Peer Support for Type 2 Diabetes

(OASIS Trial)

Recruiting at 1 trial location

Overseen By Austin P Jacobs, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Brittany L Smalls

Disqualifiers: Age less than 55, Cognitive impairment, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 3

25 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial examines how peer coaching can help older adults with type 2 diabetes manage their condition more effectively. It will explore whether regular conversations with a peer coach can make a difference. The trial will compare different coaching styles to determine which is most effective. Individuals aged 55 or older, living in rural Kentucky, and diagnosed with type 2 diabetes may find this trial suitable. As an unphased study, it offers a unique opportunity to contribute to innovative research that could enhance diabetes management for many.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It seems to focus on peer support rather than medication changes.

What prior data suggests that these peer coaching models are safe for older adults with Type 2 Diabetes?

Research has shown that peer coaching is generally safe for people with type 2 diabetes. Studies have found that it can improve blood sugar levels, quality of life, and self-care skills. These studies have reported no major safety issues. Peer support often empowers individuals and reduces stress related to diabetes. However, while peer coaching offers many benefits, it did not significantly alleviate depression in some cases. Overall, evidence suggests that peer coaching is a safe and positive way to manage type 2 diabetes. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about peer coaching for type 2 diabetes because it offers a fresh approach compared to standard treatments like medication, lifestyle changes, and insulin therapy. Unlike these traditional methods, peer coaching leverages the power of social support to help individuals manage their condition. Participants choose their own peer coach, which adds a personalized touch and fosters a supportive relationship. This approach could enhance motivation and adherence to healthy behaviors, potentially leading to better long-term outcomes for those with type 2 diabetes.

What evidence suggests that this trial's peer coaching models could be effective for Type 2 Diabetes?

Research shows that peer coaching can help people manage type 2 diabetes. Studies have found that it improves HbA1c levels, an important measure of blood sugar control. Peer coaching also enhances quality of life, boosts confidence in managing health, and reduces stress related to diabetes. This trial will evaluate different peer coaching models, with participants in groups A, B, C, and D selecting a peer coach and receiving weekly contact during the intervention period. Another study found that peer support helped people take better care of themselves and feel more involved in their own health care. Overall, peer coaching could be a promising way to help people with type 2 diabetes manage their condition better. ^{1 6 7 8 9}

Who Is on the Research Team?

Brittany L Smalls, PhD

Principal Investigator

University of Kentucky

Are You a Good Fit for This Trial?

This trial is for English-speaking adults over 55 living in rural Kentucky with Type 2 Diabetes. Peer coaches must have an HbA1c level below 7.5, while peer participants need a level above 7.5 and pass a cognitive assessment.

Inclusion Criteria

Your long-term blood sugar level (HbA1c) is higher than 7.5.

I have been diagnosed with Type 2 Diabetes.

Peer coaches must have an HbA1c level less than 7.5.

Exclusion Criteria

I have difficulty with memory or thinking clearly.

Non-English Speaking

Not a resident of a Rural Kentucky county

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Peer Coach Training

Peer coaches undergo training to develop coaching skills prior to intervention initiation

2 weeks

Intervention

Peer participants are linked to peer coaches and contacted weekly or biweekly to discuss self-management and goal setting

6 months

Weekly or biweekly contact

Follow-up

Participants are monitored for changes in A1c and other secondary outcomes

6 months

Collected at Baseline, 3 month, and 6 month follow up

What Are the Treatments Tested in This Trial?

Interventions

• Peer Coaching - Peer Participants A
• Peer Coaching - Peer Participants B
• Peer Coaching - Peer Participants C
• Peer Coaching - Peer Participants D

Trial Overview The study tests different peer coaching methods to help manage Type 2 Diabetes in older adults. It looks at how often coaches contact patients, what they discuss, and how well the pairs are matched to see which approach works best.

How Is the Trial Designed?

Group I: Peer Participants (D) Experimental Treatment 1 Intervention

Peer participants in group D will self select a peer coach using peer coach profile sheets, and will be contacted weekly during intervention period.

