Complementarity of Digital Health and Peer Support: “This Is What’s Coming”
Open accessAbstract
Purpose: This study examined integration of peer support and a Food and Drug Administration-cleared, diabetes management app (DMA) in diabetes self-management support as a scalable model for those with type 2 diabetes mellitus (T2DM). Methods: Two lay health Coaches delivered telephone-based self-management support to adults (N = 43) with T2DM recruited through a primary group practice. Those eligible were offered no-cost access to DMA for the entire 6-month study. Coaches introduced DMA and contacted individuals by phone and text with frequency dependent on participant needs/preferences. DMA supported monitoring of blood glucose, carbohydrate intake, and medication use, as well as messaging personalized to participants’ medication regimens. Clinical data were extracted from DMA, electronic medical records, and Coaches’ records. Structured interviews of 12 participants, 2 Coaches, and 5 project staff were analyzed using deductive pre-identified codes (regarding adoptability, patterns of use, value added, complementarity, and sustainability) utilizing standard procedures for qualitative analysis. Results: Of the 43 participants, 38 (88.4%) enrolled in DMA. In general, participants used both DMA and lay health coaches, averaging 144.14 DMA entries (structured, e.g., medications, and free form, e.g., “ate at a restaurant” and “stressed”) and 5.86 coach contacts over the 6-month intervention. Correlation between DMA entries and coach contacts (r = .613, p < 0.001) was consistent with complementarity as were participants’ and coaches’ observations that (a) DMA facilitated recognition of patterns and provided reminders and suggestions to achieve self-management plans, whereas (b) coaching provided motivation and addressed challenges that emerged. Mean hemoglobin A1c (A1c) declined from 9.93% to 8.86% (p < 0.001), with no pattern of coaching or DMA use significantly related to reductions. Staff identified resources to coordinate coach/DMA interventions as a major sustainability challenge. Conclusions: DMA and peer support for diabetes management are compatible and complementary. Additional practice integration research is needed for adoption and scale-up.
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PPC may be beneficial in glycemic control for diabetes management.
“PPC may be beneficial in glycemic control for diabetes management [95,96].”
From Digital Health Interventions to Prevent Type 2 Diabetes Mellitus: Systematic Review (2025) · cites this paper as [96]
The Results (Value Added; page not provided) report a decline in A1c after an intervention combining lay health coaching with a diabetes management app. The Discussion describes this as an association from uncontrolled analyses. The paper therefore supports a possible glycemic benefit from the combined intervention, but does not establish a benefit from PPC alone. (LLM, conf=0.78)
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References 51 · Cited by 11
Research works printed but not linked: 7
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- Authors
- Tang, P. Y., Duni, J., Peeples, M. M., Kowitt, S. D., Bhushan, N. L., Sokol, R. L., & Fisher, E. B.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- Fisher, Edwin B.
- Venue
- Frontiers in Clinical Diabetes and Healthcare
- Publisher
- Frontiers Media SA
- Published
- 2021-09-24
- Volume
- 2
- Pages
- 646963-646963
- ISSN
- 2673-6616 (ISSN-L)
- PMC
- PMC10012094
- OpenAlex
- W3202412062
- Cited by
- 11
- References
- 51
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 3 · 2023: 2 · 2022: 2
- FWCI
- 1.97
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Clinical Diabetes and Healthcare (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Gillings School of Public Health
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- type 2 diabetes, diabetes self-management support, peer support, mobile health, telephone coaching, blood glucose monitoring, HbA1c, intervention integration, sustainability, scalability
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