title: Are Low-Income Peer Health Coaches Able to Master and Utilize Evidence-Based Health Coaching?
abstract: OBJECTIVE
  A randomized controlled trial found that patients with diabetes had lower HbA1c levels after 6 months of peer health coaching than patients who did not receive coaching. This paper explores whether the peer coaches in that trial, all low-income patients with diabetes, mastered and utilized an evidence-based health coaching training curriculum. The curriculum included 5 core features: ask-tell-ask, closing the loop, know your numbers, behavior-change action plans, and medication adherence counseling.
  
  
  METHODS
  This paper includes the results of exams administered to trainees, exit surveys performed with peer coaches who completed the study and those who dropped out, observations of peer coaches meeting with patients, and analysis of in-depth interviews with peer coaches who completed the study.
  
  
  RESULTS
  Of the 32 peer coach trainees who completed the training, 71.9% lacked a college degree; 25.0% did not graduate from high school. The 26 trainees who passed the exams attended 92.7% of training sessions compared with 80.6% for the 6 trainees who did not pass. Peer coaches who completed the study wanted to continue peer coaching work and had confidence in their abilities despite their not consistently employing the coaching techniques with their patients. Quotations describe coaches' perceptions of the training.
  
  
  CONCLUSIONS
  Of low-income patients with diabetes who completed the evidenced-based health coaching training, 81% passed written and oral exams and became effective peer health coaches, although they did not consistently use the techniques taught.
authors: Center for Excellence in Primary Care, Department of Family and Community Medicine, University of California, San Francisco, San Francisco, California.
authors: Matthew L
authors: ML
authors: Goldman
authors: Center for Excellence in Primary Care, Department of Family and Community Medicine, University of California, San Francisco, San Francisco, California.
authors: Amireh
authors: A
authors: Ghorob
authors: Center for Excellence in Primary Care, Department of Family and Community Medicine, University of California, San Francisco, San Francisco, California.
authors: Danielle
authors: D
authors: Hessler
authors: Center for Excellence in Primary Care, Department of Family and Community Medicine, University of California, San Francisco, San Francisco, California.
authors: Russell
authors: R
authors: Yamamoto
authors: Center for Excellence in Primary Care, Department of Family and Community Medicine, University of California, San Francisco, San Francisco, California.
authors: David H
authors: DH
authors: Thom
authors: Center for Excellence in Primary Care, Department of Family and Community Medicine, University of California, San Francisco, San Francisco, California TBodenheimer@fcm.ucsf.edu.
authors: Thomas
authors: T
authors: Bodenheimer
mesh_terms: D000328:Adult; D003376:Counseling / Q000193:education* / Q000379:methods; D003920:Diabetes Mellitus / Q000628:therapy*; D004522:Educational Status; D055317:Evidence-Based Practice / Q000193:education; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010379:Peer Group; D011203:Poverty / Q000523:psychology / Q000706:statistics & numerical data*; D012648:Self Care / Q000379:methods* / Q000523:psychology; D012959:Socioeconomic Factors
keywords: coaching; diabetes; peer support; self-management support