Development of a health dialogue model for patients with diabetes: A complex intervention in a low-/middle income country

Reid, Marianne; Walsh, Corinna M.; Raubenheimer, Jacques; Bradshaw, Tim; Pienaar, Melanie; Hassan, Charmaine Elizabeth; Nyoni, Champion N.; Roux, Maretha le

doi:10.1016/j.ijans.2018.05.002

Cited by 9 publications

(14 citation statements)

References 31 publications

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“…A systematic review, on the effect of peer support on diabetes outcomes in adults, included 25 studies from high-income countries. The study also found that evidence was too inconsistent to support the endorsement of diabetes peer support [ 14 ]. Similarly, Werfalli et al (2020) conducted a recent systematic review on the effectiveness of peer and CHW-led diabetes self-management programs in LMICs in diabetes care [ 46 ].…”

Section: Discussionmentioning

confidence: 99%

“…This study’s specific focus on face-to-face peer support models was informed by a study on the development of a health dialogue model for patients with diabetes in LMICs [ 14 ]. During this model development, the findings emphasised three areas: the need to improve community awareness regarding diabetes; the use of face-to-face communication, such as peer support, or technological support such as mobile health devices, to promote the self-management of T2D in patients and creating a diabetes training platform for healthcare providers caring for patients with T2D [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Self-management in face-to-face peer support for adults with type 2 diabetes living in low- or middle-income countries: a systematic review

Pienaar

Reid

2020

BMC Public Health

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Background Peer support has been recognised as a promising strategy to improve self-management in patients living with chronic conditions, such as Type 2 diabetes (T2D). The purpose of the review was to synthesise the best available evidence on face-to-face peer support models for adults with T2D in low and middle-income countries (LMICs). Methods We searched Medline, Cumulative Index to Nursing and Allied Health, Literature Academic Search Ultimate, PsycINFO, CAB Abstracts, Health Source: Nursing/Academic Edition, SPORTDiscus, Africa-Wide Information, MasterFILE Premier, SocINDEX, ERIC, PsycARTICLES, Open Dissertations, Communication & Mass Media Complete, Health Source-Consumer Edition and Google Scholar for the period January 2000 to December 2017. Reference list checking and contact with authors were additional sources of data. Screening of papers, critical appraisal and data extraction were carried out independently by at least two reviewers. Results From 3092 abstracts retrieved from database searches, data was extracted from 12 papers. There was no consistency in design, setting, outcomes or measurement instruments amongst the papers. The papers were associated with improvements in various clinical and behavioural outcomes. Diabetic patients and community health workers (CHWs) were identified as two common face-to-face peer support models. The recruitment and selection of diabetic patients as peer supporters focused on patients from the community, with good glycaemic control and/or leadership skills, who were recommended by healthcare professionals. Recruitment of CHWs as peer supporters was done from an existing infrastructure of CHWs in the community and, thus, selection criteria were poorly described. The training of peer supporters featured as an important component, highlighting who provided training and the duration and content covered in training. Motivational interviewing was the most common theory basis of training used in the peer support interventions. Face-to-face, group and/or individual-based peer support was often supplemented by other peer support methods. The supervision of peer supporters was generally poorly described. Conclusions The comprehensive synthesis of the best available evidence has led to new insights regarding face-to-face peer support as a self-management strategy for patients with T2D in LMICs. Face-to-face peer support may be implemented in innovative ways to improve the quality of life of patients with T2D. Trial registration PROSPERO trial registry number, CRD 42018103261.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Self-management in face-to-face peer support for adults with type 2 diabetes living in low- or middle-income countries: a systematic review

Pienaar

Reid

2020

BMC Public Health

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“…During this model development, diabetes-related knowledge and practices of CHWs were found to be moderate and they have a positive attitude towards diabetes. 13 The model, furthermore, highlighted the preference of patients for one-on-one and group-based health communication instead of other forms of communication such as internetbased communication. Patients valued interaction with trained health workers and fellow patients in their own language.…”

