Telephone Coaching to Improve Diabetes Self-Management for Rural Residents

Abstract

L ow-cost methods are desperately needed for improving diabetes management for people with diabetes in rural communities. With this understanding, the research team designed a project that used student pharmacists as coaches. High rates of diabetes and its complications in many rural communities point to these sites as diabetes hot spots.1 In Washington State's diabetes hot-spot communities, 17% of people > 45 years of age have diabetes on average, compared to 8.6% of people ≥ 45 years of age statewide. In one remote rural community, 40% of the population has diabetes. People in diabetes hot-spot communities also have higher rates of hospitalizations for severe diabetes complications. Controlling diabetes to reduce the incidence of its complications rests largely on individual patients and requires vigorous self-management of the disease.2 Unfortunately, without sustained support, few people achieve their goals or master the tasks that will allow them to live healthfully and reduce their risk of costly complications.3 Telephone follow-up for education and support has been shown to be a cost-effective method for improving healthy lifestyle behaviors in a variety of conditions, including diabetes.4-7 This project tested the use of brief telephone coaching sessions to improve the health of rural residents with diabetes by helping them achieve diabetes self-management goals for regular medical care and adherence to medication, diet, and physical activity regimens. Specifically, the research intent was to determine whether: 1. Participants would be better able to implement self-management tasks and reduce their risk of diabetes complications compared to a historical control group not receiving coaching, 2. Faculty and staff at the Washington State University (WSU) Extension and College of Pharmacy would be able to develop a telephone-coaching program to support additional lifestyle modifications after diabetes education to augment health care in rural areas, and 3. Telephone coaches would be …