moderate link
R11. Kalra L, Evans A, Perez I, et al. Training carers of stroke patients: randomised controlled trial. BMJ. 2004;328(7448):1099. High link
R12. Scerbe A, O'Connell ME, Astell A, et al. Digital tools for delivery of dementia education for caregivers of persons with dementia: a systematic review and meta-analysis. PLoS One. 2023;18(5):e0283600. Moderate link
R13. Petry NM, Rash CJ, Byrne S, Ashraf S, White WB. Financial reinforcers for improving medication adherence: findings from a meta-analysis. Am J Med. 2012;125(9):888-896. High link
R14. Volpp KG, Troxel AB, Pauly MV, et al. A randomized, controlled trial of financial incentives for smoking cessation. N Engl J Med. 2009;360(7):699-709. High link
R15. Halpern SD, French B, Small DS, et al. Randomized trial of four financial-incentive programs for smoking cessation. N Engl J Med. 2015;372(22):2108-2117. High link
R16. Patel MS, Small DS, Harrison JD, et al. Effectiveness of behaviorally designed gamification interventions with social incentives for increasing physical activity (STEP UP RCT). JAMA Intern Med. 2019;179(12):1624-1632. High link
R17. Patel MS, Benjamin EJ, Volpp KG, et al. Effect of a game-based intervention to enhance social incentives to increase physical activity among families (BE FIT RCT). JAMA Intern Med. 2017;177(11):1586-1593. High link
R18. Mazeas A, Duclos M, Pereira B, Chalabaev A. Evaluating the effectiveness of gamification on physical activity: systematic review and meta-analysis of RCTs. J Med Internet Res. 2022;24(1):e26779. High link
R19. Huang R, Ritzhaupt AD, Sommer M, et al. The impact of gamification in educational settings on student learning outcomes: a meta-analysis. Educ Technol Res Dev. 2020;68:1875-1901. Moderate link
R20. Community Preventive Services Task Force. Cardiovascular disease: interventions engaging community health workers. The Community Guide. 2015. High link
R21. Kangovi S, Mitra N, Norton L, et al. Effect of community health worker support on clinical outcomes of low-income patients across primary care facilities: a randomized clinical trial. JAMA Intern Med. 2018;178(12):1635-1643. High link
R22. Kangovi S, Mitra N, Grande D, et al. Patient-centered community health worker intervention to improve posthospital outcomes: a randomized clinical trial. JAMA Intern Med. 2014;174(4):535-543. High link
R23. Patil SJ, Ruppar T, Koopman RJ, et al. Peer support interventions for adults with diabetes: a meta-analysis of hemoglobin A1c outcomes. Ann Fam Med. 2016;14(6):540-551. Moderate link
R24. Community Preventive Services Task Force. Team-based care to improve blood pressure control. The Community Guide. 2020. High link
R25. Levengood TW, Peng Y, Xiong KZ, et al. Team-based care to improve diabetes management: a Community Guide meta-analysis. Am J Prev Med. 2019;57(1):e17-e26. High link
R26. Nelson HD, Cantor A, Wagner J, et al. Effectiveness of patient navigation to increase cancer screening in populations adversely affected by health disparities: a meta-analysis. J Gen Intern Med. 2020;35(10):3026-3035. Moderate link
R27. Community Preventive Services Task Force. Patient navigation services to increase colorectal cancer screening. The Community Guide. 2022. High link
R28. Han HR, Gleason KT, Sun CA, et al. Using patient portals to improve patient outcomes: systematic review. JMIR Hum Factors. 2019;6(4):e15038. Moderate link
R29. Alturkistani A, Qavi A, Anyanwu PE, et al. Patient portal functionalities and patient outcomes among patients with diabetes: systematic review. J Med Internet Res. 2020;22(9):e18976. Moderate link
R30. Tucker KL, Sheppard JP, Stevens R, et al. Self-monitoring of blood pressure in hypertension: a systematic review and individual patient data meta-analysis. PLoS Med. 2017;14(9):e1002389. High link
R31. McManus RJ, Mant J, Franssen M, et al. Efficacy of self-monitored blood pressure, with or without telemonitoring, for titration of antihypertensive medication (TASMINH4): an unmasked RCT. Lancet. 2018;391(10124):949-959. High link
R32. Community Preventive Services Task Force. Self-measured blood pressure monitoring with additional support. The Community Guide. High link
R33. Sherlaw-Johnson C, Georghiou T, Morris S, et al. The impact of remote home monitoring of people with COVID-19 using pulse oximetry: a national population and observational study. EClinicalMedicine. 2022;45:101318. Low link
R34. Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K. Low health literacy and health outcomes: an updated systematic review. Ann Intern Med. 2011;155(2):97-107. High link
R35. Marciano L, Camerini AL, Schulz PJ. The role of health literacy in diabetes knowledge, self-care, and glycemic control: a meta-analysis. J Gen Intern Med. 2019;34(6):1007-1017. Moderate link