Group II: Peer Participants (C) Experimental Treatment 1 Intervention

Peer participants in group C will self select a peer coach using peer coach profile sheets, and will be contacted weekly during intervention period.

Group III: Peer Participants (B) Experimental Treatment 1 Intervention

Peer participants in group B will self select a peer coach using peer coach profile sheets, and will be contacted weekly during intervention period.

Group IV: Peer Participants (A) Experimental Treatment 1 Intervention

Peer participants in group A will self select a peer coach using peer coach profile sheets, and will be contacted weekly during intervention period.

Peer Coaching - Peer Participants A is already approved in United States for the following indications:

Approved in United States as Peer Health Coaching for:

• Type 2 Diabetes Mellitus self-management

Who Is Running the Clinical Trial?

Brittany L Smalls

Lead Sponsor

Trials

3

Recruited

210+

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Collaborator

Trials

2,513

Recruited

4,366,000+

Published Research Related to This Trial

Participants in a diabetes self-management coaching program who became coaches reported that their own experiences with peer coaching significantly influenced their decision to take on the coaching role.

The study highlights that these coaches emphasized commitment to their partners and shared personal challenges to foster motivation and a sense of connection, suggesting that their unique insights enhance the effectiveness of peer support in managing diabetes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Experiences of Participants Who Then Become Coaches in a Peer Coach Diabetes Self-Management Program: Lessons for Future Programs. Saint, K., Heisler, M.[2023]

This review analyzed 23 trials involving 7178 participants to explore the components and outcomes of peer support interventions for type 2 diabetes, highlighting that most interventions occurred in primary care settings and were primarily delivered face-to-face, although telephone contact was the most frequent.

While the impact of peer support on health outcomes is well-studied, the methods for evaluating the fidelity of these interventions varied widely, with only a few studies rigorously assessing adherence and competence through direct observations or recordings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Peer support interventions in type 2 diabetes: Review of components and process outcomes. Afshar, R., Tang, TS., Askari, AS., et al.[2022]

Peer health coaching significantly lowers hemoglobin A1c (A1c) levels in patients with diabetes who have low self-management and medication adherence, indicating its effectiveness in high-risk groups.

In contrast, patients with high self-management and adherence showed similar improvements in A1c regardless of whether they received coaching or usual care, suggesting that coaching is particularly beneficial for those struggling with diabetes management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Peer coaching to improve diabetes self-management: which patients benefit most? Moskowitz, D., Thom, DH., Hessler, D., et al.[2022]

In a study involving 109 low-income patients with type 2 diabetes, having a peer coach with lower self-efficacy in diabetes management and higher diabetes-related distress was linked to better improvements in patients' A1C levels.

Surprisingly, peer coaches who experienced more uncertainty about their own diabetes management were more effective in helping patients improve their diabetes control, suggesting that certain coach characteristics can enhance patient outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Diabetes peer coaching: do "better patients" make better coaches? Rogers, EA., Hessler, DM., Bodenheimer, TS., et al.[2018]

This study will evaluate the effectiveness of peer coaching in improving diabetes outcomes among 400 low-income patients with poorly controlled diabetes over a 6-month period, focusing on changes in HbA1c levels as the primary outcome.

Peer coaches, who are trained patients with diabetes, may enhance self-management skills and clinical outcomes, potentially providing a cost-effective solution to improve diabetes care in resource-limited settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effectiveness of peer health coaching in improving glycemic control among low-income patients with diabetes: protocol for a randomized controlled trial. Ghorob, A., Vivas, MM., De Vore, D., et al.[2022]

Peer coaching provides valuable support for individuals with diabetes, helping them make better dietary and activity choices.

For peer support to be effective, it is essential to have a structured follow-up program in place to ensure ongoing assistance and accountability.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The benefits of peer support with diabetes. McPherson, SL., Joseph, D., Sullivan, E.[2022]

A pilot study involving 115 adults with type 2 diabetes showed that a 26-week telephone coaching program led to significant improvements in health outcomes, including a 9% reduction in glycated hemoglobin levels and a 24% decrease in depression levels.

