Effects of a Self-efficacy Theory–Based Training Program for Peers of Patients with Type 2 Diabetes

Abstract

Background Training peer leaders to deliver patient education is expected to be a low-cost approach to providing healthcare in urban-poor areas affected by a shortage of healthcare professionals. The purpose of this study was to examine the effects of a training program on the self-efficacy and knowledge of peer leaders with type 2 diabetes. Methods A single-group longitudinal survey with baseline, intervention, and follow-up periods was conducted at a diabetes clinic in a small municipality in Metro Manila, Philippines. The intervention, a selfefficacy theory-based training program for peer-leaders of diabetic patients conducted in August 2017, comprised hands-on learning, demonstrations, quizzes, roleplaying, group sharing, physical exercise, and a buffet lunch. The primary outcome was participants' selfefficacy for management of their diabetes. Secondary outcomes were participants' knowledge of diabetes and levels of emotional distress, motivation, and confidence for guiding their peers, satisfaction with the training program, hemoglobin A1c, and quality of life. Results At 12 and 18 months after the intervention, participants' knowledge of diabetes was significantly increased compared with baseline (both P < 0.05). At earlier time points, an increasing, but not significant, trend was observed. The change in knowledge of diabetes from baseline to 18 months after intervention tended to be positively correlated with the change in self-efficacy (r = 0.594, P = 0.054). No significant differences were observed for any of the other outcomes, although the descriptive statistics showed an increasing trend for all of the outcomes except motivation. ConclusionThe training program significantly improved participants' knowledge of diabetes at 12 and 18 months after the training programs compared with baseline. A positive correlation between the changes in the levels of knowledge and self-efficacy suggested that the observed improvement of self-efficacy was facilitated by the improvement of knowledge of diabetes.

The Effect of Educational Program on Pain Management, Self-Efficacy Behavior, and Quality of Life among Adult Diabetic Patients with Peripheral Neuropathy Pain: A Randomized Controlled Trial

“…The achievement of the present study intervention program in enhancing the self-efficacy behaviors of adult patients with PDPN can be attributed to the self-efficacy enhancement resulting from the educational intervention, including self-management activities such as adherence to the medication regime, foot care, blood glucose testing, and regular follow-up, and preventive strategies against complications. The effectiveness of the educational intervention on improving self-efficacy behaviors among adult patients with T2DM has also been reported by Aminuddin et al, [26], Goodall et al, [27], Hailu et al, [30], ElGerges et al, [31], Qasim et al, [32], Chan et al, [33], Wong et al, [34], Tanimura et al, [35], and Tay et al, [36].…”

Cognitive and Emotional Changes in Peer Educators of Type 2 Diabetes Patients After Starting Peer-Support Activities

“…Immediately before the first interview (August 2017), the peer educators received a health checkup to determine the status of their own diabetes, as well as a 2-day training course on DSME that we provided with the support of health professionals in the municipality. 13 We informed the peer educators of the results of their checkups in individual followup consultations in November 2017. The training was based on previously reported DSME 16 and the ARCS model, which includes the four factors that promote and sustain motivation during learning, namely, attention (interest), relevance, confidence, and satisfaction.…”

“…Therefore, to ensure that peer educators continue to run such programs for diabetes patients, it is important that they receive continuous motivation and have the confidence (i.e., a belief in their own abilities) to run them. 12 In a quantitative analysis, Tanimura et al 13 measured the motivation and confidence of Filipino peer educators via the responses given to two multiple-choice questions, each of which had 10 answers, about the "value of educating other patients" and "confidence in educating other patients about diabetes"; however, they found that the scores of these two indicators did not change significantly during the 18 months after the peer educators received a 2-day training course. Yonekura 14 used two 4-point scales about the "value of peer support for patients" and "peereducators' own growth through peer support" to evaluate the motivation and confidence of peer educators who were supporting Japanese patients with chronic diseases; the validity of the satisfaction scale that they developed, which included the two 4-point scales, was confirmed.…”

Reasons for non-participation in a self-care training program for diabetic patients: a qualitative study

“…It has been clarified that success or failure in any training scheme depends on individuals’ fundamental beliefs and attitudes [ 10 ]. Most studies conducted on self-care schemes assessed the effects of training programs on enabling and behavior change in diabetic patients [ 11 – 16 ]; few studies have been examined the effective factors in patients’ non-participation in self-care schemes from the point of view of those who have abandoned self-care schemes [ 10 , 17 ]. However, both previous studies were conducted in developed countries (Canada and Germany) [ 10 , 17 ].…”