Qualitative analysis of peer coaches' experiences with counseling African Americans about reducing heart disease risk.

Background: Despite mounting evidence that peer coaches can make significant contributions to patient health, little is known about factors that must be addressed to engage and retain them in their role.

Objective: To identify motivators and barriers to serving as a peer coach.

Design: Open ended semi-structured interviews.

Participants And Setting: In a randomized trial of peer support, patients with well controlled hypertension and good interpersonal skills were recruited and trained to serve as peer coaches for African-American patients from the same practices who had poorly controlled hypertension. Peer coaches spoke by telephone at least three times with their same sex patient-clients on alternate months during the 6-month intervention and counseled about medication adherence as well as other healthy lifestyles.

Key Results: Of 15 trained peer coaches, ten were contacted and agreed to participate in the qualitative interview. Peer coaches had a mean age of 66 years, 50% were women, and 80% were African-American. Themes regarding favorable aspects of the peer coach experience included: meaning and satisfaction derived from contributing to community health and the personal emotional and physical benefits derived from serving as a peer coach. Negative aspects centered on: challenges in establishing the initial telephone contact and wanting more information about their patient-clients' personal health conditions and status. Peer coaches endorsed gender matching but were less clear about race-matching.

Conclusions: Programs that utilize peer support to enhance positive health behaviors should recognize that a spirit of volunteerism motivates many successful peer coaches. Program planners should acknowledge the special characteristics required of successful peer coaches when selecting, motivating and training individuals for this role.