09.2009 Eval Grantee Posters

8/8/2019 09.2009 Eval Grantee Posters

1/14

U.S.-Mexico border in California, southern end of agricultural belt

Adult Mexicans/Mexican-Americans; 23% live in poverty

336 patients randomly sampled from Clinicasroster

30 Peer Supporters: former participants in a diabeteseducation program; seen as exhibiting mastery overdiabetes; qualities of empathy, warmth, and referent power

Recruitment/Retention Innovation:

2 different recruitment letters to be sent October 2009

Test two messages to recruit and retain Peer Supporters:self vs. other oriented

6 Training Sessions: 2 full-day on weekend, 4 shorter

sessions on weekdays to begin November 2009; total 32-40 hours

Peer Supporter assigned to 6 patients with diabetes:

Goal: Help improve diabetes self-management behaviorsrelevant in multiple contexts (clinic, community, home)

Dose: Minimum of 8 contacts in first 6 months; lessfrequent contact in subsequent 6 months

Modes: Family home visits, small groups, and clinic tours

Design and Methods

Approaches to Implementing Peer Support

A program of the American Academy of FamilyPhysicians Foundation and supported by the Eli

Lilly and Company Foundation, Inc.

Organization:San Diego State University and Clinicas de Salud del Pueblo

Principal Investigators: Gu ad alu p e X. Ayala, PhD, MPH an d Joh n P. Elde r, PhD, MPH

Randomized controlled trial with two conditions: peer support vs.usual care

Data to be collected at baseline, 6 months, and 12 months

Measures from medical records: HbA1C, BMI, BP, cholesterol, ageof diabetes diagnosis, diabetes medications, hospitalizations, lasteye and foot exams, other diagnosed medical conditions

Measures from survey: medication use/adherence, health careaccess, health literacy, diabetes self-care, quality of life,acculturation, demographics, other health behaviors

Process Evaluation to assess: participant engagement, nature ofvolunteer peer supporters in Latino community, study design usingRE-AIM model

Alliance to Control Diabetes/Alianza para

Controlar la Diabetes

Follow-up assessments at

6- and 12-months

Usual care (n=168)

Intervention (n=168)6 months of peer support

Each peer supporter assigned to 6adults with diabetes.

Randomly sample 336 patients fromclinic roster & conduct baseline

Randomly assign to condition

Audience and Setting

Diabetes

control

Community navigation

Facilitate access toexternal resources(library, internet)

Problem-solveovercome social and

physical barriers(celebrations with

family, friends and co-workers; restaurant

eating; unsafeneighborhoods)

Targets for change in a diabetes peer support intervention

Modes of delivery include: family home visits, small group and clinic tours

Health care systemnavigation

Meet with patientbefore provider visitto activate = improve

communication

Facilitate utilizationof diabetes

managementresources

Home navigation

Family support and

engagementHealthy control of thesocial and physical

environments of the home

Skill building

Other Investigators and Key Personnel: And rea Cherr ington , MD, MPH, Nad ia Camp bell,MPH, Mar k Sn yd er , Ph D, Afs h an N. Baig, MD, Ming Ji, PhD, Let icia Ibar ra , MPH


2/14

People with diabetes in rural (Bafut) and urban (Bamenda)health districts of Cameroon

Peer supporters will be recruited from health care providerscaring for people with diabetes and from people with diabetes

themselves

People with diabetes (PWD) will be recruited though diabetesclinics; Bafut has three clinics and 80 diabetes patients;Bamenda has six diabetes clinics and 613 diabetes patients


Study based in social ecological model to inform anintervention with when, why, and how people engage in peersupport (social ecology of health behaviors and triggers for

peer support) The project will identify peer support devices for use by

people with diabetes and their peers (e.g., email, textmessaging, telephone), train peers in the use of them, andenable peers to interact amongst themselves usingnetworking

PWD will serve as the first contact with their peers who donot attend clinics

Other activities will include promoting peer support programs,encouraging networking among those active in peer supportprograms, hosting a webpage to circulate program materialsand curricula

