Feasibility and Acceptability of a Language Concordant Health Coaching Intervention Delivered by Nurses for Latinx With Type 2 Diabetes

Abstract

Background: Latinx immigrants have high rates of type 2 diabetes (T2D), exhibit out-of-range glycemic control, and have higher rates of diabetes-related complications than non-Latinx whites, with limited English proficiency (LEP) being a major barrier to care. Aims:We tested the feasibility and acceptability of a language concordant (provider that is proficient in the patient's preferred language) health coaching intervention delivered by nurse and nurse practitioner students in a pilot study of Latinx immigrants with T2D and LEP.Methods: A sample of 17 Latinx immigrants with T2D and LEP were split into intervention and control groups. The control group received basic diabetes care and written educational materials on diabetes self-management in Spanish. Individuals in the intervention group received the standard diabetes care offered by the clinic and six biweekly health coaching sessions (intervention) with a trained language concordant health coach. Results:The language concordant health coaching intervention was both feasible (delivery) and acceptable (satisfactory) to Latinx immigrants with T2D and LEP and resulted in clinically meaningful differences in key diabetes-related outcomes.Linking Evidence to Action: Our findings suggest that lack of language concordance between provider and patient has an important and meaningful impact on the ability of an LEP Latinx patient to receive, and perhaps act upon, adequate education for T2D management. Receiving biweekly coaching calls could have offered further emotional support for participants to discuss living with T2D, which may have helped to alleviate symptoms of depression and anxiety that individuals with T2D frequently endure.

Demystifying diabetes health coaching: A scoping review unveiling the ‘who’ and ‘where’ of health coaching for adults with type 2 diabetes

“…Of these, three studies focused on low-income individuals 16,37,40 and three studies recruited from Latinx and/or African American populations. 32,36,37 Two studies also reported occupation-specific study populations; one study was conducted among veterans 44 and another among manual labourers. 39 In addition to T2D, three studies focused on populations with comorbidities, 16,33,44 including obesity 16 and hypertension.…”

“…hospital clinics), 20,22,[25][26][27][28]37,43 six interventions were delivered through a community health setting (i.e. community health centres, public health clinics and patient homes), 21,27,32,35,36,40 and three interventions were delivered through non-healthcare sites (i.e. libraries, research offices and churches).…”

“…[22][23][24][25]28,29,32,[40][41][42] Seven study interventions were 1 year long, 16,20,21,26,37,38,44 and three interventions were longer than 1 year. 19,27,39 Most studies evaluated the effects of DHC up until the end of the intervention while 31% of studies continued to conduct follow-ups post-inte rvention, 16,21,25,29,[34][35][36][41][42][43] with the furthest follow-up occurring 17-months post-intervention. 34…”

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“…Currently, diabetes is considered as one of the most common chronic diseases. 1 Insufficient insulin secretion or insulin resistance in the human body causes metabolic disorders and cannot properly regulate blood glucose levels. 2,3 With the improvement of living standards, the acquisition of refined foods has become easier, but people's health awareness has not significantly improved.…”

“…Currently, diabetes is considered as one of the most common chronic diseases 1 . Insufficient insulin secretion or insulin resistance in the human body causes metabolic disorders and cannot properly regulate blood glucose levels 2,3 .…”