scholarly journals Characterizing Autonomy Supportiveness in Diabetes Peer Health Coaches

2021 ◽  
Vol 5 (0) ◽  
Author(s):  
Jacob Cedarbaum ◽  
Brianne Brown ◽  
Shayla Wilson ◽  
Rebecca Mase ◽  
Michele Heisler
Keyword(s):  
Glycemic Control ◽  
Autonomy Support ◽  
Health Workers ◽  
Medical Center ◽  
Controlled Trial ◽  
Department Of Veterans Affairs ◽  
Structured Interviews ◽  
Good Glycemic Control ◽  
Health Coaches ◽  
Support Autonomy

BackgroundPrior studies have shown that peer health coaching improves outcomes among adults with chronic conditions such as diabetes. These studies have also suggested that higher ratings of their peer coach’s autonomy supportiveness, i.e., the degree to which a coach supports participant choice, is associated with improved outcomes. The types of actual behaviors and interactions that participants in these coaching relationships perceive as being more or less autonomy supportive are important to define. This investigation aims to more concretely characterize the ways in which participants perceive autonomy support and how important these perceptions are to their satisfaction with their peer coaches.MethodsThis article is a qualitative investigation of the US Department of Veterans Affairs–Technology Enhanced Coaching (VA-TEC) study, a parallel randomized controlled trial with diabetes patients with poor glycemic control at the Detroit VA Medical Center. Intervention arm participants work for 6 months with peer coaches who are also VA patients who now have good glycemic control. Researchers conducted semi-structured interviews with veterans who had recently completed their 6 months of coaching. Responses to Health Care Climate Questionnaire (HCCQ) items in the trial’s 6-month survey were used to identify veterans for interviews who rated their coaches either especially high or low in terms of autonomy supportiveness. Interview responses were then analyzed in order to elucidate veterans’ perceptions of autonomy support in their coaching relationships.ResultsSemi-structured interviews were conducted with 17 of the veterans who completed the VA-TEC program. Veterans who rated their coaches higher on HCCQ items tended to emphasize the positivity and non-judgmental nature of their coaches. They also described coaches who offered them choices and non-directive suggestions in identifying health behavior goals. Veterans who gave their coaches lower HCCQ ratings described coaches who tended to be less personally engaged and less focused on addressing veterans’ specific concerns about diabetes. Some veterans who rated their coaches lower on autonomy-supportiveness felt their coaches underestimated their existing knowledge of diabetes and were overly directive in providing advice. Overall, participants’ HCCQ ratings correlated well with expressed satisfaction with their coach in interviews. ConclusionsVA-TEC participant feedback outlines meaningful ways in which coaches can support autonomy. These include, among others, eliciting participants’ personal goals, remaining positive and non-judgmental, providing suggestions for behavior changes without being overly directive, and maintaining a balance between discussing diabetes and the types of personal conversations that are crucial to building trust. The effective behaviors described in this investigation can be used to train future coaches and other lay health workers.

scholarly journals Can autonomy support have an effect on type 2 diabetes glycemic control? Results of a cluster randomized controlled trial

2020 ◽  
Vol 8 (1) ◽  
pp. e001018
Author(s):  
Qingping Yun ◽  
Ying Ji ◽  
Shenglan Liu ◽  
Yang Shen ◽  
Xuewen Jiang ◽  
...  
Keyword(s):  
Social Support ◽  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Support Group ◽  
Autonomy Support ◽  
Controlled Trial ◽  
Support Intervention ◽  
Randomized Controlled ◽  
Cluster Randomized

ObjectivesTo assess whether social support or autonomy support intervention for patients with type 2 diabetes can achieve glycemic control at the end of intervention, and to test whether the glycemic control effect can be maintained for a long time.Research design and methodsIn this cluster randomized controlled trial, 18 community healthcare stations (CHSs) were randomized to the following: (1) usual care group (UCG) offering regular public health management services, (2) social support group (SSG) providing 3-month social support intervention based on problem solving principles, and (3) autonomy support group (ASG) offering 3-month autonomy support intervention based on self-determination theory. A total of 364 patients registered in the CHSs were enrolled into either of the three groups. The primary outcome was hemoglobin A1c (HbA1c), and secondary outcomes were diabetes self-management (DSM) behaviors. Assessment was conducted at baseline and at 3 and 6 months.ResultsPatients in ASG achieved better HbA1c reduction at the end of intervention (0.53% or 7.23 mmol/mol, p<0.001) than those in the UCG and successfully maintained it up to 6 months (0.42% or 5.41 mmol/mol, p<0.001). However, patients in SSG did not experience significant change in HbA1c at 3 or 6 months when compared with patients in UCG. Besides, patients in both the SSG (0.12, p<0.05) and ASG (0.22, p<0.001) experienced improvement in exercise at 3 months. Patients in ASG sustained improvement in exercise up to 6 months (0.21, p<0.001), but those in the SSG did not.ConclusionsAutonomy support for patients with type 2 diabetes could help achieve glycemic control at the end of intervention and successfully maintain it up to 6 months. These findings indicate that autonomy support has positive long-term effects on DSM behaviors and glycemic control and can be recommended in future diabetes intervention programs.Trial registration numberChiCTR1900024354.

