Peer coaching appears to have merit as a viable, low-cost intervention with the potential of helping individuals with diabetes who need to change their behavior.

Health professionals expect clients with diabetes to change multiple behaviors as a way to decrease the risk of complications of the disease. The purpose of this study was to gain an in-depth understanding of the client's response to lifestyle change expectations. Using the transtheoretical model of change as framework for this study, clients were asked to address the level of difficulty they encountered when making lifestyle changes relating to their diabetes. Ten clients who participated in a taped telephone survey and a videotaped focus group reported that most change was difficult but not impossible. Most clients admitted that maintaining changes was a continuing battle. Both the transcripts and focus group revealed a wide variation in the clients' understanding of self-management. It was evident that successful management involves a fairly high level of cognition as well as willingness to change. Successful management involves thinking through and comprehending how diet, exercise, and medication relate to blood glucose levels. This preliminary study will be used as the basis for a more inclusive study that will focus on developing interventions that relate directly to helping clients change behavior.

Peer support is helpful for people who are struggling to cope with diabetes. If peer support is offered, a structured follow-up program needs to be in place.

Focus groups have become a popular method of collecting data for research projects. The addition of using a videotaped approach has broad implications for researchers, as it allows constant replay of the session. Although on the surface this approach seems straightforward and easy to use, the authors caution that this is not an approach for the novice. Investigators planning to use a focus group method must be well versed in group process. There is an unpredictable nature to the focus group process, and researchers need to prepare for the inevitable mishaps that lead to lost opportunities for data collection.