@article {Thom137, author = {David H. Thom and Amireh Ghorob and Danielle Hessler and Diana De Vore and Ellen Chen and Thomas A. Bodenheimer}, title = {Impact of Peer Health Coaching on Glycemic Control in Low-Income Patients With Diabetes: A Randomized Controlled Trial}, volume = {11}, number = {2}, pages = {137--144}, year = {2013}, doi = {10.1370/afm.1443}, publisher = {The Annals of Family Medicine}, abstract = {PURPOSE Peer health coaches offer a potential model for extending the capacity of primary care practices to provide self-management support for patients with diabetes. We conducted a randomized controlled trial to test whether clinic-based peer health coaching, compared with usual care, improves glycemic control for low-income patients who have poorly controlled diabetes. METHOD We undertook a randomized controlled trial enrolling patients from 6 public health clinics in San Francisco. Twenty-three patients with a glycated hemoglobin (HbA1C) level of less than 8.5\%, who completed a 36-hour health coach training class, acted as peer coaches. Patients from the same clinics with HbA1C levels of 8.0\% or more were recruited and randomized to receive health coaching (n = 148) or usual care (n = 151). The primary outcome was the difference in change in HbA1C levels at 6 months. Secondary outcomes were proportion of patients with a decrease in HbA1C level of 1.0\% or more and proportion of patients with an HbA1C level of less than 7.5\% at 6 months. Data were analyzed using a linear mixed model with and without adjustment for differences in baseline variables. RESULTS At 6 months, HbA1C levels had decreased by 1.07\% in the coached group and 0.3\% in the usual care group, a difference of 0.77\% in favor of coaching (P = .01, adjusted). HbA1C levels decreased 1.0\% or more in 49.6\% of coached patients vs 31.5\% of usual care patients (P = .001, adjusted), and levels at 6 months were less than 7.5\% for 22.0\% of coached vs 14.9\% of usual care patients (P = .04, adjusted). CONCLUSIONS Peer health coaching significantly improved diabetes control in this group of low-income primary care patients.}, issn = {1544-1709}, URL = {https://www.annfammed.org/content/11/2/137}, eprint = {https://www.annfammed.org/content/11/2/137.full.pdf}, journal = {The Annals of Family Medicine} }