Junmei Yin1, Rebecca Wong2, Shimen Au3, Harriet Chung4, Maggie Lau5, Laihar Lin6, Chiuchi Tsang5, Kampiu Lau6, Risa Ozaki2, Wingyee So2, Gary Ko7, Andrea Luk7, Roseanne Yeung8, Juliana C N Chan9. 1. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong. 2. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong Diabetes and Endocrine Centre, Prince of Wales Hospital, Shatin, Hong Kong. 3. Ruttonjee Hospital, Hong Kong. 4. Asia Diabetes Foundation, Prince of Wales Hospital, Shatin, Hong Kong Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Shatin, Hong Kong. 5. Alice Ho Mui Ling Nethersole Hospital, Tai Po, Hong Kong. 6. North District Hospital, Fanling, Hong Kong. 7. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong Diabetes and Endocrine Centre, Prince of Wales Hospital, Shatin, Hong Kong Asia Diabetes Foundation, Prince of Wales Hospital, Shatin, Hong Kong. 8. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong Asia Diabetes Foundation, Prince of Wales Hospital, Shatin, Hong Kong Division of Endocrinology, University of British Columbia, Canada. 9. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong Diabetes and Endocrine Centre, Prince of Wales Hospital, Shatin, Hong Kong Asia Diabetes Foundation, Prince of Wales Hospital, Shatin, Hong Kong Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Shatin, Hong Kong jchan@cuhk.edu.hk.
Abstract
PURPOSE: We examined the effects of participating in a "train-the-trainer" program and being a peer supporter on metabolic and cognitive/psychological/behavioral parameters in Chinese patients with type 2 diabetes. METHODS: In response to our invitation, 79 patients with fair glycemic control (HbA1c <8%) agreed to participate in a "train-the-trainer" program to become peer supporters. Of the 59 who completed the program successfully, 33 agreed to be peer supporters ("agreed trainees") and were each assigned to support 10 patients for 1 year, with a voluntary extension period of 3 additional years, while 26 trainees declined to be supporters ("refused trainees"). A group of 60 patients with fair glycemic control who did not attend the training program and were under usual care were selected as a comparison group. The primary outcome was the change in average HbA1c levels for the 3 groups from baseline to 6 months. RESULTS: At 6 months, HbA1c was unchanged in the trainees (at baseline, 7.1 ± 0.3%; at 6 months, 7.1 ± 1.1%) but increased in the comparison group (at baseline, 7.1 ± 0.5%; at 6 months, 7.3 ± 1.1%. P = .02 for between-group comparison). Self-reported self-care activities including diet adherence and foot care improved in the trainees but not the comparison group. After 4 years, HbA1c remained stable among the agreed trainees (at baseline, 7.0 ± 0.2%; at 4 years: 7.2 ± 0.6%), compared with increases in the refused trainees (at baseline, 7.1 ± 0.4%; at 4 years, 7.8 ± 0.8%) and comparison group (at baseline, 7.1 ± 0.5%; at 4 years, 8.1 ± 0.6%. P = .001 for between-group comparison). CONCLUSIONS:Patients with diabetes who engaged in providing ongoing peer support to other patients with diabetes improved their self-care while maintaining glycemic control over 4 years.
RCT Entities:
PURPOSE: We examined the effects of participating in a "train-the-trainer" program and being a peer supporter on metabolic and cognitive/psychological/behavioral parameters in Chinese patients with type 2 diabetes. METHODS: In response to our invitation, 79 patients with fair glycemic control (HbA1c <8%) agreed to participate in a "train-the-trainer" program to become peer supporters. Of the 59 who completed the program successfully, 33 agreed to be peer supporters ("agreed trainees") and were each assigned to support 10 patients for 1 year, with a voluntary extension period of 3 additional years, while 26 trainees declined to be supporters ("refused trainees"). A group of 60 patients with fair glycemic control who did not attend the training program and were under usual care were selected as a comparison group. The primary outcome was the change in average HbA1c levels for the 3 groups from baseline to 6 months. RESULTS: At 6 months, HbA1c was unchanged in the trainees (at baseline, 7.1 ± 0.3%; at 6 months, 7.1 ± 1.1%) but increased in the comparison group (at baseline, 7.1 ± 0.5%; at 6 months, 7.3 ± 1.1%. P = .02 for between-group comparison). Self-reported self-care activities including diet adherence and foot care improved in the trainees but not the comparison group. After 4 years, HbA1c remained stable among the agreed trainees (at baseline, 7.0 ± 0.2%; at 4 years: 7.2 ± 0.6%), compared with increases in the refused trainees (at baseline, 7.1 ± 0.4%; at 4 years, 7.8 ± 0.8%) and comparison group (at baseline, 7.1 ± 0.5%; at 4 years, 8.1 ± 0.6%. P = .001 for between-group comparison). CONCLUSIONS:Patients with diabetes who engaged in providing ongoing peer support to other patients with diabetes improved their self-care while maintaining glycemic control over 4 years.
Authors: Juliana C N Chan; Yi Sui; Brian Oldenburg; Yuying Zhang; Harriet H Y Chung; William Goggins; Shimen Au; Nicola Brown; Risa Ozaki; Rebecca Y M Wong; Gary T C Ko; Ed Fisher Journal: JAMA Intern Med Date: 2014-06 Impact factor: 21.873
Authors: Sharon A Brown; Shelley A Blozis; Kamiar Kouzekanani; Alexandra A Garcia; Maria Winchell; Craig L Hanis Journal: Diabetes Care Date: 2005-03 Impact factor: 19.112
Authors: Edwin B Fisher; Guadalupe X Ayala; Leticia Ibarra; Andrea L Cherrington; John P Elder; Tricia S Tang; Michele Heisler; Monika M Safford; David Simmons Journal: Ann Fam Med Date: 2015-08 Impact factor: 5.166