scholarly journals The Self-Management Experiences of Adolescents with Type 1 Diabetes: A Descriptive Phenomenology Study

2020 ◽  
Vol 17 (14) ◽  
pp. 5132
Author(s):  
Li-Chen Hung ◽  
Chu-Yu Huang ◽  
Fu-Sung Lo ◽  
Su-Fen Cheng
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Phenomenological Study ◽  
Medical Center ◽  
Self Management ◽  
Good Glycemic Control ◽  
Descriptive Phenomenology ◽  
Parental Assistance ◽  
Colaizzi's Method

Many adolescents with type 1 diabetes experience challenges in achieving good glycemic control and have insufficient understanding in executing interventions for glycemic control. This study aimed to understand self-management experiences of adolescents with type 1 diabetes in Taiwan. In this descriptive phenomenological study, we conducted in-depth interviews with 18 adolescents with type 1 diabetes from the pediatric outpatient clinic of a medical center. Data were analyzed using the Colaizzi’s method. Four themes were identified: (1) misconception regarding self-management of blood glucose; (2) conflict between depending on and breaking away from parental assistance for glycemic control; (3) encounter with disruptions in glycemic control regimen due to the presence of schedule changes; and (4) lack of motivation to achieve good glycemic control. The findings indicated that the misconceptions of adolescents with type 1 diabetes about managing glycemic levels resulted from an insufficient understanding of self-management of diabetes. In Taiwan, the heavy emphasis of academic achievement and changes of schedules during breaks tended to disrupt the regimen for glycemic control. Healthcare professionals are encouraged to provide individualized education focusing on the adolescents’ misconceptions regarding self-management of diabetes.

scholarly journals Using self-determination theory to understand and improve recruitment for the Coaching for Healthy Ageing (CHAnGE) trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259873
Author(s):  
Abby Haynes ◽  
Catherine Sherrington ◽  
Geraldine Wallbank ◽  
James Wickham ◽  
Allison Tong ◽  
...  
Keyword(s):  
Physical Activity ◽  
Controlled Trial ◽  
Qualitative Evaluation ◽  
Cluster Randomised Controlled Trial ◽  
Self Determination Theory ◽  
Healthy Ageing ◽  
Self Determination ◽  
Structured Interviews ◽  
Change Trial ◽  
Health Coaches

Background Intervention trials promoting physical activity among older people frequently report low and unrepresentative recruitment. Better understanding of reasons for participation can help improve recruitment. This study explored why participants enrolled in the Coaching for Healthy Ageing (CHAnGE) trial, including how their decision was influenced by recruitment strategies. CHAnGE was a cluster randomised controlled trial testing the effectiveness of a healthy ageing program targeting inactivity and falls. Seventy-two groups of people aged 60+ were recruited from community organisations via informal presentations by the health coaches. Methods We conducted a secondary thematic analysis of interview data from our wider qualitative evaluation in which 32 purposively sampled trial participants took part in semi-structured interviews about their experiences of CHAnGE. Data relating to recruitment and participation were analysed inductively to identify themes, then a coding framework comprising the core constructs from self-determination theory—autonomy, competence and relatedness—was used to explore if and how this theory fit with and helped to explain our data. Results Recruitment presentations promoted the CHAnGE intervention well in terms of addressing value expectations of structured support, different forms of accountability, credibility, achievability and, for some, a potential to enhance social relationships. Participation was motivated by the desire for improved health and decelerated ageing, altruism and curiosity. These factors related strongly to self-determination concepts of autonomy, competence and relatedness, but the intervention’s demonstrated potential to support self-determination needs could be conveyed more effectively. Conclusions Findings suggest that recruitment could have greater reach using: 1. Strengths-based messaging focusing on holistic gains, 2. Participant stories that highlight positive experiences, and 3. Peer support and information sharing to leverage altruism and curiosity. These theory-informed improvements will be used to increase participation in future trials, including people in hard-to-recruit groups. They may also inform other physical activity trials and community programs.

scholarly journals Sustainable improvement of HbA1c and satisfaction with diabetes care after adding telemedicine in patients on adaptable insulin regimens: Results of the TeleDiabetes randomized controlled trial

2019 ◽  
Vol 26 (1) ◽  
pp. 628-641
Author(s):  
Heidi Buysse ◽  
Peter Coremans ◽  
Frans Pouwer ◽  
Johannes Ruige
Keyword(s):  
Glycemic Control ◽  
Repeated Measures ◽  
Controlled Trial ◽  
Control Group ◽  
Life Changes ◽  
Mobile Platforms ◽  
Good Glycemic Control ◽  
Face To Face ◽  
Sustainable Improvement ◽  
Repeated Measures Analysis

