Health Coaching with Peer Support to Improve Diabetes Self-Management Education

Introduction

Type 2 diabetes mellitus (T2DM) affects nearly 25 million Americans, with the highest mortality rate being among African-Americans.  Complications of diabetes often lead to increased hospitalizations, more patient and hospital spending, and additional co-morbidities.  T2DM is best controlled through improved patient self-care which is achieved through self-management education and peer support.  

Purpose

The purpose of this project is to demonstrate how a professionally guided health coaching program, in conjunction with peer support groups, can improve type 2 diabetes self-management of African-American patients at a state-funded hospital.  This is accomplished through health coaching sessions related to stress management, exercise, medication compliance, and nutrition in conjunction with telephone coaching sessions.

Methods

Patients were selected from the medical-surgical floor during hospital admission over a period of eight weeks.  Patients completed a Foundations Class which included questionnaires about diabetes self-care and perceived stress levels along with a behavior modification video.  Patients then attended a series of four interdisciplinary Health Coaching Classes in which a different topic was discussed at each.  A specific activity was done in each class with correlating homework assignments and peer discussion.  Topics included stress management, exercise, medication, and nutrition.  The patients received telephone coaching in between classes.  Progress was measured by weekly weight checks during the classes and weekly self-monitored blood glucose averages.

Findings

SDSCA:  General diet and glucose testing showed statistically significant differences in pre- and posttest findings indicating that health coaching with peer support helped improve self-management in relation to these topics. There was not enough evidence to support statistical improvement in specific diabetic diet, exercise, or foot care.

PSS:  The results showed statistically significant differences in the pre and posttest scores indicating that health coaching with peer support decreases patients’ perceived stress levels.

Blood Glucose and Weight:  There is not enough evidence that health coaching with peer support decreases patients’ weight or blood glucose levels.

Although not all statistically significant (p < .05), the mean differences in all variables showed overall improvement.

Conclusions

Health coaching with peer support helps improve diabetes self-management among individuals with T2DM.  The outcomes of this project showed an overall improvement in self-management practices including weight loss, glycemic control, glucose monitoring, nutrition, physical activity, and stress.