Background
This review seeks to identify (a) the various components and process outcomes of type 2 diabetes peer support (PS) interventions and (b) the measures implemented to monitor intervention fidelity and evaluate outcomes in these studies.
Methods
The MEDLINE, PubMed, EMBASE (Excerpta Medica Database), CENTRAL (Cochrane Central Register of Controlled Trials), CINAHL (Cumulative Index to Nursing and Allied Health Literature), and PsycINFO databases were searched from inception to May 2019. Two reviewers independently screened and extracted data from eligible articles via the Template for Intervention Description and Replication (TIDieR) checklist (why, what, who provided, how, where, when and how much, tailoring, modifications, and how well).
Results
Twenty‐three trials were included. The total number of participants was 7178. Most interventions were in primary care. Although face‐to‐face was the most common modality of contact, rates of contact were highest for telephone. Potential peer leaders (PLs) were identified primarily through recommendations from health professionals, based on their communication skills, glycosylated hemoglobin (HbA1c), and coaching interest. PLs were mostly female, university educated, and had a long history of diabetes (≥ 10 years). PL training varied significantly in length and content; the two most frequent topics were communication skills and diabetes knowledge. Although several studies implemented methods to evaluate “intervention fidelity,” only few rigorously assessed the two key components of fidelity, “adherence” and “competence,” through audio‐ and video‐taping or direct observations.
Conclusions
The impact of PS on participants' health outcomes is well investigated; however, the implementation and evaluation strategies vary significantly across these studies. In the present review, we define the various components of PS interventions and propose suggestions for enhancing the implementation and evaluation of future PS models.
Objective
To explore the experiences of peer leaders with respect to delivering core components of a 12‐month, telephone‐based peer support intervention in type 2 diabetes within a tertiary‐care setting.
Methods
Seventeen peer leaders were recruited and interviewed. Interviews lasted approximately 20 to 45 min, were audio‐taped, and transcribed verbatim. The transcripts were analysed by two team members using the qualitative descriptive approach.
Findings
Peer leaders reported mutually beneficial and reciprocal relationships with participants. They encountered challenges in maintaining regular contact with participants and in motivating them to make lifestyle changes. To improve the programme, peer leaders suggested having more frequent – but shorter – training sessions and reducing the diabetes education component of the training programme. To enhance the intervention fidelity and retention rate, they recommended matching peer leaders to participants on more meaningful variables (e.g. diabetes‐related commonalities, personality, life experiences, etc.) beyond just gender, geographic proximity and availability. They also requested more frequent face‐to‐face contacts with participants (Modality of Contact), and additional ongoing support from the research team.
Conclusion
Peer leaders were satisfied with the intervention design. However, future studies may consider more comprehensive peer leader‐matching algorithms and increased opportunities for in‐person communication modalities.
ClinicalTrials.gov Identifier: NCT02804620.
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