title: Home-based diabetes self-management coaching delivered by paraprofessionals: A randomized controlled trial.
abstract: This study evaluated paraprofessional-led diabetes self-management coaching (DSMC) among 94 clients with type 2 diabetes recruited from a Community Care Access Centre in Ontario, Canada. Subjects were randomized to standard care or standard care plus coaching. Measures included the Diabetes Self-Efficacy Scale (DSES), Insulin Management Diabetes Self-Efficacy Scale (IMDSES), and Hospital Anxiety and Depression Scale (HADS). Both groups showed improvement in DSES (6.6 + 1.5 vs. 7.2 + 1.5, p < .001) and IMDSES (113.5 + 20.6 vs. 125.7 + 22.3, p < .001); there were no between-groups differences. There were no between-groups differences in anxiety (p > .05 for all) or depression scores (p > .05 for all), or anxiety (p > .05 for all) or depression (p > .05 for all) categories at baseline, postintervention, or follow-up. While all subjects demonstrated significant improvements in self-efficacy measures, there is no evidence to support paraprofessional-led DSMC as an intervention which conveys additional benefits over standard care.
authors.affiliation: a Toronto Central Community Care Access Centre , Toronto , Ontario , Canada.|b West Park Healthcare Centre , Toronto , Ontario , Canada.
authors.forename: Tim
authors.initials: T
authors.lastname: Pauley
authors.affiliation: a Toronto Central Community Care Access Centre , Toronto , Ontario , Canada.|b West Park Healthcare Centre , Toronto , Ontario , Canada.
authors.forename: Judith
authors.initials: J
authors.lastname: Gargaro
authors.affiliation: c Chronic Disease Management, Saint Elizabeth , Markham , Ontario , Canada.
authors.forename: Glen
authors.initials: G
authors.lastname: Chenard
authors.affiliation: a Toronto Central Community Care Access Centre , Toronto , Ontario , Canada.
authors.forename: Helen
authors.initials: H
authors.lastname: Cavanagh
authors.affiliation: d VHA Home HealthCare , Toronto , Ontario , Canada.
authors.forename: Sandra M
authors.initials: SM
authors.lastname: McKay
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D001007:Anxiety / Q000209:etiology / Q000523:psychology; D003153:Community Health Services / Q000379:methods* / Q000706:statistics & numerical data; D003863:Depression / Q000209:etiology / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D000071252:Mentoring / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D008875:Middle Aged; D009864:Ontario; D011594:Psychometrics / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D020377:Self Efficacy; D000073278:Self-Management / Q000379:methods* / Q000706:statistics & numerical data; D018709:Statistics, Nonparametric
keywords: Diabetes mellitus; home care services; insulin; paraprofessional; self-management coaching