1. Ratanawongsa, Neda MD, MPH
  2. Handley, Margaret A. PhD, MPH
  3. Sarkar, Urmimala MD, MPH
  4. Quan, Judy PhD
  5. Pfeifer, Kelly MD
  6. Soria, Catalina BA
  7. Schillinger, Dean MD


Safety net systems need innovative diabetes self-management programs for linguistically diverse patients. A low-income government-sponsored managed care plan implemented a 27-week automated telephone self-management support/health coaching intervention for English-, Spanish-, and Cantonese-speaking members from 4 publicly funded clinics in a practice-based research network. Compared to waitlist, immediate intervention participants had greater 6-month improvements in overall diabetes self-care behaviors (standardized effect size [ES] = 0.29, P < .01) and 12-Item Short Form Health Survey physical scores (ES = 0.25, P = .03); changes in patient-centered processes of care and cardiometabolic outcomes did not differ. Automated telephone self-management is a strategy for improving patient-reported self-management and may also improve some outcomes.