Intervention Mapping as a Guide for the Development of a Diabetes Peer Support Intervention in Rural Alabama

Abstract

IntroductionPeer support is a promising strategy for the reduction of diabetes-related health disparities; however, few studies describe the development of such strategies in enough detail to allow for replication. The objective of this article is to describe the development of a 1-year peer support intervention to improve diabetes self-management among African American adults with diabetes in Alabama's Black Belt.MethodsWe used principles of intervention mapping, including literature review, interviews with key informants, and a discussion group with community health workers, to guide intervention development. Qualitative data were combined with behavioral constructs and principles of diabetes self-management to create a peer support intervention to be delivered by trained peer advisors. Feedback from a 1-month pilot was used to modify the training and intervention.ResultsThe resulting intervention includes a 2-day training for peer advisors, who were each paired with 3 to 6 clients. A one-on-one in-person needs assessment begins an intensive intervention phase conducted via telephone for 8 to 12 weeks, followed by a maintenance phase of at least once monthly contacts for the remainder of the intervention period. A peer support network and process measures collected monthly throughout the study supplement formal data collection points at baseline, 6 months, and 12 months.DiscussionIntervention mapping provided a useful framework for the development of culturally relevant diabetes peer support intervention for African Americans living in Alabama's Black Belt. The process described could be implemented by others in public health to develop or adapt programs suitable for their particular community or context.

Using an intervention mapping approach for planning, implementing and assessing a community-led project towards malaria elimination in the Eastern Province of Rwanda

“…The use of IM approach in MEPR guided the process of interventions development based on theory and local context to respond to community needs [17, 52]. IM also guided the ecological perspective adopted by MEPR—encompassing both personal and environmental determinants of malaria during project interventions [9].…”

Peer Coaches to Improve Diabetes Outcomes in Rural Alabama: A Cluster Randomized Trial

“…Details of engagement, recruitment and intervention development are reported elsewhere. [17][18][19] Briefly, adults who had been told by a doctor or nurse they had diabetes and who wanted help with self-management were eligible to participate. Individuals were excluded from participation if they did not have a primary care provider, had advanced illness with limited life expectancy, planned to move out of the area within the next year, or were unwilling to work with a peer coach over the telephone.…”

The utilization of video-conference shared medical appointments in rural diabetes care

“…Yet, the spread and access to these services are limited in rural areas due to lack of healthcare specialists and skill sets to conduct SMA's [23][24][25] . The challenges of health-care delivery in rural areas are social and geographic isolation, limited access to multi-disciplinary expertise, lack of decision support and inter-professional exchange for the local providers 11,23,24,26 .…”

“…The challenges of health-care delivery in rural areas are social and geographic isolation, limited access to multi-disciplinary expertise, lack of decision support and inter-professional exchange for the local providers 11,23,24,26 . These sociogeographic barriers may be overcome by video-teleconferencing technology for real-time SMA (video-SMAs) between a distant provider and the local patients.…”