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Peer Support and Positive Outcomes in Diabetes

May 1, 2014
 

Peer support takes A1c from 11.1% at baseline to 8.3%, representing a drop of 2.8%…. 

In a recent experimental study, researchers examined the feasibility of peer interventions on multiple aspects of diabetes care including: diabetes self-care behaviors, glycemic control, social support and emotional well-being, linkages to health care providers, and the sustainability of the intervention after 18 months.

A total of 46 adults in rural Uganda with type 2 diabetes mellitus were selected for this study. Each study participant attended a 5 hour diabetes education program with topics covering; diabetes self-care, healthy eating, importance of activity, medication use, monitoring blood sugars and related problems. They also received a 1 hour review with role play and use of supportive communication skills, such as active listening. Following the diabetes classes, each study participant was matched with a partner according to age and gender. Study participants were required to make weekly contacts by phone or in person, over a 4 month period. These contacts were designed as a support system to assist with daily management, provide social and emotional support, and encourage appropriate contact with health care providers when necessary. Following each contact with their assigned partner, participants were asked to complete a written log.

Descriptive statistics were used to summarize the findings and t-tests were used to compare pre- and post-measures by partner status using a Bonferonni correction for multiple comparisons. Electronic phone records showed that 68% of participants made a phone contact with a peer at least weekly. Attendance for the first and second educational meetings was 76% and 88%, respectively. When reporting total contact with peers, 93% of study participants used cell phones and 60% contacted each other in person. Of participants who completed the study, no one had less than 6 contacts with a peer during the intervention period and 89.7% reported increased contact with a health care provider.

Multiple improvements were seen throughout the study. The average HbA1c levels went from 11.1% at baseline to 8.3% following commencement of the study, representing a drop of 2.8%. Diastolic blood pressure dropped from an average of 85mmHg at baseline to 76mmHg. Before the intervention, 80% of participants had a blood pressure ≥130/80 mmHg, however following the intervention, only 56% did. Overall, 80% of participants indicated that they received helpful advice and were encouraged to contact the clinic: 72% of participants reported receiving encouragement towards their diabetes care; that they learned a lot; and were capable of discussing diabetes.

This short-term peer support program was a successful intervention for improving diabetes outcomes in this rural setting, with participants experiencing positive behavioral and physiologic outcomes for up to 18 months after the intervention.

Practice Pearls:
  • Diabetic peer support groups may be beneficial for empowering patients, promoting compliance and adherence to medications, as well as promoting healthy lifestyle factors
  • In poor demographic areas, where health care is often difficult to access, such strategies may result in similar benefits
  • Utilization of all possible resources for promoting positive outcomes in diabetic patients is essential for the successful management of this condition 

Baumann LC, Frederick N, Betty N, Josephine E, Agatha N. A Demonstration of Peer Support for Ugandan Adults With Type 2 Diabetes. Int J Behav Med. 2014; Accessed online from http://wioc.wisc.edu/events/2014-Health/readings/baumann-et-al-demonstration-of-peer-support.pdf