Peer mentors have been proven to improve diabetes outcomes, especially among diverse patients. Delivering peer mentoring via remote strategies (phone, text, mobile applications) is critical, especially in light of the recent pandemic. We conducted a real-world evaluation of a remote diabetes intervention in a safety-net delivery system in New York. We summarized the uptake, content, and pre-post clinical effectiveness for English- and Spanish-speaking participants. Of patients who could be reached, 71% (n = 690/974) were enrolled, and 90% of those (n = 618/690) participated in coaching. Patients and mentors had a mean of 32 check-ins, and each patient set an average of 10 goals. 29% of the participants accessed the program via the smartphone application. Among participants with complete hemoglobin A1c data (n = 179), there was an absolute 1.71% reduction (P < .01). There are multiple lessons for successful implementation of remote peer coaching into settings serving diverse patients, including meaningful patient-mentor matching and addressing social determinants.
Introduction:
Disparities in access to care coupled with chronic conditions that represent 70% of healthcare spending, highlight the importance of accessible support beyond in-person primary care. In this study, we assessed the feasibility of a virtual peer mentoring program, in which individuals who have successfully managed to live with hypertension serve as peer mentors to individuals with the same condition. We measured clinical improvement through possible blood pressure (BP) reductions as well as program engagement and satisfaction among study participants.
Methods:
The study consisted of 451 participants enrolled in a Medicare Advantage plan with hypertension and/or a recent systolic BP reading ≥140 mmHg. Participants were matched with a peer mentor and provided with virtual one-on-one engagement based on their hypertension management challenges. The program was defined as feasible if the average monthly engagement rate over the 6-month study period was at least 70%. A one-sample proportion test was used to determine feasibility and the Wilcoxon signed rank test assessed changes in BP between the first month and the sixth month after enrollment. Descriptive statistics were generated from the exit survey upon program completion.
Results:
The average monthly engagement rate was greater than 70% (p < 0.001), indicating program feasibility. 116 individuals (25.7%) had a baseline systolic BP ≥ 140 mmHg, or diastolic BP ≥ 90 mmHg with both first and sixth month BP data. In this cohort, we found statistically significant median reductions in systolic BP >5 mmHg (-7.5 mmHg; p=0.003) as well as diastolic BP (-3.9 mmHg; p<0.001). The program received high satisfaction with a net promoter score of 79.
Conclusion:
This study showed a virtual peer mentoring program for individuals with hypertension is feasible. Both systolic and diastolic BP improved in the peer-matched group suggesting a beneficial intervention. In addition, the exit survey responses indicated satisfactory and positive experiences in this peer mentoring program.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.