This 2-year study evaluates whether tele-education adds to improvement and maintenance of good glycemic control and patient satisfaction. Adult patients were randomly assigned to study, getting immediate access to tele-education, or control group, getting this surplus education after 3 months. At several moments, clinical data were retrieved and patients completed questionnaires. Multivariate analyses of covariance and repeated measures analysis of variance were conducted. Implementation of tele-education in between face-to-face contacts improved glycemic control for both groups, which was maintained over a 2-year period. Tele-education did not have an influence on glucose measurements or on hypoglycemic events. Patients were satisfied with this tele-educational tool and appreciated use of personal messages. Further research should focus on the possible influence of “life changes” and influence on “need for more tele-educational feedback,” and consequently on the provision of (mobile) platforms adaptable to patient’s (changing life) situations.

STUDI KUALITATIF : KEBUTUHAN IBU HAMIL DENGAN DIABETES MELITUS GESTASIONAL DI KABUPATEN KARANGANYAR JAWA TENGAH

2020 ◽  
pp. 17-26
Author(s):  
Arista Apriani ◽  
M Mufdlilah ◽  
Menik Sri Daryanti
Keyword(s):  
Social Support ◽  
Pregnant Women ◽  
Health Center ◽  
Blood Sugar ◽  
Interpretative Phenomenological Analysis ◽  
Health Workers ◽  
Phenomenological Analysis ◽  
Lifestyle Changes ◽  
Structured Interviews ◽  
Diabetes Melitus

ABSTRAK GDM dapat berpotensi menimbulkan komplikasi serius yang dapat mengakibatkan risiko kesehatan jangka pendek dan jangka panjang bagi ibu dan bayinya. diagnosis GDM menimbulkan efek emosional yang negatif. Persepsi ibu hamil tentang GDM dapat memengaruhi perubahan gaya hidup. Garis pertama penatalaksanaan DMG yaitu dengan perubahan gaya hidup. Tujuan menggali secara mendalam kebutuhan ibu dengan diagnosis diabetes melitus gestasional. Metode penelitian kualitatif dengan pendekatan  fenomenologi. Lokasi di Kabupaten Karanganyar yaitu Puskesmas Jaten I, Puskesmas Matesih dan RSUD Kabupaten Karanganyar, pada bulan Oktober 2019 - Januari 2020. Sampel secara criterion sampling Pengumpulan data dengan semistructure interview dengan one on one interview. Uji Keabsahan Data dengan Credibility pada penelitian ini menggunakan strategi validitas triangulasi, Tranferability, Dependability, Confirmability. Analisis data dengan Interpretative Phenomenological Analysis (IPA). Hasil penelitian kebutuhan ibu hamil dengan DMG teridentifikasi empat tema, yaitu dukungan keluarga dalam hal mengontrol pola makan, mengatarkan periksa ke tenaga kesehatan, dan mengingatkan untuk aktifitas olah raga. Dukungan sosial, yaitu cara mengontrol gula darah. Dukungan tenaga kesehatan, yaitu saran dan motivasi untuk mengontrol gula darah. Informasi mendapat saran atau perawatan DMG dalam kehamilan adalah dari tenaga kesehatan yaitu bidan, dokter, serta selain tenaga kesehatan dari teman dan internet. Kesimpulannya kebutuhan ibu hamil dengan DMG teridentifikasi empat tema, yaitu dukungan keluarga, dukungan sosial, dukungan tenaga kesehatan dan informasi.   Kata kunci: diabetes melitus gestasional, kehamilan, kebutuhan.   ABSTRACT GDM can overcome serious problems that can overcome short-term and long-term health problems for mother and baby. a diagnosis of GDM has a negative emotional effect. Pregnant women 's perception of GDM can affect lifestyle changes. The first line of management of DMG is lifestyle changes. Diagnosis of gestational diabetes mellitus. Qualitative research methods by studying phenomenology. Locations in Karanganyar Regency are Jaten I Health Center, Matesih Health Center and Karanganyar District Public Hospital, in October 2019 - January 2020. Sample sampling criteria Data collection by semi-structured interviews with one-on-one interviews. Data Validity Test with Credibility in this study using the triangulation validity strategy, Transparency, Dependability, Confirmability. Data analysis with Interpretative Phenomenological Analysis (IPA). The results of the study of the needs of pregnant women with DMG identified four themes, namely supporting the family in terms of controlling diet, sending check to health workers, and reminding for sports activities. Social support, which is a way to control blood sugar. Support of Health Workers, namely advice and motivation to control blood sugar. The information obtained from DMG advice or treatment in the assessment is from health workers, namely midwives, doctors, and also health workers from friends and the internet. In conclusion, the needs of pregnant women with DMG identified four themes, namely family support, social support, support of health workers and information.  

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