Study protocol: The Technology-Enhanced Coaching (TEC) program to improve diabetes outcomes - A randomized controlled trial
Heisler, Michele, Rebecca Mase, Brianne Brown, Shayla Wilson, and Pamela J. Reeves. 2017. "Study protocol: The Technology-Enhanced Coaching (TEC) program to improve diabetes outcomes - A randomized controlled trial." Contemporary Clinical Trials, 55: 24-33.
Racial and ethnic minority adults with diabetes living in under-resourced communities face multiple barriers to sustaining self-management behaviors necessary to improve diabetes outcomes. Peer support and decision support tools each have been associated with improved diabetes outcomes.
In this study, 290 primarily African American adults with poor glycemic control were recruited from the Detroit Veteran's Administration Hospital and randomized to Technology-Enhanced Coaching (TEC) or Peer Coaching alone. Participants in both arms were assigned a peer coach trained in autonomy-supportive approaches. Coaches are diabetes patients with prior poor glycemic control who now have good control. Participants met face-to-face initially with their coach to review diabetes education materials and develop an action plan. Educational materials in the TEC arm were delivered via a web-based educational tool tailored with each participant's personalized health data (iDecide). Over six months, coaches called their assigned participants once a week to provide support for weekly action steps. Data were also collected on a control group with no contact with study staff. The study assessed changes in A1c, blood pressure, other patient-centered outcomes, and mediators and moderators of intervention effects.
Findings indicate that tailored e-Health tools with educational content may enhance the effectiveness of peer coaching programs to better prepare patients to set self-management goals, identify action plans, and discuss treatment options with their health care providers. The study provides insights for scalable self-management support programs for diabetes and chronic illnesses that require high levels of sustained patient self-management.