Other Titles
PiCASO Trial: Peer i-Coaching for Activated Self-Management Optimization in Adolescents and Young Adults with Childhood-Onset Chronic Conditions [Title Slide]
Abstract
Background: Adolescents and young adults (AYA) with childhood-onset chronic conditions often struggle during the transition from pediatric to adult healthcare and from being a child living with a chronic condition to an adult who effectively manages their chronic condition. Despite shared developmental, psychosocial, and healthcare transition challenges, most research is condition-specific, limiting generalizability and overlooking shared self-management needs (1-3). The PiCASO study evaluated a peer coaching intervention to improve self-management and patient activation among AYA during this critical transition and demonstrated the feasibility and impact of a noncategorical approach.
Methods: A randomized controlled trial was conducted in which 222 AYA (aged 16 to 22 years) with at least one of nine chronic conditions (sickle cell disease, chronic kidney disease, diabetes, lupus, inflammatory bowel disease, cystic fibrosis, stem cell transplant, organ transplant, cancer) were randomized to peer health coaching from a peer with a chronic condition (intervention, n=147) or an active educational control (n=75). Coaches (aged 19-26 years) were trained as health coaches and received close supervision. AYA and coaches communicated by telephone/text over 12 months. Self-management and patient activation outcomes were collected at baseline and 3, 6, 9, and 12 months. Multi-level, mixed-effect longitudinal models tested for treatment differences in the trajectory of outcomes across 12-months.
Results: AYA had a mean age of 18.4 years, were 62% female, 48% White, and 41% Black. Participants had high engagement in peer coaching with 1,871 coaching calls averaging 27.5 minutes over the 12 months (median: 15 calls/participant). Intervention participants had significantly greater improvement in self-management compared to controls (intent-to-treat analysis, p=0.003, Cohen’s d=0.61, medium effect). Patient activation increased significantly in both treatment groups; however, the groups did not differ in the pattern of change (p>.05). The noncategorical sample revealed shared trajectories of self-management growth.
Conclusions & Implications for Nursing Science: This peer health-coaching intervention was highly engaging and demonstrated improvements in self-management outcomes across conditions. This intervention provides evidence for integrated care models that could be incorporated into a range of clinics and community-based transition programs.
Notes
References:
1. Huang, Y., Li, S., Lu, X., Chen, W., & Zhang, Y. (2024). The Effect of Self-Management on Patients with Chronic Diseases: A Systematic Review and Meta-Analysis. Healthcare, 12(21), 2151.
2. Van de Velde, D., De Zutter, F., Satink, T., Costa, U., Janquart, S., Senn, D., & De Vriendt, P. (2019). Delineating the concept of self-management in chronic conditions: A concept analysis. BMJ Open, 9(7), e027775.
3. Qi, Y., Xia, L., Chen, Y., Yi, T., Hu, Y., Xie, Z., Wang, Y., & Dong, C. (2025). Health self-management programs for adolescents and young adults with chronic medical conditions transitioning from pediatric to adult care: A scoping review. European Journal of Pediatrics, 184, Article 711.
Sigma Membership
Beta Epsilon
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Randomized Controlled Trial
Research Approach
Quantitative Research
Keywords:
Stress and Coping, Mentoring and Coaching, Sub-Acute Care, Chronic Diseases, Health Self Care, Self-Management (Psychology), Adolescents, Young People, Teenagers, Young Adults
Recommended Citation
Docherty, Sharron L.; Maslow, Gary; Pollock, McLean; Silva, Susan; Denio, Erin; Craig, Lakaya; and Misiewicz, Remi, "The PiCASO Trial: Studying AYA Chronic Illness Self-Management Using a Noncategorical Approach" (2026). International Nursing Research Congress (INRC). 233.
https://www.sigmarepository.org/inrc/2026/presentations_2026/233
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-08-27
The PiCASO Trial: Studying AYA Chronic Illness Self-Management Using a Noncategorical Approach
Toronto, Ontario, Canada
Background: Adolescents and young adults (AYA) with childhood-onset chronic conditions often struggle during the transition from pediatric to adult healthcare and from being a child living with a chronic condition to an adult who effectively manages their chronic condition. Despite shared developmental, psychosocial, and healthcare transition challenges, most research is condition-specific, limiting generalizability and overlooking shared self-management needs (1-3). The PiCASO study evaluated a peer coaching intervention to improve self-management and patient activation among AYA during this critical transition and demonstrated the feasibility and impact of a noncategorical approach.
Methods: A randomized controlled trial was conducted in which 222 AYA (aged 16 to 22 years) with at least one of nine chronic conditions (sickle cell disease, chronic kidney disease, diabetes, lupus, inflammatory bowel disease, cystic fibrosis, stem cell transplant, organ transplant, cancer) were randomized to peer health coaching from a peer with a chronic condition (intervention, n=147) or an active educational control (n=75). Coaches (aged 19-26 years) were trained as health coaches and received close supervision. AYA and coaches communicated by telephone/text over 12 months. Self-management and patient activation outcomes were collected at baseline and 3, 6, 9, and 12 months. Multi-level, mixed-effect longitudinal models tested for treatment differences in the trajectory of outcomes across 12-months.
Results: AYA had a mean age of 18.4 years, were 62% female, 48% White, and 41% Black. Participants had high engagement in peer coaching with 1,871 coaching calls averaging 27.5 minutes over the 12 months (median: 15 calls/participant). Intervention participants had significantly greater improvement in self-management compared to controls (intent-to-treat analysis, p=0.003, Cohen’s d=0.61, medium effect). Patient activation increased significantly in both treatment groups; however, the groups did not differ in the pattern of change (p>.05). The noncategorical sample revealed shared trajectories of self-management growth.
Conclusions & Implications for Nursing Science: This peer health-coaching intervention was highly engaging and demonstrated improvements in self-management outcomes across conditions. This intervention provides evidence for integrated care models that could be incorporated into a range of clinics and community-based transition programs.
Description
Despite shared developmental, psychosocial, and healthcare transition challenges, most research on adolescent and young adult chronic condition self-management is condition-specific, limiting generalizability and overlooking shared self-management and transition-related needs. The PiCASO study evaluated a peer coaching intervention to improve self-management and patient activation among AYA during this critical transition and demonstrated the feasibility and impact of a noncategorical approach.