Effectiveness and Applicability of Self-Management Peer Coaching in the Continuity of Diabetes Care
Bibliographic record
Abstract
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. Disclosure P. McGowan: None.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.044 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".