Peer advisers compared with specialist health professionals in delivering a training programme on self‐management to people with diabetes: a randomized controlled trial

Abstract

Aims To assess the effectiveness and acceptability of peer advisers in diabetes in delivering a programme of training on self-management for people with diabetes.Methods Adults with diabetes were randomly allocated to an education programme delivered either by trained peer advisers or by specialist health professionals. The primary outcome measure was change in knowledge tested before and at the conclusion of the four courses, each consisting of six sessions. Glycated haemoglobin and Diabetes Care Profile were assessed at baseline and at 6 months. Sessional and end-of-course evaluation responses were analysed, as was the attendance record.Results Eighty-three patients were randomized. Of these, 14 failed to attend and two were excluded. Knowledge scores improved significantly in both groups, but there was no difference between the groups for any of the knowledge domains. No difference was noted in the Diabetes Care Profiles or in glycated haemoglobin. The attendance record was similar in both groups. In the post-sessional evaluations, both groups scored highly, with the health professionals significantly more so. The post-course questionnaire exploring patients' understanding and confidence in self-management of specific aspects of diabetes care revealed no difference between the groups.Conclusions Trained patients are as effective in imparting knowledge to their peers as specialist health professionals. Both are also acceptable to patients as trainers. However, lay tutors require to be given appropriate training, specific to the education programme they would be expected to deliver.

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.…”

“…During the past decade, there has been a proliferation of research examining the feasibility, acceptability, and health-related impact of peer support interventions in the context of diabetes care. [3][4][5][6][7][8][9][10][11][12][13][14] Based on a review of peer support interventions for patients with diabetes, Heisler 15,16 identified five models of peer support, including 1) face-to-face group self-management programs, 2) peer coaches or mentors, 3) community health workers (CHWs), 4) telephone-based peer support, and 5) Internet or e-mail-based peer support.…”

Patients’ beliefs on the impediments to good diabetes control: a mixed methods study of patients in general practice

“…21,22 There is strong evidence that motivational interviewing can facilitate lifestyle change. [23][24][25] It appears from this study that there is a need for increased provision of such services because a few minutes with a GP or practice nurse a few times a year is insufficient to address the habitual behaviours that contribute to the condition.…”

Peer support: time to tap the (largely) untapped

“…peer advisors in the Isle of Wight). 8 The questions that come to the fore are: 'Does peer support make a difference to the person, to their diabetes and to health services?' and 'Is there a potential for peer support to help us deal with the diabetes epidemic?'…”