Diabetes Mellitus
Conditions
Keywords
diabetes mellitus, peer support, pragmatic clinical trial
Brief summary
It is unclear whether peer coaching is effective in minority populations living with diabetes in hard-to-reach, under resourced areas such as the rural South. We examined the effect of an innovative peer coaching intervention plus brief education vs. brief education alone on diabetes outcomes.
Detailed description
The purpose of this project was to provide robust evidence on the effectiveness of a peer support intervention in improving diabetes outcomes by conducting a group-randomized, controlled implementation trial of a volunteer peer support intervention. The study had three specific aims: Aim 1. In Phase I (months 0-8), to perform a qualitative needs assessment with peer advisors and health care providers to inform peer advisor roles and responsibilities (i.e., the intervention) and peer advisor recruitment strategies, curriculum and training; and patient recruitment plans. Aim 2. Also in Phase I, to pilot our collaboratively developed intervention and, based on pilot test results, to recruit and train peer advisors for the intervention, and begin patient recruitment. Aim 3. In Phase II (months 9-32), conduct the group randomized implementation trial and evaluate it using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework.
Interventions
BEHAVIORALENCOURAGE Study
This intervention tested the effects of a peer coaching program plus brief diabetes education versus brief diabetes education alone on diabetes outcomes.
Sponsors
University of Alabama at Birmingham
Weill Medical College of Cornell University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
19 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* 19 or older in age, diagnosed with diabetes, under the care of a doctor
Exclusion criteria
* not community dwelling, less than 19 years old, pregnant, end-stage medical conditions with limited life expectancy, no access to telephone, does not speak english
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| patient activation | change in patient activation in 12 months | self-report using the 13 item Patient Activation Measure (PAM13) |
| LDL cholesterol | Change in LDL cholesterol in 12 month | measured using finger stick, spectrophotometer to measure LDL cholesterol |
| diabetes self-care behaviors questionnaire | Change in diabetes self-care behaviors at 12 months | aspects of diabetes self-management such as taking medications as directed, self-report of exercise, and eating behaviors |
| depressive symptoms | change in depressive symptoms at 12 months | self-report using Patient Health Questionnaire 8 (PHQ8) |
| quality of life | Change in quality of life measures at 12 months | self-report using Short form-1 (SF1), and Euroquol (EQ-5D) |
| Glycated hemoglobin (A1c) | Change in A1c in 12 months | fingerstick, point-of-care a1c test |
| Blood pressure | Change in blood pressure measure in 12 months | Measured using digital automated blood pressure monitor |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| diabetes knowledge | change in diabetes knowledge in 12 months | assessed using the Spoken Knowledge in Low Literacy in Diabetes Scale |
| trust in physicians | change in trust in physicians in 12 months | assessed using the Trust in Physicians Scale |
| composite measure of healthcare utilization | Change in health care utilization in 12 months | self-report by participant, number of times utilized healthcare services |
| body mass index | change in BMI in 12 months | weight measured using digital scale, height measured using stadiometer |
Outcome results
None listed