STUDY: Design and Methods




Organization:Centre for Population Studies and Health Promotion

Investigators: Pasch al Kum Awah, PhD and Andre- Pascal Kengne, MD, PhD

80 people with diabetes and 80 as their peers (one perpatient)

All participants allocated to intervention group; outcomescompared between urban and rural participants (repeatedmeasures; participants serve as own control)

Anthropometric, risk factor, biological, behavioral,psychosocial wellbeing, self care, compliance, and quality oflife data

Baseline, mid-duration, and end-of-project evaluations (20-

month study period)

Peer Collaboration in Diabetes Care

PEERSDIACARE Cameroon

Study aims: To identify and create enabling environments for peer support between people withdiabetes, families, and healthcare providers in rural and urban Cameroon

Me n

43 %Women

57 %

58.6

57

57.7

56

56.5

57

57.5

58

58.5

59

Men Wom en Overa l l

Mean age (years)

29.9

28.5

26.5

24

25

26

27

28

29

30

31

Vis it 1 Vis it 2 Vis i t 3

Mean BMI by v is i t (kg/m2)

Preliminary results

180.5

176.1

170.7

16 5

17 0

17 5

18 0

18 5

V is i t 1 Vis i t 2 Visi t 3

Mean FBG by v is i t (mg/dl )

13 8 14 2 14 1

81 82 83

0

20

40

60

80

10 0

12 0

14 0

16 0

Vis it 1 Vis it 2 Visi t 3

Mean SBP by v is i t (mmHG)

Mean DBP by visi t (mmHG)


3/14

400 low income English and Spanish-speaking patients with type 2diabetes and HbA1C >8% recruited from 4 community health clinicsin San Francisco, California

Potential peer coaches (patients with diabetes, HbA1c


4/14

People with diabetes (PWD) in Hong Kong, SAR, CHINA

Patients receiving structured care augmented by a web-baseddisease management program enrolled in the Joint Asia DiabetesEvaluation Program (JADE)


Motivated and knowledgeable peer leaders will undergo a 32-hourTrain the trainer program (4 workshops, 8-hours each) for furtherempowerment and development of leadership skills

Supported by a program manager, peer leaders will maintain regularcontact with their assigned mentees in the intervention groupthrough phone calls, sharing sessions and other forms oftelecommunications

Peer leaders will encourage their peers to use the Telephone LinkedCare (TLC) automated system for knowledge enhancement andmotivational support

Each peer leader will contact their mentees (10 per mentor) twiceper month by 15-20 minute phone calls for 3 months

After 3 months, peer leaders will call their mentees between clinicvisits or more often, if needed

Design and Methods




Organization: Asia Diabetes Foundation and Hong Kong Institute of Diabetes and Obesity,The Chinese University of Hong Kong, Hong Kong SAR, CHINA

Principal Investigator: Julian a C. N. Cha n, MD, FRCP

Co-Investigators: Gar y T.C. Ko, MD FRCP, Rebe cca Y.M. Won g, RN MA, Sh im en Au, RN, Lan ce lot Mu i, BSc, MPH,

Eva Kan, RN MPH, Alice P.S. Kong, MBChB, FRCP, Ronald C.W. Ma, MB, BChir, MRCP, Peter C.Y. Tong, PhD FRCP,

Joseph Lau, MSc, PhD, Brian Oldenburg, PhD, Robert H. Friedman, MD, Wingyee So, MD FRCP.

