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

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.