Sustained Effects of a Nurse Coaching Intervention via Telehealth to Improve Health Behavior Change in Diabetes

Abstract

Background: Diabetes educators and self-management programs are scarce in rural communities, where diabetes is the third highestranking health concern. The goal of this study was to evaluate the benefits of nurse telehealth coaching for persons with diabetes living in rural communities through a person-centered approach using motivational interviewing (MI) techniques. Materials and Methods: A randomized experimental study design was used to assign participants to receive either nurse telehealth coaching for five sessions (intervention group) or usual care (control group). Outcomes were measured in both groups using the Diabetes Empowerment Scale (DES), SF-12, and satisfaction surveys. Mean scores for each outcome were compared at baseline and at the 9-month follow-up for both groups using a Student's t test. We also evaluated the change from baseline by estimating the difference in differences (pre-and postintervention) using regression methods. Results: Among the 101 participants included in the analysis, 51 received nurse telehealth coaching, and 50 received usual care. We found significantly higher self-efficacy scores in the intervention group compared with the control group based on the DES at 9 months (4.03 versus 3.64, respectively; p < 0.05) and the difference in difference estimation (0.42; p < 0.05). Conclusions: The nurse MI/telehealth coaching model used in this study shows promise as an effective intervention for diabetes self-management in rural communities. The sustained effect on outcomes observed in the intervention group suggests that this model could be a feasible intervention for long-term behavioral change among persons living with chronic disease in rural communities.

Older Adult Self-Efficacy Study of Mobile Phone Diabetes Management

“…31 Patient coaching is increasingly being used to describe personalized patient decision support, including motivational interviewing. 37,38 Participants received training on the use of the PCS following study enrollment. Training included how to utilize the functions of the PCS on a mobile phone, including entering BG data, receiving automatic message data, and messaging certified diabetes educators (CDEs) assigned to participants.…”

Tracking Health Data Is Not Enough: A Qualitative Exploration of the Role of Healthcare Partnerships and mHealth Technology to Promote Physical Activity and to Sustain Behavior Change

“…These statistics point to the need for mHealth designers and researchers to focus on how mHealth technology might be used for sustained health behavior change and improved health. The research in this area suggests that behavior changes are more likely to be sustained if patients are involved in identifying and establishing their own goals and include partnerships with health care providers [27]. …”

Telehealth Nursing Effectiveness in Stroke Patients

“…Findings suggest that telestroke network usage seems to be beneficial in managing acute ischemic stroke and may decrease the need for transfer, optimizing the stroke therapy to shorten the hospital stay and to increase the discharge home, with additional financial benefit and cost-saving for the hospital [9]. The use of telehealth and telecommunications technologies helps in promoting self-care management and enhancing health care outcomes in persons with stroke and severe disabilities and is favored by family as well as caregivers [11,12]. Telestroke is aiming to increase patient access, at a lower cost while maintaining the quality of health care[ Figure 3]The importance of matching the telestroke technology to the needs of the population, lessons learned from these investigations, and future directions for research are addressed in these papers [12,13,14].…”

“…The most recent article was published in September, 2017, we can easily observe the timely relevance of the topic of telehealth, nursing and stroke. Four of the selected articles were pertaining to telehealth nursing management and education for stroke patients(10%, n=4) [24,25,27,31], two articles were about the benefits of telestroke for speedy discharge and recovery(5.4%, n=2) [29,34], seven were about telehealth nursing education and care for stroke patients as well as caregivers(18.92%, n=7) [11,12,30,32,33,34,36], two covered the topic of a stroke-specific, care coordination home telehealth (CCHT) program (5.4%,n=2) [18,19], two were related to acceptance of telestroke by caregivers in home setting(5.4%, n=2) [25,37], five articles emphasized how telehealth and such techniques help in savings and decrease stroke patient cost( 13.5%,n=5) [3,14,17,22,28], seven more papers discussed how telemedicine is considered along with other strategies to manage stroke(18.92%, n=7) [7,15,16,20,23,38,39], six papers described the methods in which acute ischemic stroke is managed in emergency medicine with telehealth and related techniques(16.27%,n=6) [2,6,8,9,13,35] and two articles covered how telehealth helps in diagnosis of stroke(5.4%, n=2) [15,29]. Findings suggest that telestroke network usage seems to be beneficial in managing acute ischemic stroke and may decrea...…”