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Technologically Enhanced Coaching (TEC): A Program for Improving Diabetes Outcomes


Peer mentoring and support models have been found in two recent VA RCTs to be more effective than usual care, financial incentives, and usual nurse care management to improve glycemic control in high-risk veteran patients with poor glycemic control.

While peer supporters and coaches can be trained in effective behavioral approaches to support other veterans’ self-management behaviors, such supporters necessarily lack content expertise to help veterans better share in treatment decisions and goal-setting with their health care providers.

Accordingly, in an AHRQ-supported RCT we developed and tested tailored, interactive tools with diabetes and medication information embedded in the tool software that peer coaches and other outreach workers can employ to facilitate discussions with patients. Such tools could enhance the sustainability and effectiveness of coaching programs to better prepare patients to set self-management goals, action plans, and to discuss treatment options with their health care providers.


Aim 1. Test the effectiveness of a technology-enhanced peer coaching (TEC) program in improving glucose control relative to usual care. 

Aim 2. Assess the impact of the intervention on key patient-centered outcomes, including patients’ satisfaction with care, perceived social support, diabetes-specific quality of life, and self-care behaviors related to glycemic control.

Aim 3. Identify patient characteristics associated with willingness to participate in the intervention and mediators and moderators of the intervention’s impact on patient outcomes.

Aim 4. Assess the cost-effectiveness of the program in improving glucose control.


Diabetes patients with poor glycemic control from the Detroit VA Medical Center.