title: Study protocol: The Technology-Enhanced Coaching (TEC) program to improve diabetes outcomes - A randomized controlled trial.
abstract: 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.
  
  
  
  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 are delivered via a web-based, educational tool tailored with each participant's personalized health data (iDecide). Over six months, coaches call their assigned participants once a week to provide support for weekly action steps. Data are also collected on an Observational Control group with no contact with study staff. Changes in A1c, blood pressure, other patient-centered outcomes and mediators and moderators of intervention effects will be assessed.
  
  
  
  290 participants were enrolled.
  
  
  
  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 will provide insights for scalable self-management support programs for diabetes and chronic illnesses that require high levels of sustained patient self-management.
authors.affiliation: Center for Clinical Management Research Ann Arbor VA, HSR&D, Ann Arbor, MI, United States; Department of Internal Medicine, University of Michigan School of Medicine, Ann Arbor, MI, United States.
authors.forename: Michele
authors.initials: M
authors.lastname: Heisler
authors.affiliation: Center for Clinical Management Research Ann Arbor VA, HSR&D, Ann Arbor, MI, United States; Department of Internal Medicine, University of Michigan School of Medicine, Ann Arbor, MI, United States. Electronic address: rmase@umich.edu.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Mase
authors.affiliation: Center for Clinical Management Research Ann Arbor VA, HSR&D, Ann Arbor, MI, United States.
authors.forename: Brianne
authors.initials: B
authors.lastname: Brown
authors.affiliation: Center for Clinical Management Research Ann Arbor VA, HSR&D, Ann Arbor, MI, United States.
authors.forename: Shayla
authors.initials: S
authors.lastname: Wilson
authors.affiliation: John D. Dingell VA Medical Center, Detroit, MI, United States.
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Reeves
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D001741:Black or African American; D001794:Blood Pressure; D003194:Computer-Assisted Instruction / Q000379:methods; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology / Q000628:therapy; D006442:Glycated Hemoglobin; D020407:Internet; D055118:Medication Adherence; D000071252:Mentoring / Q000379:methods; D008824:Michigan; D009042:Motivation; D010353:Patient Education as Topic / Q000379:methods; D018802:Patient-Centered Care / Q000379:methods; D010379:Peer Group; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D012648:Self Care / Q000379:methods; D020377:Self Efficacy; D012959:Socioeconomic Factors; D014481:United States; D014493:United States Department of Veterans Affairs; D064887:Observational Studies as Topic
chemical_list: D006442:Glycated Hemoglobin
keywords: Decision aid; Diabetes; Health coaching; Peer-support; Self-management; Trial registration:The ClinicalTrials.gov registration number is NCT01855399.