Transformative Peer coaching & training for young adults with chronic illness

Unmet Need

An excellent alternative for the growing burden of chronic illness is patient-centered self-management. This method empowers patients to manage their condition actively, improving treatment outcomes and reducing the burden on healthcare providers. Self-management is essential in successful outcomes for adolescents and young adults (AYAs) with childhood-onset chronic conditions (COCCs). Through active engagement with their treatments, AYAs develop the self-management skills necessary for transitioning from pediatric to adult care. Notably, such skills lead to adherence to lifestyle modifications and medication regimens vital for achieving positive adult outcomes. It's worth noting that despite its importance, only 32% of youth with special health care needs receive adequate transition preparation, highlighting the urgency for comprehensive interventions in this area. Evidence has demonstrated that peer-to-peer interventions have been successful in managing other conditions. Importantly, studies have shown that AYAs are interested in peer support interventions to address their challenges. Yet, peer coaching is underutilized to support COCCs. Therefore, to address this challenge, there is a need for scalable and proven interventions that implement coaching programs that assist AYAs with COCCs in developing and implementing self-management skills.

Technology

Duke inventors introduced a peer coaching initiative to empower AYAS with COCCs to manage their health actively. Research has shown that peer support interventions are well-suited to address challenges AYAs face and, importantly, that AYAs are interested in this type of support. PICASO, or Peer i-Coaching for Activated Self-Management Optimization, is a mobile health intervention that pairs AYAs with peer coaches who have firsthand experience with COCCs. The program fosters self-management skills such as goal-setting, navigating healthcare systems, effective communication with medical professionals, and emotional coping. PICASO adopts a non-directive approach, encouraging patients to address challenges independently. The coaching helps this by providing emotional support, knowledge, and experience. Built on a free and proven telementoring platform, it is adaptable for deployment in various settings, including hospitals, schools, camps, and other settings. PICASO effectiveness has been demonstrated in a randomized controlled trial demonstrating clinically meaningful improvement in self-management ability (patient activation measure).

Other Applications

This technology could also be expanded to aid any patient population in developing self-management skills.

Advantages

• Uniquely tailored for young adults.
• Based on 20 years of mentoring work for young adults with chronic illnesses.
• Focuses on setting goals, fostering self-discovery, and ensuring accountability for health behavior changes
• Address daily management, social/emotional support, providing linkage to clinical care, and ongoing support. Educates on the distinctions between pediatric and adult healthcare systems