Personalized Diabetes Education and Coaching
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University of California-Irvine
Orange County
Diabetes
University-affiliated Outpatient Clinics
Mexican and Vietnamese-Americans
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PROJECT
Community-based diabetes coaches are incorporated into the care team.
Diabetes coaches, who themselves have type 2 diabetes, are recruited directly from the local community and trained to work one-on-one with patients who are identified using an existing electronic diabetes registry. The coaches share language and sociodemographic characteristics with the patients and have the ability to serve as “cultural brokers” for what may otherwise be a hard-to-reach population within the clinics.
The coach-patient interaction occurs 20 minutes before regularly scheduled medical appointments, in a private area of the doctor’s office. During that encounter, the diabetes coach addresses self-efficacy, social and cultural barriers to care, lifestyle changes and medication adherence. Using the patient’s personal medical information, obtained directly from the patient and the medical record, the coach tailors the meeting to his or her individual needs. After a patient’s visit with the doctor, coaches debrief patients and help them understand their treatment plan. Coaches also follow up with phone calls
two weeks after the first doctor’s visit, and one week prior to subsequent visits, which usually occur every three months.
RATIONALE
Communication barriers between patients with limited English proficiency and their providers can lead to higher complication rates and poor health outcomes for patients, especially for those who must manage chronic disease. Effective patient-provider communication may result in better health outcomes and help reduce health disparities.
Through culturally appropriate, personalized education, coaches can help patients build information seeking and communication skills that can improve patient-provider communication. The fact that the coaches have type 2 diabetes, are from the same communities, and speak the same languages as the patients they coach creates a peer relationship that
may help the patients be more open to the information offered in the coaching session.
The intervention’s potential for success also relies on the timing of the coaching. The coaching that occurs immediately before the patient’s visit with the doctor may encourage better doctor-patient communication inside the doctor’s office.
EVALUATION PLAN
Funded by Finding Answers in 2006.
A randomized controlled trial is comparing the coached care intervention to basic diabetes education materials adapted from the American Diabetes Association. The main outcome measure is glucose control, measured by HbA1c levels. Secondary outcomes include LDL cholesterol and blood pressure. Other outcomes include diabetes-specific functional status and follow-through on, and satisfaction with, the negotiated treatment regimen.
Clinical measures are being taken at the first and fifth office visits. A mail-back survey is being sent to patients six months post-intervention.
Outcomes for both Mexican-American and Vietnamese-American patient populations are being examined to determine the intervention’s effectiveness for each ethnic group.
Principal Investigator:
- Quyen Ngo-Metzger, MD, MPH
Publications
The Effects of Financial Pressures on Adherence and Glucose Control Among Racial/Ethnically Diverse Patients with Diabetes
Journal of General Internal Medicine. 2012; 27(4): 432-437.
Full Article (may require subscription)
Marital status and gender differences in managing a chronic illness: The function of health-related social control
Social Science & Medicine. 2010; 71(10): 1831-1838.
Full Article (may require subscription)
Project Website
Coached Care for Diabetes Program (CCDP)
For More Information
Please Contact:
Quyen Ngo-Metzger, MD, MPH
Qhngo@uci.edu
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