Peer Coaching to Improve Diabetes Self-Management: Which Patients Benefit Most?

Moskowitz, David; Thom, David H.; Hessler, Danielle; Ghorob, Amireh; Bodenheimer, Thomas

doi:10.1007/s11606-013-2367-7

Cited by 79 publications

(75 citation statements)

References 29 publications

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“…PS led to greater reductions in HbA1c than did controls across all groups, but the differential impact of PS was greatest among those initially in the low adherence group (68). In the dyadic support intervention among veterans with diabetes, described above (53), improvements in blood glucose measures were especially pronounced among those with low initial levels of diabetes support ( p for interaction < 0.001) and among those with low health literacy ( p for interaction < 0.05) (77).…”

Section: Reaching the "Hardly Reached"mentioning

confidence: 82%

Peer Support in Health Care and Prevention: Cultural, Organizational, and Dissemination Issues

Fisher

Coufal²,

Parada³

et al. 2014

Annu. Rev. Public Health

104

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As reviewed in the article by Perry and colleagues (2014) in this volume, ample evidence has documented the contributions of peer support (PS) to health, health care, and prevention. Building on that foundation, this article discusses characteristics, contexts, and dissemination of PS, including (a) fundamental aspects of the social support that is often central to it; (b) cultural influences and ways PS can be tailored to specific groups; (c) key features of PS and the importance of ongoing support and backup of peer supporters and other factors related to its success; (d ) directions in which PS can be expanded beyond prevention and chronic disease management, such as in mental health or interventions to prevent rehospitalization; (e) other opportunities through the US Affordable Care Act, such as through patientcentered medical homes and chronic health homes; and ( f ) organizational and policy issues that will govern its dissemination. All these demonstrate the extent to which PS needs to reflect its contexts-intended audience, health problems, organizational and cultural settings-and, thus, the importance of dissemination policies that lead to flexible response to contexts rather than constraint by overly prescriptive guidelines.

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Section: Reaching the "Hardly Reached"mentioning

confidence: 82%

Peer Support in Health Care and Prevention: Cultural, Organizational, and Dissemination Issues

Fisher

Coufal²,

Parada³

et al. 2014

Annu. Rev. Public Health

104

View full text Add to dashboard Cite

show abstract

“…The greatest differential benefit of peer support relative to usual care control was among those categorized as low on medication adherence or self management. 31 In a peer support intervention for diabetes management among ethnic minority patients of safety-net clinics in San Francisco, 17 participants were categorized at baseline as low, medium or high on medication adherence and on self management.…”

Section: S3 a Practical Functional Definition For Disseminationmentioning

confidence: 99%

Contributions of Peer Support to Health, Health Care, and Prevention: Papers from Peers for Progress

Fisher

Ayala

Ibarra

et al. 2015

The Annals of Family Medicine

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SUBSTANTIAL evidence documents the benefits of peer support provided by community health workers, lay health advisors, promotores de salud, and others. The papers in this supplement, all supported by the Peers for Progress program of the American Academy of Family Physicians Foundation, contribute to the growing body of literature addressing the efficacy, effectiveness, feasibility, reach, sustainability, and adoption of peer support for diabetes self-management. They and additional papers supported by Peers for Progress contribute to understanding how peer support can be implemented in real world settings. Topics include examination of the peers who provide peer support, reaching the hardly reached, success factors in peer support interventions, proactive approaches, attention to emotions, peer support in behavioral health, dissemination models and their application in China, peer support in the patient-centered medical home, research challenges, and policy implications.

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“…A previous subgroup analysis and secondary analysis of RCTs showed that peer support interventions for patients with diabetes are most effective for those having poor self-management skills, poor baseline diabetes support, and lower levels of health literacy. 40,41 Further innovative studies of interventions that sustain self-management behaviors in white non-Hispanic populations targeting high-risk groups with the above-noted characteristics need to be done.…”

Section: Discussionmentioning

confidence: 99%

Peer Support Interventions for Adults With Diabetes: A Meta-Analysis of Hemoglobin A1c Outcomes

Patil

Ruppar

Koopman

et al. 2016

The Annals of Family Medicine

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PURPOSE Peer support intervention trials have shown varying effects on glycemic control. We aimed to estimate the effect of peer support interventions delivered by people affected by diabetes (those with the disease or a caregiver) on hemoglobin A 1c (HbA 1c ) levels in adults. METHODSWe searched multiple databases from 1960 to November 2015, including Ovid MEDLINE, the Cochrane Central Register of Controlled Trials, CINAHL, and Scopus. We included randomized controlled trials (RCTs) of adults with diabetes receiving peer support interventions compared with otherwise similar care. Seventeen of 205 retrieved studies were eligible for inclusion. Quality was assessed with the Cochrane risk of bias tool. We calculated the standardized mean difference (SMD) of change in HbA 1c level from baseline between groups using a random effects model. Subgroup analyses were predefined.RESULTS Seventeen studies (3 cluster RCTs, 14 RCTs) with 4,715 participants showed an improvement in pooled HbA 1c level with an SMD of 0.121 (95% CI, 0.026-0.217; P = .01; I 2 = 60.66%) in the peer support intervention group compared with the control group; this difference translated to an improvement in HbA 1c level of 0.24% (95% CI, 0.05%-0.43%). Peer support interventions showed an HbA 1c improvement of 0.48% (95% CI, 0.25%-0.70%; P <.001; I 2 = 17.12%) in the subset of studies with predominantly Hispanic participants and 0.53% (95% CI, 0.32%-0.73%; P <.001; I 2 = 9.24%) in the subset of studies with predominantly minority participants; both were clinically relevant. In sensitivity analysis excluding cluster RCTs, the overall effect size changed little. CONCLUSIONSPeer support interventions for diabetes overall achieved a statistically significant but minor improvement in HbA 1c levels. These interventions may, however, be particularly effective in improving glycemic control for people from minority groups, especially those of Hispanic ethnicity. Ann Fam Med 2016;14:540-551. doi: 10.1370/afm.1982. INTRODUCTIONT he global burden of diabetes is expected to increase from 381.8 million people affected in 2013 to an estimated 591.9 million by 2035.1 Despite increasing evidence of benefits from self-management education, only 5% of Medicare-insured and 7% of privately insured people with diabetes receive this intervention within 1 year of diagnosis. [2][3][4] Diabetes self-management education improves hemoglobin A 1c (HbA 1c ) levels, and longer duration of education further lowers levels; however, the benefits decline 1 to 3 months after education ends. 5 The World Health Organization (WHO) has stated that peer support appears to be a promising approach to improving and sustaining diabetes self-management behaviors. 6 Randomized controlled trials (RCTs) using peer support interventions delivered by people affected by diabetes have shown varying results on glycemic control, however. A 2012 narrative review examined the effect of peer support interventions on diabetes outcomes, but several additional studies with these interventions have b...

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Peer Coaching to Improve Diabetes Self-Management: Which Patients Benefit Most?

Cited by 79 publications

References 29 publications

Peer Support in Health Care and Prevention: Cultural, Organizational, and Dissemination Issues

Peer Support in Health Care and Prevention: Cultural, Organizational, and Dissemination Issues

Contributions of Peer Support to Health, Health Care, and Prevention: Papers from Peers for Progress

Peer Support Interventions for Adults With Diabetes: A Meta-Analysis of Hemoglobin A1c Outcomes

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