Buchholz, Jill

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Background: Type 2 diabetes (T2DM) requires initial and continuous patient education for lifelong management due to the complexity of the disease. However, diabetes education is not very well-supported in the office setting due to the providers’ limited time per patient. However, with the aid of technology-based intervention, patients can be more supported and educated, leading to better T2DM control.

Aims: The purpose of this scholarly project was to evaluate the effectiveness of diabetes education through tele-coaching in patients with T2DM for improved self-care and clinical outcomes, including hemoglobin A1c (A1c) and body mass index (BMI).

Method: A mixed-method, single group quasi-experimental study and a post-intervention qualitative interview was conducted on 14 patients with T2DM and A1c greater than 6.5%. The intervention consisted of weekly tele-coaching diabetes education via phone calls or Zoom and action prompt text messages twice a week for 8 weeks. After completing the intervention, an individual interview with four structured interview questions was performed to explore the participants’ tele-coaching experience.

Results: Eleven participants completed the study. After 8 weeks of intervention, the BMI change from pre- to post-intervention was not statistically significant, and the effect size was small (t(10) = 1.174, p = .268, d = 0.35). The A1c from pre- to post-intervention was also non-significant, and had a small effect (V = 33.50, p = .213, d = 0.43). However, the diabetes self-care activity score from pre- to post-intervention was statistically significant and the effect was large (V = 4, p = .006, d = 0.92). The post-intervention interviews show that tele-coaching diabetes education had positive impacts on the participants’ diabetes self-care and their motivation through more frequent support in reminding them for continuous self-care. However, 4 out of 11 participants preferred in-person office visits over tele-coaching.

Conclusion: Diabetes self-care activity significantly improved after tele-coaching diabetes education, but A1c and BMI did not improve substantially. Patients perceived that tele-coaching was supportive, but some still preferred in-person education.

Keywords: Type 2 diabetes, hemoglobin A1c, weight loss, diabetes self-care, diabetes education, tele-coaching.