Date of Award

Spring 3-22-2026

Document Type

Scholarly Project

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Sheri Jacobson, PhD, RN

Second Advisor

Robert Bland, DNP, CCRN-K

Abstract

Practice Problem: In patients with type 2 diabetes, poor glycemic control among adults remains a significant challenge in primary care settings, particularly within federally qualified health centers (FQHCs) that serve underserved populations. At the FQHC practice site, patients were managed using standard care with quarterly follow- up visits, without a structured hybrid coaching approach. This inconsistency contributed to a high number of patients with hemoglobin A1c (HgbA1c) levels ≥ 9%, placing them at increased risk for diabetes-related complications.

PICOT Question: In adults with poorly controlled type 2 diabetes (HgbA1c ≥ 9%) (P), does monthly hybrid coaching delivered through in-person and/or telemedicine visits using a structured checklist (I), compared to current standard practice (C), improve glycemic control (O) over a 10-weeks (T)?

Evidence: Evidence supports the effectiveness of hybrid coaching interventions in improving diabetes self-management and glycemic outcomes. This approach is supported by randomized controlled trials and systematic reviews demonstrating that coaching delivered in-person or via telehealth improves patient engagement and glycemic control.

Intervention: This DNP Scholarly project implemented monthly hybrid diabetes coaching sessions guided by an evidence-based structured checklist aligned with American Diabetes Association (ADA) guidelines. Providers conducted coaching visits either in person or through telemedicine, focusing on lifestyle modification, medication adherence, and diabetes self-management strategies.

Outcome: Twenty-two patients were enrolled in the DNP Scholarly project, of whom 16 completed both coaching sessions and post-intervention HgbA1c testing. Among those who completed the intervention, the mean HgbA1c decreased from 11.17% at baseline to 9.62% post-intervention, representing a 1.55% reduction and demonstrating both statistical and clinical improvement in glycemic control.

Conclusion: The findings suggest that structured hybrid coaching sessions supported by a standardized diabetes management checklist can improve glycemic outcomes in adults with poorly controlled type 2 diabetes. This approach offers a sustainable strategy to strengthen chronic disease management in primary care settings serving underserved populations.

Comments

Scholarly project submitted to the University of St. Augustine for Health Sciences in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice.

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

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