Aim: To use peer support and information technology to facilitatecare providers to implement structured care and empower PWD toacquire self-management skills and improve quality of care

A 12-month, multi-center, randomized, parallel study involving 600PWD receiving structured care through the JADE program, with halfof them randomized to receive peer support (n=300)

Primary outcomes HbA1c, BP, body weight and lipid profile

Secondary outcomes Cognitive-psychological-behavioralmeasures using Chinese validated questionnaires:

Mental Health (Depression Anxiety and Stress Scale (DASS21)

Self-efficacy (Diabetes Empowerment Scale (C-DES)

Diabetes Self Care Activities (SDSCA)

User acceptability and cost-effectiveness of programs

Peer Support, Empowerment And Remote Communication

Linked by Information Technology (PEARL):

A Multi-Component Program to Improve Community-Based Diabetes Care


5/14




Organization:National Research Council of Argentina (CONICET) with the CENEXA. Centre ofExperimental and Applied Endocrinology (UNLP-CONICET),

PAHO/WHO Collaborating Centre for Diabetes (ARGENTINA)

Principal Investigator: Juan Jose Gagliard ino, MDOther Investigators:Charles Clark Jr., MD and Kate Lorig, DrPH



Optimizing Diabetes Outcomes: The Role of Peers

Study aims:To compare the benefits of a diabetes education program with peers as part of the education team, forthe provision of ongoing psychological and practical support in an 18-month pilot trial.

People with type 2 diabetes from La Plata city (Argentina)

Recruitment and Selection:Physicians and patients from a local primary care institution;

Peers from our team based upon good diabetes control,motivation, communication skills and interest.

Peers addressing diabetes education, provision of emotional support, solving of daily self-care problems.

Peers will have scheduled contacts with supportees and members of education team:

bimonthly encounters at buffet restaurant with a nutritionist (food selection and meal plan);weekly (first 6 months), biweekly (next 3 months) and monthly (remaining study period) telephonecommunications to assess patients problems and clinical, metabolic and psychological progress;

monthly group teleconference (peer plus supportees) (telephone company contract for cell phoneprovision and discount rates).

Knowledge(solve problems)

Motivation(sustained healthybehaviour)

Skills(self-carepractices)

Empowerment

Improved diabetes control

Better quality of life

Randomly selected patients allocated into 2 groups (94 peopleeach; 6 months). Follow-up: 12-months.

Patient education courses: 4 small interactive group weeklysessions (2 h each), including knowledge, skills and attitudes;reinforcement session at 6 months.

Peer support group: patients attend the education courses andreceive peer support.

Evaluation

A1C changes will be the primary outcome variable; it was used to estimate sample size.

QUALIDIAB data set (clinical, metabolic, therapeutic and economic data; complications) (0-12 months)

Abbreviated QUALIDIAB data collection at 6 months;

WHO-5 and patient and peer satisfaction (SF-8 questionnaire) at 6 months.Statistical analyses: test and chi2 for continuous and categorical data, respectively.


6/14

Insured middle-class patient population in San Antonio, TX

Mentors and mentees are patients recruited from 15 practiceswithin WellMed

Recruitment strategies include: electronic reminders to physicians,referrals, informational pamphlets, posters, word of mouth, andmailings


Adapting a successful Diabetes Peer Mentoring Program, Carpeta Roja (CR), from low income, uninsuredpopulation to middle-class population

Mentors receiving formal training and drawing on their own experiences will provide support to menteesthrough in-person meeting, telephone, and other communication

Mentors will work with 1-5 mentees at a time for 3-14 months, depending on patient need and will completean 8-week self-management course prior to beginning mentoring phase

Design and Methods




Organization:The American Academy of Family Physicians National Research Network (with

Latino Health Access, LA Net, and WellMed Medical Group)

Principal Investigator: Lynd ee Knox

Co-Investigators: Ame rica Brach o, MD, Debo ra h Grah am , MSPH, MPH, Jess ica Huf f, Pat ricia

Cantero, PhD, Margie Gomez, Michelle Henry, MSN

Practice-level randomized controlled trial and multiple start date, wait list design. 3 arms: Usual care, 101course only, 101 plus CR. Outcomes for mentees and mentors assessed.

