Guadalupe X Ayala1, Leticia Ibarra2, Andrea L Cherrington3, Humberto Parada4, Lucy Horton5, Ming Ji6, John P Elder7. 1. San Diego State University College of Health and Human Services and Institute for Behavioral and Community Health, San Diego State University Research Foundation, San Diego, California ayala@mail.sdsu.edu. 2. Clínicas de Salud del Pueblo, Inc, Brawley, California. 3. Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama. 4. University of North Carolina at Chapel Hill. 5. Institute for Behavioral and Community Health, San Diego State University Research Foundation, San Diego, California. 6. University of South Florida College of Nursing, Tampa, Florida. 7. San Diego State University College of Health and Human Services and Institute for Behavioral and Community Health, San Diego State University Research Foundation, San Diego, California.
Abstract
PURPOSE: Peer support can promote diabetes control, yet research on feasible and effective peer support models is lacking. This randomized controlled trial tested a volunteer-based model of peer support for diabetes control. METHODS:Thirty-four volunteer peer leaders were recruited and trained to provide support to 5 to 8 patients each through telephone contact, in-person, individual, and group support. Planned dose was 8 contacts, preferably in the first 6 months. Patients with uncontrolled diabetes were randomly sampled from the medical records of 3 community clinics. After a baseline interview and medical records review to obtain baseline values for the primary outcome, HbA1c, 336 patient participants were randomly assigned to a 12-month peer support intervention or usual care. The assessment protocol was repeated at 6 and 12 months after baseline. RESULTS: Thirty peer leaders delivered an average of 4 contacts each per assigned participant (range 1-24). Despite the lack of intervention fidelity, the intervention was effective at reducing glycated hemoglobin (HbA1c) among intervention as compared with usual care participants (P=0.05). Similar trends were observed in frequency of meeting fruit and vegetable guidelines (P =0.09), a secondary outcome. Counterintuitively, usual care participants reported checking their feet more days out of 7 than intervention participants (P =0.03). CONCLUSIONS: Given the modest changes we observed, combined with other evidence for peer support to promote diabetes control, additional research is needed on how to modify the system of care to increase the level of peer support delivered by volunteers.
RCT Entities:
PURPOSE: Peer support can promote diabetes control, yet research on feasible and effective peer support models is lacking. This randomized controlled trial tested a volunteer-based model of peer support for diabetes control. METHODS: Thirty-four volunteer peer leaders were recruited and trained to provide support to 5 to 8 patients each through telephone contact, in-person, individual, and group support. Planned dose was 8 contacts, preferably in the first 6 months. Patients with uncontrolled diabetes were randomly sampled from the medical records of 3 community clinics. After a baseline interview and medical records review to obtain baseline values for the primary outcome, HbA1c, 336 patientparticipants were randomly assigned to a 12-month peer support intervention or usual care. The assessment protocol was repeated at 6 and 12 months after baseline. RESULTS: Thirty peer leaders delivered an average of 4 contacts each per assigned participant (range 1-24). Despite the lack of intervention fidelity, the intervention was effective at reducing glycated hemoglobin (HbA1c) among intervention as compared with usual care participants (P=0.05). Similar trends were observed in frequency of meeting fruit and vegetable guidelines (P =0.09), a secondary outcome. Counterintuitively, usual care participants reported checking their feet more days out of 7 than intervention participants (P =0.03). CONCLUSIONS: Given the modest changes we observed, combined with other evidence for peer support to promote diabetes control, additional research is needed on how to modify the system of care to increase the level of peer support delivered by volunteers.
Authors: David Moher; Sally Hopewell; Kenneth F Schulz; Victor Montori; Peter C Gøtzsche; P J Devereaux; Diana Elbourne; Matthias Egger; Douglas G Altman Journal: BMJ Date: 2010-03-23
Authors: Edwin B Fisher; Muchieh Maggy Coufal; Humberto Parada; Jennifer B Robinette; Patrick Y Tang; Diana M Urlaub; Claudia Castillo; Laura M Guzman-Corrales; Sayaka Hino; Jaimie Hunter; Ariana W Katz; Yael R Symes; Heidi P Worley; Cuirong Xu Journal: Annu Rev Public Health Date: 2014-01-02 Impact factor: 21.981
Authors: Michael S Spencer; Ann-Marie Rosland; Edith C Kieffer; Brandy R Sinco; Melissa Valerio; Gloria Palmisano; Michael Anderson; J Ricardo Guzman; Michele Heisler Journal: Am J Public Health Date: 2011-06-16 Impact factor: 9.308
Authors: Elizabeth A Prezio; Dunlei Cheng; Bijal A Balasubramanian; Kerem Shuval; Darla E Kendzor; Dan Culica Journal: Diabetes Res Clin Pract Date: 2013-02-28 Impact factor: 5.602
Authors: Paul Bray; Doyle M Cummings; Susan Morrissey; Debra Thompson; Don Holbert; Kyle Wilson; Eric Lukosius; Robert Tanenberg Journal: Ann Fam Med Date: 2013 Mar-Apr Impact factor: 5.166
Authors: Heidi Michels Blanck; Cathleen Gillespie; Joel E Kimmons; Jennifer D Seymour; Mary K Serdula Journal: Prev Chronic Dis Date: 2008-03-15 Impact factor: 2.830
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
Authors: Sonal J Patil; Todd Ruppar; Richelle J Koopman; Erik J Lindbloom; Susan G Elliott; David R Mehr; Vicki S Conn Journal: Ann Fam Med Date: 2016-11 Impact factor: 5.166
Authors: Janett A Hildebrand; John Billimek; Jung-Ah Lee; Dara H Sorkin; Ellen F Olshansky; Stephen L Clancy; Lorraine S Evangelista Journal: Patient Educ Couns Date: 2019-09-09
Authors: Sarah D Kowitt; Katrina R Ellis; Veronica Carlisle; Nivedita L Bhushan; Kristin Z Black; Kaitlyn Brodar; Nicole M Cranley; Kia L Davis; Eugenia Eng; Michelle Y Martin; Jared McGuirt; Rebeccah L Sokol; Patrick Y Tang; Anissa I Vines; Jennifer S Walker; Edwin B Fisher Journal: Support Care Cancer Date: 2018-10-06 Impact factor: 3.603
Authors: David Simmons; Christopher Bunn; Fred Nakwagala; Monika M Safford; Guadalupe X Ayala; Michaela Riddell; Jonathan Graffy; Edwin B Fisher Journal: Ann Fam Med Date: 2015-08 Impact factor: 5.166
Authors: Sarah D Kowitt; Guadalupe X Ayala; Andrea L Cherrington; Lucy A Horton; Monika M Safford; Sandra Soto; Tricia S Tang; Edwin B Fisher Journal: Ann Behav Med Date: 2017-12
Authors: Melawhy L Garcia; Sheila F Castañeda; Matthew A Allison; John P Elder; Gregory A Talavera Journal: Diabetes Res Clin Pract Date: 2019-04-04 Impact factor: 8.180