Dayle Hunt Joseph

Peer coaching: an intervention for individuals struggling with diabetes.

PURPOSE The purpose of this study was to determine the value of peer coaching and its influence on behavior change. METHODS Coaches who were known to be successfully managing their diabetes were paired with individuals who were struggling with behavior change associated with managing diabetes. The pairs were matched according to age, sex, and physical appearance. Coaches met initially with participants in a face-to-face meeting for 1 hour and talked with them once a week for 10 to 15 minutes for the next 8 weeks. The initial interview and subsequent phone conversations focused on the persons problems and efforts at behavior change. RESULTS At the end of the study, the pairs participated in a videotaped focus group to discuss their views on coaching and its influence on behavior change. Participants reported that coaching was personal, useful in disease management, and helpful in their quest to establish and adhere to routines of care. Participants also reported making progress toward changing their behavior related to diet, exercise, and blood glucose monitoring. Sustained behavior change was not measured. CONCLUSIONS Peer coaching appears to have merit as a viable, low-cost intervention with the potential of helping individuals with diabetes who need to change their behavior.

Overcoming Obstacles to Behavior Change in Diabetes Self-Management

PURPOSE this study describes how 5 individuals with type 2 diabetes overcame obstacles that interfered with maintaining behavior changes in diet, exercise, and self-monitoring of blood glucose (SMBG). METHODS In-depth interviews provided the framework for this descriptive study. During audiotaped, face-to-face, follow-up structured and unstructured interviews, the participants shared their experiences about obstacles encountered and strategies used to overcome them. Each case was examined independently, and all cases were then compared with each other. RESULTS Obstacles that interfered with maintaining a diet plan were hunger, planned and unplanned meal events, and the desire for new foods. Physical illness and unexpected life events were obstacles to maintaining an exercise and SMBG plan. CONCLUSIONS Health professionals who assist patients who are beginning behavior change or having difficulty maintaining changes need to have an understanding of the various obstacles and how patients can maintain behavior changes over time.

Risk Taking Among Diabetic Clients

Diabetic clients must make daily decisions about their health care needs. Observational and anecdotal evidence suggests that vast differences exist between the kinds of choices diabetic clients make and the kinds of chances they are willing to take. The purpose of this investigation was to develop a diabetic risk-assessment tool. This instrument, which is based on subjective expected utility theory, measures risk-prone and risk-averse behavior. Initial findings from a pilot study of 18 women clients who are on insulin indicate that patterns of risk behavior exist in the areas of exercise, skin care, and diet.