The goal of this 2-year research project was to investigate the feasibility and effectiveness of telephone peer coaching for persons with type 2 diabetes. It involved a partnership between a university and 11 diabetes centers. One hundred nine persons with type 2 diabetes or who were familiar with type 2 diabetes (e.g., family members) were trained as coaches and learned how to use self-management behavioral change strategies and to navigate the healthcare system. Diabetes educators recruited 115 adults with type 2 diabetes who were experiencing difficulty managing.
Coaches and subjects were paired, and over a 6-month period, coaches telephoned subjects once each week and engaged in a 30 minute conversation focusing on managing their condition, their medications and on their family and work life. Both coaches and subjects completed questionnaires at baseline, and at 6 and 12 months. A one-way repeated-measures analysis of variance was used to investigate change with 14 measures. To investigate the peer coaching process, a grounded theory qualitative analysis was conducted to obtain information on the coaching process.
The analysis showed statistically significant improvements between baseline and 12 months, namely: A1c (-9%), patient activation (+15%), depression (-24%), self-efficacy (+23%), communication with health care professionals (+23%), and diabetes empowerment (+10%). Further analysis found that these results were not influenced by covariates of age, gender, number of chronic health conditions and education level. The main themes found in the qualitative study which contributed to participant improvements were: learning self-management skills, personal accountability, encouragement, finding resources, and the boundary between the coach and participant.
This pilot “pragmatic” study demonstrated that peer coaches are acceptable to clinicians and clients and have an important role in the continuity of care for persons experiencing diabetes.
P. McGowan: None.