title: Sustained effects of a nurse coaching intervention via telehealth to improve health behavior change in diabetes.
abstract: BACKGROUND
  Diabetes educators and self-management programs are scarce in rural communities, where diabetes is the third highest-ranking health concern. The goal of this study was to evaluate the benefits of nurse telehealth coaching for persons with diabetes living in rural communities through a person-centered approach using motivational interviewing (MI) techniques.
  
  
  METHODS
  A randomized experimental study design was used to assign participants to receive either nurse telehealth coaching for five sessions (intervention group) or usual care (control group). Outcomes were measured in both groups using the Diabetes Empowerment Scale (DES), SF-12, and satisfaction surveys. Mean scores for each outcome were compared at baseline and at the 9-month follow-up for both groups using a Student's t test. We also evaluated the change from baseline by estimating the difference in differences (pre- and postintervention) using regression methods.
  
  
  RESULTS
  Among the 101 participants included in the analysis, 51 received nurse telehealth coaching, and 50 received usual care. We found significantly higher self-efficacy scores in the intervention group compared with the control group based on the DES at 9 months (4.03 versus 3.64, respectively; p<0.05) and the difference in difference estimation (0.42; p<0.05).
  
  
  CONCLUSIONS
  The nurse MI/telehealth coaching model used in this study shows promise as an effective intervention for diabetes self-management in rural communities. The sustained effect on outcomes observed in the intervention group suggests that this model could be a feasible intervention for long-term behavioral change among persons living with chronic disease in rural communities.
authors: 1 Betty Irene Moore School of Nursing, University of California Davis , Sacramento, California.
authors: Heather
authors: H
authors: Young
authors: Sheridan
authors: S
authors: Miyamoto
authors: Deborah
authors: D
authors: Ward
authors: Madan
authors: M
authors: Dharmar
authors: Yajarayma
authors: Y
authors: Tang-Feldman
authors: Lars
authors: L
authors: Berglund
mesh_terms: D000328:Adult; D000368:Aged; D003920:Diabetes Mellitus / Q000451:nursing* / Q000517:prevention & control*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D062405:Motivational Interviewing; D009723:Nurse-Patient Relations; D017060:Patient Satisfaction; D012424:Rural Population; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000379:methods*
keywords: behavioral health; diabetes; technology; telehealth; telemedicine; telenursing