Impact of Peer Health Coaching on Glycemic Control in Low-Income Patients With Diabetes: A Randomized Controlled Trial

The Article in Brief

Impact of Peer Health Coaching on Glycemic Control in Low-Income Patients With Diabetes: A Randomized Controlled Trial

David H. Thom , and colleagues

Background Many primary care practices have no one available to provide the time-consuming counseling and teaching of self-management skills that have been shown to improve diabetes. Peer educators and coaches are trained patient volunteers who themselves have diabetes and can provide ongoing support for self-management to a small group of clients. This study tests the impact of individual peer coaching on glucose control for patients with poorly controlled diabetes seen in public clinics.

What This Study Found Clinic-based peer health coaching improves the glycemic control of patients with poorly controlled diabetes seen in urban public health clinics. A randomized controlled trial involving almost 300 low-income patients with poorly controlled type 2 diabetes found patients who receive one-on-one coaching and self-management support from volunteer peer coaches saw a greater reduction in HbA1c levels than those in the usual care arm at 6 months' follow-up. HbA1c levels decreased 1 percent or more in 50 percent of coached patients vs 32 percent of usual care patients, and levels at 6 months were less than 7.5 percent for 22 percent of coached vs 15 percent of usual care patients. The authors note that because peer coaches experience similar challenges of living with the same chronic condition as the patients they assist, they are uniquely poised to engage and motivate them in self-management.

Implications

• Peer coaches represent a potential resource to increase primary care capacity and remove some of the burdens of patient-self management support from primary care clinicians and staff.