David Moskowitz|David H. Thom|Danielle Hessler|Amireh Ghorob|Thomas Bodenheimer
Peer Coaching to Improve Diabetes Self-Management: Which Patients Benefit Most?
Alameda Health System|University of California, San Francisco|University of California, San Francisco|University of California, San Francisco|University of California, San Francisco
peer health coaching effective method enhancing selfmanagement support patients diabetes unclear whether peer health coaching equally beneficial patients poor glycemic control effective subgroups patientsto examine whether effect peer health coaching hemoglobin a1c a1c modified characteristics known associated diabetes controlsubgroup analyses randomized control trialtwo hundred ninety nine patients diabetes receiving care public health clinics participated randomized controlled trial peer health coacheswe examined whether association study group change a1c modified differences patients demographic behavioral psychosocial characteristics analyses adjusted covariables associated change a1cthe effect coaching patient a1c modified patients level selfmanagement degree medication adherence baseline p02 p03 respectively adjusted models participants low selfmanagement one standard deviation mean score usual care group experienced slight increase a1c 03 health coaching group experienced decrease 09 participants high selfmanagement one standard deviation mean score groups experienced similar decrease a1c usual care group 10 health coaching group 11 participants low medication adherence usual care group experienced increase a1c 05 health coaching group experienced decrease 08 participants high medication adherence experienced similar decreases usual care group 11 health coaching group 13 peer health coaching larger effect lowering a1c patients low levels medication adherence selfmanagement support patients higher levels peer health coaching interventions may effective targeted highrisk patients diabetes poor glycemic control poor selfmanagement medication adherence