Assessing reach by tracking number of patients assessed as eligible, the number who sign-up for mentoring,and the number who receive mentoring

Diabetes Distress Scale, EQ-5D for quality of life, and Perceived Diabetes Self-Management Scale

HbA1c, blood pressure and LDL

Implementation/process: Recruitment strategies, retention, adaption for senior patient population, adaption forwell resourced healthcare setting, adaption for diverse SES and ethnic background

Evaluating the Implementation and Effectiveness

of a Diabetes Peer Mentoring Program


7/14

Peer champions and partners were recruited by anurse at the Mityana Diabetes Clinic

In May 2009, 19 champions attended first meeting

Champions were matched with 27 partners in thesame age group and gender, and in close livingproximity


Training for champions conducted in English using the Champion Diabetes Guidebook

Initial peer meeting held in May 2009 (27 attendees) and booster sessions were held in July and August(34 attendees)

Community meetings educated participants on diabetes and emotional and psychosocial issues thatmay arise, and trained champions in communication skills

All participants and health care providers were given cell phones using a closed network to maintainregular contact between peers and providers without airtime charges

Champions made contact with partners at least once per week over 3 months

A meeting was held in September 2009 to obtain feedback about the program and post-measures fromall participants





Organization:The University of Wisconsin-Madison School of Nursing (USA); andMulago Hospital, Department of Medicine, Kampala and Mityana District Hospital,

Mityana (UGANDA)

Principal Investigator: Lind a C. Bau m an n , PhD, RN

Other Investigators: Agath a Nam bu ya, MD, Fre d Nakwa gala, MD, MS, andJosep h ine Ejan g, RN (Mulago Hos p ital Dep ar tm en t of Med icine)

Pre-test post-test design of a 12-week pilot intervention

Measures included a self-administered questionnaire, HbA1c, blood pressure, and BMI

Mityana Clinic Nurse kept a log of all champion-partner contacts

Cell phone records to track usage among champions, partners, and health care providers

A Peer Champion Program for Ugandan

Adults with Diabetes

Study Aims/Questions: To test the feasibility and short-term impact of a peer champion program foradults with type 2 diabetes in the community of Mityana, Uganda


8/14

People with diabetes (PWD) in the community in Yaound, Cameroon

All enrolled participants are diabetes patients being followed-up at thediabetes clinic of the National Obesity Centre

Potential peer supporters recruited for training based on health careprovider recommendation, area of residence, cultural background, andsuccess in controlling diabetes

10 Peer Supporters selected after completion of training based on HbA1c


9/14

People living with Type 2 diabetes in the state of Victoria, Australia

Participants selected from people with Type 2 diabetes who are registered on the database of DiabetesAustralia-Victoria (non-governmental organization)

At least 20 peers selected as peer supporters based on personal characteristics (e.g., acceptance of diverseviews)

Participants ages 25-75 with diabetes at least 12-months


Lay peer supporters/group facilitators will complete three-days of training to acquire group facilitation,communication and other basic skills aimed at helping the group members to achieve the desired individualand group health and social outcomes of the Peers for Progress Diabetes Program.

One group leader per 8-15 people with diabetes to encourage behavioral change, build problem solving,risk assessment and communication skills, assist participants to access to local resources, provide a venuefor informal information exchange and feedback,

12-monthly peer-led sessions in participants local communities over 12 months; sessions addressbehavior change, chronic disease self-management, emotional, appraisal, and informational support;supported by workbook of content and resources




Evaluate efficacy of peer support intervention and its transferability to other settings, populations, andcountries

Participants will be clustered by region and these groups randomly assigned to intervention or waitlistcontrol arms

Create 32 groups of 8-15 people with diabetes (16 groups to each arm with at least 99 participants in eacharm)

Reach and engagement of intended audience per RE-AIM

Measuring outcomes (HbA1c, BMI. behaviors, quality of life, psychosocial, group effectiveness, and system

outcomes), implementation, and comprehensive economic evaluation

Measurement at baseline, 6, 12, and 18 months

A controlled evaluation of the Australasian Peer

for Progress Diabetes Program (PfP-DP) and its

Transferability to Other Countries

Organization: Monash University, School of Public Health & Preventive Medicine

Principal Investigator: Brian Oldenburg, PhD

Co-Investigators: James A. Dunb ar an d Prasu na Redd y (Flind ers a nd Deakin Universities,

