The goal of this clinical trial is to compare the effects of peer coaching models in older adults with unmanaged type two diabetes. The main questions it aims to answer are: * Are peer coaching models effective at promoting Type 2 Diabetes Mellitus self-management? * If effective, which facets of the peer model are most effective? Peer coaches will undergo peer coach training. * Reach out to peer participants on a weekly/biweekly time frame to discuss self-management and goal setting. Retain records of contact, topics discussed, and general notes on interactions. Researchers will compare differences in the frequency of contact, as well as how peer coaches were matched to peer participants to see if efficacy of the intervention is altered between groups.
The Older Adults using Social Support to Improve Self-Care (OASIS) intervention is an asset-based approach, utilizing the unique social structure existing in Kentucky's rural Appalachian communities to address self-care behaviors as they relate to Type 2 Diabetes Mellitus (T2DM) management. The intervention will be composed of two groups: peer coaches who have managed T2DM (HbA1c \< 7.5%), and peer participants who have unmanaged T2DM (HbA1c ≥ 7.5%). Peer coaches will undergo training prior to intervention initiation to develop coaching skills. Peer participants will be linked to a peer coach in one of four ways: (1) self-select coach with contact once a week (2) self-selected coach with contact every 2 weeks (3) matched with peer coach with contact once a week (4) matched with peer coach with contact every 2 weeks. In addition to evaluating the effectiveness of a peer coaching model, the four groups will be evaluated allowing for a more detailed understanding of factors that influence self-care behaviors. Stakeholders will also be engaged at three time points: prior to the intervention, study mid-point, and at study conclusion. At study conclusion, a small cohort of both peer participants and peer coaches will be invited to contribute to stakeholder group interviews. Information exchange with stakeholders will aid in developing a robust understanding of influential factors and how to effectively promulgate the intervention.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
76
Peer participants will be contacted by peer coaches on a weekly basis.
Peer participants will be contacted by peer coaches on a bi-weekly basis
Barren River Area Development District
Bowling Green, Kentucky, United States
RECRUITINGUK HealthCare
Hazard, Kentucky, United States
RECRUITINGNumber of participants with change in A1c
Obtained using point of care assessment
Time frame: Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
Diabetes Empowerment
"Attitudes Towards Diabetes - DES". 5 point scale ranging from 1 "Strongly Agree" to 5 "Strongly Disagree", where lower scores indicate greater feelings of empowerment.
Time frame: Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
Quality of Life Index
"EuroQofL-5D" measures acts of daily living (ADL) on a five point scale ranging from 0 "no" problems to 5 "extreme" problems, where higher scores indicate lower ability to engage in ADL.
Time frame: Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
Social Support
"MOS Social Support Survey" a five point scale ranging from 1 "none of the time" to 5 "all of the time" where higher scores indicate better social support.
Time frame: Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
Depression Scale
"Geriatric Depression Scale: Short Form" is a binary survey where participants can select "yes" or "no". Each "yes" is a singular point, if a score \>5 points it is suggestive about depression and warrant a follow-up comprehensive assessment. A score of greater than or equal to 10 is almost always indicative of depression.
Time frame: Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
Problem Areas in Diabetes
"Problem Areas In Diabetes (PAID) Scale" a five point scale ranging from 0 "not a problem" to 4 "serious problem", where a higher score indicates more problems in diabetes management.
Time frame: Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
Diabetes Self-Management
Diabetes Self-Management Questionnaire (DSMQ) is a four point scale ranging from 0 "does not apply to me" to 3 "applies to me very much". Higher scores indicate better diabetes management.
Time frame: Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
Acts of Daily Living
"Lawton-Brody Instrumental Activities of Daily Living Scale (I.A.D.L) is a binary where "0" is low functioning and "1" is high functioning. Higher scores indicate higher functioning
Time frame: Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
Social Network Scale
"Lubbens Social Network Scale - 6 (LSNS-6) is a five point scale ranging from "0" none to "5" nine or more. Higher scores indicate greater amount of social support.
Time frame: Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
Diabetes Knowledge Questionnaire
"Diabetes Knowledge Questionnaire (DKQ)" is a 24-item survey that has shown sensitivity to a diabetes knowledge intervention; additionally, it targets knowledge deficits which can be related to measurable outcomes, false statements, or common and/or serious misconceptions. Participants can select "yes", "no", or "don't know".
Time frame: Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
Problem Solving Skills
"Diabetes Problem-Solving Inventory (DPSI)" includes 9 items that assess how individuals living with diabetes cope with challenges of T2D-related self-care. The inventory measures three components: healthy eating, physical activity, and stress management. Overall problem-solving rating is provided on a 5-point scale from 1 "(very poor strategy)" to 5 "(excellent strategy)".
Time frame: Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
Brooks Medication Adherence
"Brooks Medication Adherence Scale" is a 6-item scale and is sensitive to changes in adherence due to intervention.
Time frame: Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
Frailty
"Pictorial Fit-Frail Scale" measures frailty phenotype using a validated assessment that characterizes frailty by exhaustion, low physical activity, weakness, and low body mass index. Individuals are characterized as frail if they have affirmative responses to 3 or 4 of the items. By identifying frailty phenotype, individuals at increased risk for adverse health outcomes can be identified, which serves as an indicator for complex patient management.
Time frame: Collected at Baseline, 6 months (at the end of the intervention), 3-months and 6-months post-intervention.
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