What Peer Mentoring Adds to Already Good Patient Care: Implementing the Carpeta Roja Peer Mentoring Program in a Well-Resourced Health Care System

Abstract

PURPOSE The purpose of this study was to evaluate the impact of a peer support program on the health outcomes of patients already receiving well-organized, comprehensive diabetes care. METHODS We used a mixed-methods, nonrandomized, control-group design to evaluate the impact of a peer-mentoring program on the health outcomes and self-management behaviors of adults with type 2 diabetes in 15 primary care practices in San Antonio. Propensity score analysis, t-tests, and multivariable repeated analyses were used to evaluate impact. Qualitative interviews were conducted with 15 participants in the intervention group and analyzed using a grounded theory approach. RESULTS Both intervention and control groups showed significant improvement on all health indicators from baseline to 6-month follow-up (P <.001). Hemo-globin A 1c (HbA 1c) decreased slightly faster for patients in the intervention group (P = .04). Self-management behaviors improved significantly from baseline to 6-month follow-up for the intervention group. Interviewed participants also reported reductions in social isolation and extension of impact of health behavior changes to multiple generations of family members. CONCLUSIONS The addition of peer mentoring to already well-organized comprehensive diabetes care does not improve outcomes. However, findings suggest that the impact of the program extends to members of the participants' families, which is an intriguing finding that deserves further study.

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

“…Key findings curated by Peers for Progress and reported by papers in this supplement [35][36][37][38][39][40][41] help to guide these efforts.…”

“…After its own initial appraisal of 15 sites, Texas-based WellMed extended its peer support program to all 23 of the clinical sites in its network. 36 In Clínicas de Salud del Pueblo in southern California, the Puentes hacia una major vida program for adults with diabetes was used as a model for addressing childhood obesity and helped to guide changes to the clinics' system of care, including provider training and EHR changes to ensure documentation of peer support.…”

“…All participants were offered diabetes education, but those who participated in peer mentoring as well showed more rapid improvement in glycemic control and also reported reductions in social isolation and the extension of benefits to their families. 36 Using the PCMH as a base for peer support was the focus of a collaboration of Peers for Progress with the National Council of La Raza, TransforMED, and Alivio Medical Center, a federally qualified health center serving predominantly Latinos in Chicago. The program, Compañeros en Salud, was closely coordinated with clinical teams, providing individualized as well as group patient education and support.…”

Perceived Significance of Engagement in Research Prioritization Among Chronic Kidney Disease Patients, Caregivers, and Health Care Professionals: A Qualitative Study

“…Peer mentorship can help establish connections among individuals with relatable experiences and positively impact patients’ adjustment to living with chronic disease. 27 , 28 Formalized peer support may improve goal setting, decision making, and self-management for those on or nearing dialysis. 29 However, in the absence of opportunities for peer interaction for those with nondialysis CKD, patients in our study identified research engagement as a way of addressing their perceived lack of community.…”

Cardiovascular risk outcome and program evaluation of a cluster randomised controlled trial of a community-based, lay peer led program for people with diabetes

“…Interestingly those projects conducted in populations with better access to either privately or publicly funded health care did not appear to benefit significantly with respect to clinical health outcomes from additional peer support [11, 15, 22]. …”