Aus tra lia); Dr. Ralph Aud ehm and Greg John son (Diabet es Aus tra lia- Victor ia, Aus tra lia);

Rob Carte r (Deakin University, Aus tr alia); Maximilian d e Cour ten an d Rory Wolfe (Mon as h

Univers ity, Aust ralia); Dr. Pilvikki Abs etz (Nation al Ins titu te o f Public Health , Finlan d );

Anua r Zaini (Mon as h University Malaysia)

Design and Methods


10/14

African American adults in a community-based setting (Ypsilanti, MI) and Latino adults (Spanish and English-speaking) in a clinic-based setting (Detroit, MI)

Participants recruited by provider/community organization referral, advertisements in newspapers and flyers,clinic-based computerized databases, invited presentations at churches


Peer Leader Training focuses on diabetes-related

knowledge, behavioral strategies (e.g., 5-step goal

setting model) and communication skills Intervention consists of a 3-month, theoretically-driven

diabetes self-management education (DSME) program

(monthly one-on-one sessions, monthly phone calls,

MD appointment preparation) followed by a Peer-Led

Empowerment-based Approach to Self-management

Efforts in Diabetes (PLEASED)




Organization: University of Michigan Medical School, Department of Medical Education andDepartment of Internal Medicine, and the University of Michigan School of Public Health,Department of Health Behavior and Health Education

Principal Investigators: Tricia S. Tang, PhD an d Miche le Heisle r, MD, MPA

Co-Investigators: Robe rt And ers on , MEd , Ed D; Mar th a Fun n ell, MS, RN, CDE; Joh n Piet te ,PhD; Micha el Spen cer , MSW, Ph D; Felix Valb u en a, MD (Com m u n ity Healt h & Social Services )

Randomized controlled design

Participants are randomized to receive either DSME co-led by CDE/CHW and 2 peer leaders followed by 12months of DSMS or DSME followed by 12 months of self-directed support (control group).

Peer-led self management support in real

world clinical and community settings

Design and Methods

Investigating impact of PLEASED intervention following 3-months DSME at 6-months and 12-months compared tosame duration of self-directed support; also confirming impact of 3-months DSME to improve outcomes

Outcome measures include A1C, blood pressure, lipd control, self-management behaviors (Summary of Diabetes

Self-Care Activities), quality of life (Diabetes Distress Scale), and reach to and engagement of intended audience(RE-AIM framework)

PLEASED: 12-months of ongoing, peer-led diabetes self-management support (DSMS) weekly sessions based on

patients priorities, questions, and concerns to build motivation, set goals, draft action plans, problem-solve; follow-up

phone calls as needed; matched with at least one peer buddy for ongoing support)


11/14

Adult patients with type 2 diabetes receiving care from CommunityHealth Centers in rural, impoverished Alabamas Black Belt

Recruiting only patients with A1c >7.5%

Networked Recruitment of peer advisors: 2-3 peers initiallyrecruited by practice staff, then use peer social networks and otherestablished community networks to recruit additional peers


Pilot peer advisor training program in September 2009, piloting recruitment and the intervention November 2009

Peer advisors collaborated in developing training curriculum; pilot peer advisors to assist in further refinement oftraining and intervention

Beginning early winter, 2-day peer advisor training to occur in each target geographic area (Central, West)

Peers will deliver a 12-month intervention to support diabetes self-management goals, facilitate patientempowerment, and raise the BAR (Be prepared; Ask and learn; Reflect) to get the most out of office visits with theprovider

Peer advisors will make weekly, 15-20 minute contacts with clients for the first 8 weeks of intervention, and monthlycontacts thereafter; in addition, there will be contacts before and after office visits with the provider

Design and Methods




Organization:University of Alabama at Birmingham, School of Medicine

Principal Investigator: Mon ika M. Saffo rd , MD

Co-Principal Investigators: Mon a Fou ad , MD, MPH; An d rea Cher rin gto n , MD, MPH

