Empowering a new generation of e-patients: Stanford Youth Diabetes Coaching Program
Tom Ferguson coined the term e-patients to describe individuals who are equipped, enabled, empowered and engaged in their health and health care decisions. Our hypothesis is that developing the skills and attributes necessary to be an e-patient is particularly important in under-served, ethnic minority communities and that as part of the Stanford Youth Diabetes Coaches Program, high school students can be taught to develop these skills for themselves and support their families to acquire them as well.
The CDC reports that compared to non-Hispanic white adults, the risk of diagnosed diabetes was significantly higher in minority populations. Additionally, in less than a decade, the prevalence of Type 2 Diabetes and prediabetes has more than doubled among US adolescents. Efforts to address this through education are predominantly healthcare-centric, traditionally where patients and community members passively receive information from experts. What if we could seamlessly integrate knowledge transmission and skill building into each person’s life cycle? What if we could leverage the inherent altruism of teens to help their family members and the aspirational goals of physicians in training to help their communities to set up a diabetes education and prevention system that was accessible, sustainable and reproducible even for under resourced communities?
In our research we have partnered family medicine residency programs with high schools in low income, ethnic minority, at risk communities to bring residents into the high schools to teach students to become diabetes self-management coaches for their family members. The goal of the project is to create web-based, innovative, effective, scalable, technology-enhanced curriculum to support sustained participation of high school students and their families, incorporating the best practices of secondary education with the most current theories of behavior change for health improvement. The curriculum emphasizes health literacy, goal setting for health improvement, and intra-family social support for engaging in healthy behaviors. Participating residents learn how to work in partnership with high schools and gain an enhanced understanding of the communities they serve. After residency graduation, the web based curriculum would be easy to access, efficient to use, and fun to continue to teach wherever they might practice. And the high school students, empowered by regular personal interactions with physicians at their schools, internalize and share with their families the realization that diabetes prevention and self-management coaching are part of daily life, like the other life skills they are being taught, not a stand-alone body of technical knowledge, dependent on an expert for access. This approach is cheap, leverages strengths in low-income ethnic minority communities, benefits the whole family, and provides experience in community health for physicians in training. Ultimately, the program has the potential to support the development of equipped, enabled, empowered and engaged patients in communities that have historically been dis-empowered and distrustful of the medical system.