Author Affiliations: Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina.
Behavioral change interventions delivered through the telephone have accumulated solid evidence supporting their efficacy for multiple behaviors, including physical activity and dietary change.1 It is commendable that Frosch et al2 undertook this approach in a sample of patients with limited external resources. Their most significant finding is that a telephonic “coaching” intervention was feasible and well-received by even the most socially and economically disadvantaged. While the “dose” and possibly content of the intervention studied was not adequate to elicit a differential change compared with controls, there are several important lessons embedded in the study's findings. Specifically, 98% of participants were reached by phone within 1 week of enrollment; 94% reviewed the provided DVD; 85% of those randomized to telephonic coaching participated; and 73% of those completed all 5 sessions. These statistics indicate a desire for diabetes self-management education and a willingness to engage in such interventions. Importantly, these results directly challenge the perception that individuals of lower socioeconomic status may be less motivated to learn self-care strategies.3,4
Wolever RQ, Eisenberg DM. What Is Health Coaching Anyway?: Standards Needed to Enable Rigorous ResearchComment on “Evaluation of a Behavior Support Intervention for Patients With Poorly Controlled Diabetes”. Arch Intern Med. 2011;171(22):2017-2018. doi:10.1001/archinternmed.2011.508