Co-Investigators: Su sa n Ap p el, Ph D; W. Tim ot h y Gar vey, MD, PhD; Jewell Halan ych ,MD, MPH; Miche lle Mar tin , PhD; Mar ia Pisu , Ph D; Rober t Ost er , PhD, Mar y Ann et te

Wright, PhD

Group-randomized, controlled implementation trial(randomized at the practice level)

Reach evaluated by comparing number of eligible patientsapproached for recruitment with the number enrolled

200 patients in each trial arm, total of 400

Data collected at baseline and 12 months

Primary outcomes: HbA1c, blood pressure, cholesterol

Secondary outcomes: Self-management behaviors, quality of life, and psychosocial factors

Health care utilization will be measured through medical record review

UAB Diabetes Research Translation Center is supporting 6-month data collection and cost-effectiveness analysis

Encourage: Evaluating Community Peer Advisors and

Diabetes Outcomes in Rural Alabama


12/14

People with type 2 diabetes (PWD) in four districts (two urban, two rural) fromtwo provinces central and northeast regions of Thailand

20 VHVs and six health staff selected for training (Selection Criteria: must haveat least 3 PWDs in their areas of responsibility; read/write in Thai; can completetraining and project)

VHVs (peers) function as link between communities and frontline health careproviders


Training curricula for VHVs to be developed during 5-day workshop including selected PWDs, VHVs, local healthpersonnel, medical doctors, and project researchers

20 VHVs and 6 health staff attend 4-day training based on previously developed curricula and develop activityplan at end of training

VHV work with PWDs and families (e.g., identify problems, set goals, identify approaches for addressing them);includes regular home visits for problem solving and providing feedback

Frequency of home visits mutually agreed upon by VHVs and PWDs; no less than 2 visits per month

Meetings among all PWD, families, and VHVs every two months for group support, follow-up on activities,problem-solving, network-building, and ensuring continuity of care between community and health center





Quasi-experimental, Two groups, pre-post test design; aim to pre and post test all 20 VHVs and 60 PWDs undertheir responsibility

Comparison group: same number of VHVs and PWDs from non-participating, similar socio-economic districts inthe same provinces

Among participants, measuring dietary intake, physical activity, proper skin and foot care, HbA1C, bloodpressure, BMI, quality of life, perceived susceptibility, severity, self-efficacy and benefits, perceived supportreceived

Among VHVs, measuring self-efficacy in providing support and motivation

Peer supports for sustainable self-care and enhancing quality

of life among diabetes mellitus type 2 patients in Thailand

Study Aims/Questions: Build the capacity of village health volunteers (VHV) in motivating DM type 2patients to develop and maintain self management behaviors by applying an ecological approach

Organization:Mahidol University, Faculty of Public Health, Department of Health Educationand Behavioral Science

Principal Investigator: Boos aba San gua np ras it, PhD, MPH

Co-Investigators: Chaisr i Sup orn silaph ach ai, MD, MPH (Minist ry o f Pub lic Health ); Rewad eeChon gsu wat , PhD, MS; Cha nu an th on g Tana su garn , MPH, DrPH; Prasit Leera p an , MEd, PhD;

Sun ee Lakam pa n, EdD


13/14

Xhosa women with type 2 diabetes in Mfuleni Township, CapeTown, South Africa

Women recruited to be Diabetes Buddies (DB) at the Women for

Peace center, an NGO

Audience & Setting

22 women to be assigned to buddy-pairs (DBs) with the purpose of providing reciprocal, ongoing support

12-week program (weekly meetings for 3 months) attended by DBs, covering nutrition, exercise, providingreciprocal support, and managing relationships with health care providers

Training program, based on Diabetes Prevention Program (DPP), led by a paid peer mentor

DBs given cell phones and trained to use SMS application to record daily blood glucose levels, text messagetheir buddies, and receive motivational prompts

Study Methods & Findings




Organizations:University of California-Los Angeles,

Global Center for Children and Families (USA) with

the Stellenbosch University and Women for Peace (SOUTH AFRICA)

Investigators: Mary Jane Roth eram - Boru s, Margaret Gwegwe,

Mark Tom lin so n, Marion Keim

One group, pretest-posttest design

Average age of DBs was 53 years old; almost all had lived for over 5 years in their homes: formal brickstructures with running water on the premises, flush toilet, and electricity. Fewer than half had any

employment. All participants were assessed at baseline, 3 months, and 6 months later.

