Experiences in peer-to-peer training in diabetes mellitus: challenges and implications

Abstract

This paper briefly describes the functions of peer advisers in diabetes (PADs) and their training. The formal process used in the assessment of the peer advisers at the completion of the training courses is also stated. The findings of a recent randomized controlled trial to study the effectiveness of peer advisers in delivering a programme of education on self-management are also described. The experience gained after the completion of four courses for the training of peer advisers, in addition to a review of the literature, forms the basis for discussion of the subject of peer-to-peer support activities in diabetes. PADs are effective in the provision of one-to-one psychosocial support and advice on self-management. They are also effective as committee members and advocates for diabetes. More recently, they have been shown to be effective as teachers on self-management to their peers with diabetes. With the imminent explosion in the number of people with diabetes, there will be increased need for psychosocial support and in the requirement for the provision of education on self-management. It is unlikely that health services would be given sufficient resources to cope with this. Society should identify alternative resources. People with diabetes and their close carers are the obvious choice, and we need to commence their training now. The implications for primary care are discussed.

Effectiveness of community-based peer-led diabetes self-management programmes (COMP-DSMP) for improving clinical outcomes and quality of life of adults with diabetes in primary care settings in low and middle-income countries (LMIC): a systematic review and meta-analysis

“…In many instances, the former appear to be preferred. [10][11][12][13][14][15][16][17][18][19] However, there is growing interest in the use of community health workers (CHWs) as an approach for improving the health of people and communities that recognise the impact of a person's and a community's peer network in health activities. 20 CHWs are considered as peers because they have close relations to the community from which the patients originate and often share the same language and culture; they can provide the 'context specific' support and the reciprocal exchange of information for creating lifestyle changes, and they bridge the cultural gap between the person with diabetes and his health.…”

A Review of Volunteer-Based Peer Support Interventions in Diabetes

“…[3][4][5][6][7][8][9][10][11][12][13][14][33][34][35][36] The 12 interventions included seven RCTs, four studies using a pre-/postdesign, 6,8,10,13 and one study using nonrandomized allocation of intervention and comparison groups. 14 Intervention delivery Face-to-face, group-based programs.…”

Reducing resistance to treatment, through group intervention, improves clinical measurements in patients with type 2 diabetes

“…Although Therapeutic Patient Education (TPE), for people with diabetes can be undertaken on an individual level, by a healthcare provider such as a nurse [10], dietician or a physician, by peer groups [11] or electronic remote learning [12], NICE has recommended that diabetes education should be provided by an appropriately qualified multidisciplinary teams to groups of people with the disease. Over time, the emphasis in these educational programs has shifted from a didactic approach to patient empowerment approaches [10] and it is clear now that programs incorporating behavioral and psychosocial strategies with or without ethnic and cultural adaptation have demonstrated improved outcomes [11-13].…”