Cardiometabolic Outcomes and Program Participation in Prescription for Your Health: A Rural Hospital-Based Wellness Program in Appalachia

Introduction Rural Appalachian communities experience a high burden of cardiometabolic disease and barriers to preventive and wellness services. This study retrospectively evaluated documented program participation and cardiometabolic outcomes among active participants in Prescription for Your Health (P4YH), a rural hospital-based wellness program in West Virginia. Methods This retrospective evaluation used data collected during routine operation of P4YH. The analytic cohort included 585 active participants as of March 2026. The hospital-curated dataset included demographic and program participation information and available clinical and wellness measures. Duration of participation was summarized for the full cohort, and changes in available paired cardiometabolic measures were examined using matched pairs t -tests. Exploratory subgroup analyses included participants with diabetes and metabolic syndrome. Results Among 585 active participants, duration of documented program participation varied, with many participants maintaining a connection with P4YH over time. In paired analyses, waist circumference decreased by 0.19 inches (95% CI, −0.34 to −0.03; P = .0174), and diastolic blood pressure decreased by 3.38 mmHg (95% CI, −4.54 to −2.21; P < .0001). Among participants with diabetes and paired HbA1c measurements (n = 56), mean HbA1c decreased by 0.25 percentage points (95% CI, −0.44 to −0.06; P = .0106), with a larger decrease among those with initial HbA1c ≥7.0% (n = 23; −0.65 percentage points; 95% CI, −1.00 to −0.29; P = .0010). Other overall paired cardiometabolic outcomes did not change significantly. Conclusions This retrospective evaluation found longitudinal program participation and favorable changes in selected cardiometabolic measures among P4YH participants. Although the observational design does not allow these changes to be attributed directly to the program, the findings provide real-world evidence from a locally developed rural hospital-based wellness model and support continued evaluation of its potential role in supporting long-term engagement and cardiometabolic health.