With Peer Wellness Coaches, Everybody Wins

Peer wellness coaches benefit from diabetes self-management support (DSMS) just as much as the patients they coach.

Patients who are trained to help others with their condition are utilized by many healthcare settings, as they augment care provided by licensed medical professionals. In fact, these peer wellness coaches are often able to teach patients more successfully than clinical staff. As a result, providers find peer coaches to be invaluable for patients who have mental health, addiction, and chronic conditions, as well as for communities where access to care, language, or culture is a barrier to good healthcare.

In a recent study, researchers from the University of California Berkeley employed diabetics who were trained to provide diabetes self-management support (DSMS) to other patients in San Francisco. Given that access to DSMS and ongoing support is crucial for successful long-term diabetes management, the study’s goal was to elucidate the processes peer wellness coaches use to engage patients.

The authors first created a focus group to learn about coaches’ general attitudes, and then 17 qualitative, semi-structured interviews with community-based peer coaches followed. After extracting information about how the coaches engaged with their patients, the researchers learned that peer coaches had 3 chief roles in DSMS: advisor who teaches and strategizes; supporter who builds trust and motivates; and role model who empathizes and exemplifies.

The study also demonstrated how peer coaches use different ways of setting emotional boundaries and helping patients work toward health behavior changes. Many researchers tend to suggest that all peer coaches should use identical approaches, but that might not be the most strategy effective, since different approaches provide flexibility to help coaches deal with cultural or literacy issues of which clinicians are often unaware.

Previous research has shown that low-income patients who worked with peer coaches had significantly lower glycated hemoglobin levels after 6 months compared to control groups. The peer wellness coaches observed in the present study also improved the management of their own diabetes over time, so they benefit from DSMS just as much as the patients they coach.

Family, caretakers, friends, and healthcare professionals can be advisors, supporters, and role models, but they can rarely fulfill all 3 roles. In contrast, peer wellness coaches fulfill all 3 roles simultaneously, while providing their own health benefits.