Supporting diabetes self-care in underserved populations: a randomized pilot study using medical assistant coaches

Purpose: The purpose of this study was to evaluate the impact of an innovative intervention that utilized a certified medical assistant with specific diabetes training to work with a multidisciplinary diabetes care team to help provide basic diabetes self-care education and self-care support in low-income minority populations with type 2 diabetes. Research Design and Methods: Enrolled participants were randomized to either Medical Assistant Coaching (MAC; N = 25) or Treatment as Usual (TAU; N =25). De-identified data was obtained on a matched no-contact control group (NCC; N=50). Results: ANCOVA comparisons revealed no significant differences between the 3 groups on A1C but a trend was observed. A1Cs decreased across time for the MAC group, while increasing for the TAU and NCC groups. ANCOVA comparisons also indicated that the MAC group experienced significantly greater increases in perceived empowerment and a larger, although nonsignificant, reduction in perceived diabetes related problems than the TAU group. Conclusions: This randomized controlled pilot study suggests that the inclusion of a medical assistant self-care coach as part of the diabetes care team holds promise in improving outcomes and should be further examined in a large scale study.