Online Program

Training adolescents to be self-management coaches for diabetic family members: A novel approach to empower at-risk youth and their families

Monday, November 4, 2013

Liana Gefter, MD, Stanford Center for Education and Research in Family and Community Medicine, Stanford School of Medicine, Stanford, CA
Lisa Rosas, PhD MPH, Stanford Prevention Research Center, Stanford University, Palo Alto, CA
Eunice Rodriguez, DrPH, Department of Pediatrics, Stanford University School of Medicine, Stanford University, Palo Alto, CA
Isabella Chu, MPH, Department of Medicine, General Medical Disciplines, Stanford School of Medicine, Stanford, CA
Nancy Morioka-Douglas, MD, MPH, Stanford Center for Education and Research in Family and Community Medicine, Stanford School of Medicine, Stanford, CA
In less than a decade, the prevalence of type 2 diabetes and prediabetes has more than doubled among US adolescents. Ethnic minorities and children of diabetics have the highest risk. We developed an innovative strategy whereby physicians trained healthy high school students in underserved schools to become diabetes self-management coaches for diabetic family members. The goal was to empower high-risk teens with knowledge and skills to prevent and control diabetes while capitalizing on the proven benefits of self-management and social support. We aimed to determine program impact on adolescents' diabetes knowledge, psychosocial assets, and health behaviors (physical activity and diet). We used a quasi-experimental mixed methods study collecting pre and post test questionnaires from 56 participants and 124 controls, and in-depth interviews with 15 students and 9 diabetic family members. We used linear regression to determine differences in knowledge, psychosocial assets and health behaviors on the pre- and post-tests between control and intervention students, and qualitative software to analyze content of interview transcripts. Compared to control students, participants significantly increased their diabetes knowledge and two indicators of psychosocial assets (p<0.05). In interviews, students reported improved health behaviors, regular use of action plans to accomplish goals, and the ability to affect positive change in family members' lives; and diabetic family members attributed willingness to improve health behaviors to being coached by a loved one. Overall, this program increased knowledge about diabetes and improved psychosocial assets among high-risk youth; and holds promise for improving diabetes management for family members.

Learning Areas:

Administer health education strategies, interventions and programs
Advocacy for health and health education
Chronic disease management and prevention
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related education

Learning Objectives:
Identify the need for diabetes awareness and prevention programs that directly reach at-risk adolescents. Describe the curriculum model used to train adolescents to become diabetes coaches for family members. Explain the efficacy and advantages of a family based approach to diabetes self-management.

Keyword(s): Self-Management, Adolescents

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: After graduating from medical school at Stanford, I designed and implemented the Stanford Youth Diabetes Coaching Program from its inception, and I designed the evaluation tools to assess the course efficacy. I also conducted the in depth qualitative interviews with course participants. I am a physician researcher with a background in education through Teach for America. During my years in medical school, I created and implemented health outreach programs with under-resourced local schools.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.