{"doi":"10.2337/dc23-2487","title":"Medical Assistant Health Coaching for Type 2 Diabetes in Primary Care: Results From a Pragmatic Cluster Randomized Controlled Trial","abstract":"OBJECTIVE: This cluster (clinic-level) randomized controlled trial (RCT) compared medical assistant (MA) health coaching (MAC) with usual care (UC) among at-risk adults with type 2 diabetes in two diverse real-world primary care environments: a federally qualified health center (FQHC; Neighborhood Healthcare) and a large nonprofit private insurance-based health system (Scripps Health). RESEARCH DESIGN AND METHODS: A total of 600 adults with type 2 diabetes who met one or more of the following criteria in the last 90 days were enrolled: HbA1c ≥8% and/or LDL cholesterol ≥100 mg/dL and/or systolic blood pressure (SBP) ≥140 mmHg. Participants at MAC clinics received in-person and telephone self-management support from a specially trained MA health coach for 12 months. Electronic medical records were used to examine clinical outcomes in the overall sample. Behavioral and psychosocial outcomes were evaluated in a subsample (n = 300). RESULTS: All clinical outcomes improved significantly over 1 year in the overall sample (P < 0.001). The reduction in HbA1c was significantly greater in the MAC versus UC group (unstandardized Binteraction = -0.06; P = 0.002). A significant time by group by site interaction also showed that MAC resulted in greater improvements in LDL cholesterol than UC at Neighborhood Healthcare relative to Scripps Health (Binteraction = -1.78 vs. 1.49; P < 0.05). No other statistically significant effects were observed. CONCLUSIONS: This was the first large-scale pragmatic RCT supporting the real-world effectiveness of MAC for type 2 diabetes in U.S. primary care settings. Findings suggest that this team-based approach may be particularly effective in improving diabetes outcomes in FQHC settings.","journal":"Diabetes Care","year":2024,"id":471053,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9536,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":445046,"name":"Emily C. Soriano","orcid":"0000-0002-1069-9324","position":1,"is_corresponding":false},{"id":421766,"name":"Linda C. Gallo","orcid":"0000-0002-3678-5888","position":2,"is_corresponding":false},{"id":453302,"name":"Taylor L. Clark","orcid":"0000-0002-3689-0071","position":3,"is_corresponding":false},{"id":437955,"name":"Samantha R. Spierling Bagsic","orcid":"0000-0003-1274-3736","position":4,"is_corresponding":false},{"id":454129,"name":"Haley Sandoval","orcid":null,"position":5,"is_corresponding":false},{"id":527528,"name":"Jennifer A. Jones","orcid":null,"position":6,"is_corresponding":false},{"id":453304,"name":"Scott C. Roesch","orcid":"0000-0001-6574-1916","position":7,"is_corresponding":false},{"id":453305,"name":"Todd Gilmer","orcid":"0000-0002-8360-3522","position":8,"is_corresponding":false},{"id":324467,"name":"James Schultz","orcid":null,"position":9,"is_corresponding":false},{"id":526604,"name":"Thomas Bodenheimer","orcid":"0000-0001-6106-9288","position":10,"is_corresponding":false},{"id":231685,"name":"Athena Philis‐Tsimikas","orcid":"0000-0002-3986-9630","position":11,"is_corresponding":false},{"id":453300,"name":"Addie L. Fortmann","orcid":"0000-0002-0350-5288","position":0,"is_corresponding":true}],"reference_count":38,"raw_metadata":null,"created_at":"2026-07-19T02:05:44.736405Z","pmid":"38752923","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}