Medical Assistant Coaching to Support Diabetes Self-Care Among Low-Income Racial/Ethnic Minority Populations

Ruggiero, Laurie; Riley, Barth B.; Hernandez, Rosalba; Quinn, Lauretta; Gerber, Ben S.; Castillo, Amparo; Day, John; Ingram, Diana; Wang, Yamin; Butler, Paula

doi:10.1177/0193945914522862

Cited by 43 publications

(68 citation statements)

References 35 publications

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“…A positive change in the self-care activities as indicated by increased self-care scale scores after education and telephone follow-up demonstrates that regular monitoring of patients is beneficial. In previous studies on diabetic patients, education 3,18,19 and telephone-delivered follow-up 11,12,20,21 have been found to have a positive influence on self-care behaviors of patients. The telemedicine intervention was shown to be related to improved self-efficacy, which was directly and indirectly associated with improved glycemic control.…”

Section: Discussionmentioning

confidence: 94%

Does Telephone Follow-Up and Education Affect Self-Care and Metabolic Control in Diabetic Patients?

Kanadli

Ovayolu

2016

Holistic Nursing Practice

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The major goal of diabetes control is to assist patients to perform self-care and metabolic control. One possible way to achieve this goal is education and regular monitoring of patients by telephone. Thus, the present study was conducted with the aim of investigating the impact of education and telephone follow-up on self-care and metabolic control in diabetic patients. This experimental study was conducted at a hospital in the Central Anatolia region of Turkey, with 88 diabetic patients including 44 intervention subjects and 44 control subjects. After an initial discussion, patients in the intervention group received education and telephone follow-up for 3 months. Required approvals were obtained before initiation of the study. Data were collected using a questionnaire form and the Diabetes Self-Care Scale. The Diabetes Self-Care Scale scores ranged between 140 and 210, where higher scores indicated increased self-care activities of patients. At the end of the study, the self-care score was found to increase from 61.3 ± 10.9 to 89.9 ± 12.3 in the intervention group (P < .005), but it showed a reduction from 56.5 ± 7.6 to 54.7 ± 9.3 after 3-month period in the control group. Education and telephone follow-up was also found to reduce the values of several variables of metabolic control including hemoglobin A1c, total cholesterol, triglycerides, low-density lipoprotein cholesterol, and systolic blood pressure. In conclusion, education and telephone follow-up of diabetic patients led to increased self-care scores and had a positive impact on metabolic control variables. In light of these findings, we suggest that education and tele-health home monitoring may be provided on a continuous basis to help patients sustain self-care behaviors that they have adopted during the study period.

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Section: Discussionmentioning

confidence: 94%

Does Telephone Follow-Up and Education Affect Self-Care and Metabolic Control in Diabetic Patients?

Kanadli

Ovayolu

2016

Holistic Nursing Practice

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“…5 They also serve as health coaches to improve lifestyle behaviors 9 , chronic disease care processes 3,10 -18 , and medication adherence. 19 These innovative MA roles have been reported across diverse settings, including private practices 2,3,5,20 , community health centers 5,10,13,15,16,19 , academic primary-care practices 8,9,12,14 , rural practices 17 , and large health care systems. 4,5,7 Outcomes in studies that have focused on or included MA role expansion or innovation have varied.…”

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confidence: 99%

“…9 However, Ferrer and colleagues 2 found that there was poor adoption of MA health coaching, and several randomized trials testing the effects of MA diabetes health coaches found no significant differences in hemoglobin A1C levels or hospitalizations between control and intervention group patients. 10,13,15,18 There is currently a limited understanding as to why there was success in some studies and not others.…”

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confidence: 99%

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Barriers and Facilitators to Expanding Roles of Medical Assistants in Patient-Centered Medical Homes (PCMHs)

et al. 2018

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Background: Many primary care practices participating in patient-centered medical home (PCMH) transformation initiatives are expanding the work roles of their medical assistants (MAs). Little is known about attitudes of MAs or barriers and facilitators to these role changes.Methods: Secondary data analysis of qualitative cross-case comparison study of 15 New Jersey primary care practices participating in a PCMH project during 2012 to 2013. Observation field notes and in-depth and key informant interviews (with physicians, office managers, staff and care coordinators) were iteratively analyzed using grounded theory.Results: MA roles and responsibilities changed from a mostly reactive role, completing tasks dependent on physician orders during the patient visit and facilitating patient flow through the office, to a more proactive one, conducting previsit planning, engaging in the overall care for patients, and assisting with population management. MAs differed in their attitudes about increased responsibilities, with some welcoming the opportunity to take on expanded roles, others resenting their increased responsibilities, and some expressing insufficient understanding regarding why new tasks and procedures were being implemented.

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“…In the case of diabetes care, which addresses prescribed self-care goals, evidence exists of improvement in self-care using health coaching with a MA. 20 Among people with uncontrolled diabetes, hypertension, or hyperlipidemia, in-clinic health coaching by MAs over one year improved biomarkers of health risks. 9 We explored the feasibility of training MAs to address health coaching for improved nutrition, physical activity, and sleep among the general clinic population.…”

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confidence: 99%

Delivery of Health Coaching by Medical Assistants in Primary Care

et al. 2017

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Background Health coaching is potentially a practical method to assist patients in achieving and maintaining healthy lifestyles. In health coaching, the coach partners with the patient, helping patients discover their own strengths, challenges, and solutions. Methods Two medical assistants were provided with brief training. The 12-week program consisted of telephone coaching with in-person visits at the beginning and end of the program. Coaching targeted improvements in diet, physical activity, and/or sleep habits using a self-care planning form. Results A total of 82 subjects enrolled in the program, 72% completed 8 weeks and 49% completed 12 weeks. Subjects who completed assessments at 12 weeks had significant weight loss despite the fact that weight loss was not a study goal. There also were improvements in diet and physical activity. Subject who completed the study were highly satisfied with the program and felt that health coaching should be available in all family medicine clinics. The main barrier providers voiced was remembering to refer patients. The medical providers indicated high satisfaction with the study and valued having coaching available for their patients. Conclusions Medical assistants can be trained to assist patients with lifestyle changes that are associated with improved health and weight control.

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Medical Assistant Coaching to Support Diabetes Self-Care Among Low-Income Racial/Ethnic Minority Populations

Cited by 43 publications

References 35 publications

Does Telephone Follow-Up and Education Affect Self-Care and Metabolic Control in Diabetic Patients?

Does Telephone Follow-Up and Education Affect Self-Care and Metabolic Control in Diabetic Patients?

Barriers and Facilitators to Expanding Roles of Medical Assistants in Patient-Centered Medical Homes (PCMHs)

Delivery of Health Coaching by Medical Assistants in Primary Care

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