title: Effectiveness of peer-led self-management coaching for patients recently diagnosed with Type 2 diabetes mellitus in primary care: a randomized controlled trial.
abstract: OBJECTIVE
  To study the effectiveness of a peer-led self-management coaching intervention in recently diagnosed patients with Type 2 diabetes.
  
  
  METHODS
  Randomized controlled trial of recently diagnosed patients with Type 2 diabetes from 54 participating general practices. The intervention group received three home visits by an experienced peer (expert patient) who adhered to the recommended treatment and lifestyle guidelines. Together with their expert patient, participants set feasible goals and these were evaluated in the next visit. Participants in the control group received care as usual. At baseline, 3 months and 6 months post-intervention, participants completed a questionnaire measuring changes in self-efficacy, coping, physical activity, dietary habits, psychological well-being, depressive symptoms and diabetes related distress.
  
  
  RESULTS
  In total, 327 patients were eligible for inclusion in the study of which 133 consented to participate. In participating patients, self-efficacy, coping and saturated fat intake improved significantly over time. Analyses of participants with low self-efficacy at baseline (25th percentile: 44) revealed a significant time × group difference, F = 3.71; P = 0.03. Participants who reported low psychological well-being at baseline increased substantially throughout the study (F = 23.84; P < 0.01) but no significant time × group differences were found.
  
  
  CONCLUSIONS
  A peer-led self-management coaching programme for recently diagnosed patients with Type 2 diabetes improved self-efficacy of patients experiencing low self-efficacy shortly after diagnosis.
authors.affiliation: Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht, The Netherlands. i.vanderwulp-2@umcutrecht.nl
authors.forename: I
authors.initials: I
authors.lastname: van der Wulp
authors.forename: J R J
authors.initials: JR
authors.lastname: de Leeuw
authors.forename: K J
authors.initials: KJ
authors.lastname: Gorter
authors.forename: G E H M
authors.initials: GE
authors.lastname: Rutten
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000534:rehabilitation*; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010379:Peer Group; D011320:Primary Health Care; D040242:Risk Reduction Behavior; D012648:Self Care / Q000379:methods*; D012657:Self-Help Groups; D011795:Surveys and Questionnaires