The intervention also enhanced patients' self-efficacy by 23% and communication with their physicians by 22%, demonstrating that peer coaching can effectively support diabetes self-management and improve overall health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Role and Effectiveness of Telephone Peer Coaching for Adult Patients With Type 2 Diabetes. McGowan, P., Lynch, S., Hensen, F.[2020]

Peer support for type 2 diabetes is most effective when facilitators and participants have strong relationships and group dynamics, highlighting the importance of interpersonal connections in support settings.

Training for peer support facilitators should focus on building confidence and fostering an equal dynamic among participants, while also addressing how to appropriately conclude support groups.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Learning from the experience of peer support facilitators and study nurses in diabetes peer support: A qualitative study. Holman, D., Simmons, D., Ockenden, N., et al.[2022]

The study evaluated the effectiveness of Diabetes Education by Peer Coaching on diabetes management, measuring outcomes like Fasting Blood Sugar (FBS) and HbA1c over 12 months with various secondary health indicators.

Results suggest that peer coaching can enhance self-control and self-efficacy in diabetes management, indicating it may be a beneficial interactive approach to diabetes education tailored to specific cultural contexts.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Effectiveness of a Peer Coaching Education on Control and Management of Type 2 Diabetes in Women: A Protocol for a Randomized Controlled Trial. Aalaa, M., Sanjari, M., Aghaei Meybodi, HR., et al.[2020]

In a study involving 32 low-income patients with diabetes, 81% of those who completed an evidence-based health coaching training program became effective peer health coaches, demonstrating the program's efficacy in skill development.

Despite their success in passing exams, the peer coaches did not consistently apply the coaching techniques with their patients, indicating a gap between training and practical application that may need to be addressed for better patient outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Are Low-Income Peer Health Coaches Able to Master and Utilize Evidence-Based Health Coaching? Goldman, ML., Ghorob, A., Hessler, D., et al.[2018]

Citations

1. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/36307372/

The impact of peer coach-led type 2 diabetes mellitus ... Our findings showed that peer coaching was helpful in improving HbA1c levels, quality of life, self-efficacy, diabetes distress and patient activation.

2. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0738399124000399

Effect of peer support interventions in patients with type 2 ... A narrative synthesis of the results showed that peer support significantly improved QOL, self-management, self-efficacy, and HbA1c control in patients with ...

3. diabetesjournals.org diabetesjournals.org/care/article/48/5/807/158051/Community-Based-Peer-Support-for-Diabetes

Community-Based Peer Support for Diabetes Management The primary outcome was HbA1c; secondary outcomes included BMI, fasting plasma glucose (FPG), systolic and diastolic blood pressure, LDL ...

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9161069/

Effectiveness of a personal health coaching intervention ... This study is based on the need to develop an intervention that helps patients to establish behavioural changes in order to achieve glycaemic control.

5. link.springer.com link.springer.com/article/10.1007/s12170-024-00737-6

Recent Findings on the Effectiveness of Peer Support for ... At both 6 and 9 months, significant improvements were observed in intermediate targets of the FAMS intervention compared to controls including ...

6. sciencedirect.com sciencedirect.com/science/article/pii/S0738399124000399/pdf

Effect of peer support interventions in patients with type 2 ... Peer support significantly improved QOL, self-management, self-efficacy, and HbA1c control in patients with T2DM, but had no significant effect on depression.

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC3601392/

Impact of Peer Health Coaching on Glycemic Control in Low ... Of 2 clinic-based peer educator interventions, 1 found no intervention effect, whereas the other found a significant drop in HbA1c levels for the intervention.

8. jmir.org jmir.org/2025/1/e60703

Health Coaching and Its Impact in the Remote ... Conclusions: Health coaching was associated with improved diabetes control and self-management among patients with T2DM on remote monitoring.

9. bmcpublichealth.biomedcentral.com bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-023-16049-0

A peer support program results in greater health benefits for ... Being a peer leader in a diabetes prevention program was associated with greater health benefits during and after the intervention period.