Outcomes monitored: exercise, social support, anxiety, blood sugar, BMI, blood pressure.

Social support showed immediate improvement at 3 months and continued to increase at 6 months.

Exercise and diastolic blood pressure did not improve over time.

For anxiety, BMI, blood sugar, and systolic blood pressure, outcomes appeared slightly worse at the 3-month assessment compared to baseline, but between 3 and 6 months either leveled off or showedimprovement.

The women who did the most text messaging with their buddies had much higher BMIs than those whotexted less, at all time points.

Preliminary results indicate that some improvements might not occur immediately, but appear over time.

Diabetes Buddies


14/14

People with type 2 diabetes in East of England UK (mainlyCambridgeshire)

Participants will be recruited through their general practitioners(assisted by Primary Care Research Network) and communitynetworking

Peers will be recruited through an initial survey, and will beselected and trained by the study team


Peers will receive training to offer assistance with living withdiabetes, motivational interviewing, and in support skills

A diabetes nurse will assist in providing linkages to care

Peer support will occur through individual and/or group settings

Peers will have up to 10 individuals at one time for 1:1 meetings,give 4-10 hours per week for 6 months

Group settings will have 20 individuals and two leads




Organization:Cambridge University Hospitals NHS Foundation Trust, Institute of MetabolicScience, University of Cambridge General Practice and Primary Care Research Unit

Principal Investigators: David Sim m on s, FRCP FRACP MD, Jon at h an Graf fy, FRCGP MD

Co-Investigators: Simo n Coh n, PhD; Sara h Don ald, BSc; Pete r Rob ins, MA, Vet MB; Cha rlot te Padd ison ,

PhD; Toby Provost, PhD; Mark Evans, MD, FRCP; Amanda Adler, PhD, FRCP; Catherine Walsh, FRCPsych

East of England, United Kingdom

Cluster randomized trial with 2X2 comparison of individual,group, combined individual/group support, and normal care

Aim to recruit 1520 participants in 80 community clusters

Reach assessed by recruitment rate from initial survey,attendance for support sessions, intervention fidelity, andcomparison with routine health service data

HbA1c over 12 months, body weight, blood pressure

Surveys: self-management (DSCAM), self-efficacy (DMSES),and quality of life (EQ-5D)

Qualitative (e.g., meaning of peer support) and economicanalyses

RAPSID: Can Peer Support (Group or Individual Intervention)

Enable People with Diabetes and Improve Health?

Design and Methods

Diabetes PLUSPeer-Led Understanding & Support

Overview of different support approaches

1:1 Peer Support

GroupBasedSupportgroup

Control 1:1 only

Group only Both

Content: Eductn& usual

care

Assist in dailymanagement

and livingwith diabetes

Discussion ofsocial andemotionalaspects of lifewith diabetes

Socialcontextualsupport

Linkage toclinicalCare

Individual1:1support

Yes Sharingexperiences& mentoring

Individualdiscussion

No Individualreview of careaccess, linkvia Nurse if

needed

Groupsupport

Yes Sharingexperiences& co-mentoring ingroup

Groupdiscussion

Yes Groupdiscussn ofaccessing

services. Linkvia Nurse if

need

Combinedsupport

Yes Sharingexperiences& mentoring(group +/-individually)

Individualand/or group

discussion

Yes BothcomponentsAs above.

NormalCare

Yes - - - -

2 x 2 factorial study design

East Cambs

Fenland

Hunts

SouthCambs

Main study areas

Documents

09.2009 Eval Grantee Posters