Section: Introductionmentioning

confidence: 99%

“…Patients valued interaction with trained health workers and fellow patients in their own language. 13,14 There is substantial literature supporting the positive effects of peer support on diabetes outcomes. 7,15 However, research on peer support programmes in diabetes, suitable for this context, is limited.…”

Section: Introductionmentioning

confidence: 99%

The impact of a face-to-face peer-support intervention on adults with type 2 diabetes: a cluster-randomised trial

Pienaar

Reid

Nel

2021

Journal of Endocrinology, Metabolism and Diabetes of South Afri

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To establish the impact of a face-to-face peer-support intervention on adults with type 2 diabetes in South Africa. Methods: A cluster randomised controlled trial was conducted involving 288 adults with type 2 diabetes from six communities in the Free State province. Individuals (n = 141) in three communities were randomly allocated to the intervention group, and individuals (n = 147) in another three communities were randomly allocated to the control group. Trained community health workers led monthly group sessions and home visits. The control group received the usual care. The primary outcome of the study was glycated haemoglobin (HbA1c), measured at baseline and endpoint after four months. Secondary outcomes included blood pressure, body mass index and waist circumference, measured at baseline and endpoint. Descriptive statistics were calculated per group. Results: No significant changes from baseline were found between groups regarding HbA1c (p = 0.87), body mass index (p = 0.21), waist circumference (p = 0.24) and systolic blood pressure (p = 0.13). Compared with the control group, the intervention group had a significant improvement in diastolic blood pressure (p = 0.02). Conclusions: The face-to-face peer-support intervention delivered by trained community health workers in a semi-urban rural area resulted in a significant improvement in diastolic blood pressure of adults with type 2 diabetes.

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“…Type 2 diabetes mellitus (T2DM) is the leading underlying cause of death in women (7.2%) and second amongst both genders and people of all ages [5]. It is forecasted that by the year 2040, one in every ten adults residing in LMICs will be living with diabetes [6]. Therefore, selfmanagement is an important part of the treatment in Non-Communicable Diseases (NCD) [7] such as diabetes.…”

Section: Introductionmentioning

confidence: 99%

Barriers for User Acceptance of Mobile Health Applications for Diabetic Patients: Applying the UTAUT Model

Petersen

Jacobs

Pather

2020

Lecture Notes in Computer Science

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The literature illustrates that technology will widen health disparity if its use is restricted to patients who are already motivated and demonstrate good self-management behaviours. Additionally, despite the availability of free mobile health (m-health) applications for diabetes self-management, usage is low. There are also limited studies of m-health acceptance in South Africa. This research is delineated to the Western Cape, South Africa. The populace suffers from increasing numbers of diabetic patients. Segments of the population also suffer from technological forms of exclusion, such as limited internet access. Therefore, the objective of this study was to identify challenges for user acceptance that discourages the use of m-health applications. This study analysed 130 semi-structured interviews, using thematic content analysis. Respondents were predominantly female with type 2 diabetes, older than 50, residing in the Western Cape. It used key constructs from the Unified Theory of Acceptance and Use of Technology (UTAUT) model. The results confirmed that all four UTAUT constructs; performance expectancy ("the degree to which an individual believes that using the system will help him or her to attain gains in performance"), effort expectancy ("the degree of ease associated with the use of the system", social influence ("the degree to which an individual perceives that important others believe he or she should use the new system") and facilitating conditions ("the degree to which an individual believes that an organisational and technical infrastructure exists to support the use of the system"), explains the challenges for m-health acceptance in low socio-economic areas. Factors such as technology anxiety, resistance to change and a lack of trust in the use of devices for self-management need to be considered when implementing future interventions.

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Development of a health dialogue model for patients with diabetes: A complex intervention in a low-/middle income country

Cited by 9 publications

References 31 publications

Self-management in face-to-face peer support for adults with type 2 diabetes living in low- or middle-income countries: a systematic review

Self-management in face-to-face peer support for adults with type 2 diabetes living in low- or middle-income countries: a systematic review

The impact of a face-to-face peer-support intervention on adults with type 2 diabetes: a cluster-randomised trial

Barriers for User Acceptance of Mobile Health Applications for Diabetic Patients: Applying the UTAUT Model

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