It is unclear whether peer coaching is effective in minority populations living with diabetes in hard-to-reach, under resourced areas such as the rural South. We examined the effect of an innovative peer coaching intervention plus brief education vs. brief education alone on diabetes outcomes.
The purpose of this project was to provide robust evidence on the effectiveness of a peer support intervention in improving diabetes outcomes by conducting a group-randomized, controlled implementation trial of a volunteer peer support intervention. The study had three specific aims: Aim 1. In Phase I (months 0-8), to perform a qualitative needs assessment with peer advisors and health care providers to inform peer advisor roles and responsibilities (i.e., the intervention) and peer advisor recruitment strategies, curriculum and training; and patient recruitment plans. Aim 2. Also in Phase I, to pilot our collaboratively developed intervention and, based on pilot test results, to recruit and train peer advisors for the intervention, and begin patient recruitment. Aim 3. In Phase II (months 9-32), conduct the group randomized implementation trial and evaluate it using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
424
This intervention tested the effects of a peer coaching program plus brief diabetes education versus brief diabetes education alone on diabetes outcomes.
Glycated hemoglobin (A1c)
fingerstick, point-of-care a1c test
Time frame: Change in A1c in 12 months
Blood pressure
Measured using digital automated blood pressure monitor
Time frame: Change in blood pressure measure in 12 months
LDL cholesterol
measured using finger stick, spectrophotometer to measure LDL cholesterol
Time frame: Change in LDL cholesterol in 12 month
diabetes self-care behaviors questionnaire
aspects of diabetes self-management such as taking medications as directed, self-report of exercise, and eating behaviors
Time frame: Change in diabetes self-care behaviors at 12 months
depressive symptoms
self-report using Patient Health Questionnaire 8 (PHQ8)
Time frame: change in depressive symptoms at 12 months
quality of life
self-report using Short form-1 (SF1), and Euroquol (EQ-5D)
Time frame: Change in quality of life measures at 12 months
patient activation
self-report using the 13 item Patient Activation Measure (PAM13)
Time frame: change in patient activation in 12 months
body mass index
weight measured using digital scale, height measured using stadiometer
Time frame: change in BMI in 12 months
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diabetes knowledge
assessed using the Spoken Knowledge in Low Literacy in Diabetes Scale
Time frame: change in diabetes knowledge in 12 months
trust in physicians
assessed using the Trust in Physicians Scale
Time frame: change in trust in physicians in 12 months
composite measure of healthcare utilization
self-report by participant, number of times utilized healthcare services
Time frame: Change in health care utilization in 12 months