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Randomized Controlled Trial
. 2018 Feb 17;18(1):262.
doi: 10.1186/s12889-018-5148-8.

Peer support to improve diabetes care: an implementation evaluation of the Australasian Peers for Progress Diabetes Program

Zahra Aziz  1   2 , Michaela A Riddell  3   4 , Pilvikki Absetz  5   6 , Margaret Brand  3 , Brian Oldenburg  7   3 ; Australasian Peers for Progress Diabetes Project Investigators
Collaborators, Affiliations
Randomized Controlled Trial

Peer support to improve diabetes care: an implementation evaluation of the Australasian Peers for Progress Diabetes Program

Zahra Aziz et al. BMC Public Health. .

Abstract

Background: Several studies have now demonstrated the benefits of peer support in promoting diabetes control. The aim of this study is to evaluate the implementation of a cluster randomised controlled trial of a group-based, peer support program to improve diabetes self-management and thereby, diabetes control in people with Type 2 Diabetes in Victoria, Australia.

Methods: The intervention program was designed to address four key peer support functions i.e. 1) assistance in daily management, 2) social and emotional support, 3) regular linkage to clinical care, and 4) ongoing and sustained support to assist with the lifelong needs of diabetes self-care management. The intervention participants attended monthly group meetings facilitated by a trained peer leader for 12 months. Data was collected on the intervention's reach, participation, implementation fidelity, groups' effectiveness and participants' perceived support and satisfaction with the intervention. The RE-AIM and PIPE frameworks were used to guide this evaluation.

Results: The trial reached a high proportion (79%) of its target population through mailed invitations. Out of a total of 441 eligible individuals, 273 (61.9%) were willing to participate. The intervention fidelity was high (92.7%). The proportion of successful participants who demonstrated a reduction in 5 years cardiovascular disease risk score was 65.1 and 44.8% in the intervention and control arm respectively. Ninety-four percent (94%) of the intervention participants stated that the program helped them manage their diabetes on a day to day basis. Overall, attending monthly group meetings provided 'a lot of support' to 57% and 'moderate' support to 34% of the participants.

Conclusion: Peer support programs are feasible, acceptable and can be used to supplement treatment for patients motivated to improve behaviours related to diabetes. However, program planners need to focus on the participation component in designing future programs. The use of two evaluation frameworks allowed a comprehensive evaluation of the trial from the provider-, participant- and public health perspective. The learnings gained from this evaluation will guide and improve future implementation by improving program feasibility for adoption and acceptability among participants, and will ultimately increase the likelihood of program effectiveness for the participants.

Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12609000469213 . Registered 16 June 2009.

Keywords: Implementation evaluation; PIPE impact metric; Participant-level factors; Peer support; Provider-level factors; Public health impact; RE-AIM framework; Self-management; Type 2 diabetes.

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Conflict of interest statement

Authors’ information

Zahra Aziz, MPH is a PhD candidate in the School of Population and Global Health, University of Melbourne in Australia. Her PhD aims to investigates the factors that influence the implementation and transferability of socio-behavioural interventions for the prevention and management of T2DM by identifying the key success factors required to improve their uptake in real-world settings. She has designed the evaluation logic model for PfP-DP and led this implementation evaluation. Before commencing her PhD, she has worked as a researcher and program evaluation specialist in Australia and Pakistan. She has also completed a Master of Public Health degree from the University of Melbourne, Australia.

Michaela A Riddell, PhD is an Adjunct Senior Research Fellow at the School of Clinical Sciences at Monash Health. Michaela along with Peers for Progress Investigators designed the Peers for Progress study, conceptualized, managed and supervised collection of data. As the Aust PfP-DP project manager, she contributed to the training of peer leaders and their ongoing support through weekly teleconferences and regular email contact. She assisted in the design of baseline & outcome surveys and process evaluation surveys. She contributed to preliminary data cleaning and submission of data to the Peers for Progress consensus database.

Twitter:@micriddell.

ORCID ID: orcid.org/0000-0001-8852-0569

Pilvikki Absetz PhD is a Research Director at the University of Eastern Finland, Department of Public Health and Clinical Nutrition, and an Adjunct Professor of Health Promotion at University of Tampere, Faculty of Social Sciences, Finland. She is a behavioural scientist and a global expert in lifestyle interventions in prevention and management of type 2 diabetes and other chronic conditions. She contributed to the planning of the PfP-DP intervention program, and the evaluation framework and measures, as well as to the interpretation of findings and writing of this manuscript.

Margaret Brand B.Ec & Acc, MPH Margaret has worked at Monash University for the past 9 years in numerous research roles. She is currently working with the Cancer Research Program at Monash University as the Research Coordinator for the Victorian Lung Cancer Registry (VLCR). In her current position, Margaret is responsible for coordinating data collection from hospital sites within VLCR, including operations, infrastructure, resources and regulatory compliance. In this position, Margaret is responsible for management of data collection staff, management of the VLCR database and producing reports for stakeholders.

Brian Oldenburg PhD is Professor and Chair of Non-Communicable Disease Control in the School of Population and Global Health, University of Melbourne, Australia. He is a behavioural scientist and an expert in the prevention and control of chronic conditions. His research program focuses on improving the prevention and control of cardiometabolic conditions such as diabetes, heart disease, and their co-morbidities in Australia and other countries.

Ethics approval and consent to participate

The study received ethics approval from the Monash University Human Research Ethics Committee (MUHREC) Project number CF09/1692 –2009000920. Participants were given a detailed participant information sheet after which written informed consent from all participants was obtained.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Logic model for PfP-DP evaluation design
See this image and copyright information in PMC

References

    1. UN General Assembly Resolution 66/2 . Sixty-sixth session of the United Nations general assembly. New York: United Nations; 2011. Political declaration of the high-level meeting of the general assembly on the prevention and control of noncommunicable diseases.
    1. Murray CJ, Barber RM, Foreman KJ, Abbasoglu Ozgoren A, et al. Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990-2013: quantifying the epidemiological transition. Lancet. 2015;386(10009):2145–2191. doi: 10.1016/S0140-6736(15)61340-X. - DOI - PMC - PubMed
    1. International Diabetes Federation (IDF). Diabetes Atlas – 7th Edition [Internet]. Brussels (Belgium): IDF Diabetes Atlas 2015. Available from: http://www.diabetesatlas.org/. Accessed 10 May 2017.
    1. Funnell MM. Peer-based behavioural strategies to improve chronic disease self-management and clinical outcomes: evidence, logistics, evaluation considerations and needs for future research. Fam Pract. 2010;27(Suppl 1):i17–i22. doi: 10.1093/fampra/cmp027. - DOI - PMC - PubMed
    1. Heisler M. Different models to mobilize peer support to improve diabetes self-management and clinical outcomes: evidence, logistics, evaluation considerations and needs for future research. Fam Pract. 2010;27(Suppl 1):i23–i32. doi: 10.1093/fampra/cmp003. - DOI - PMC - PubMed

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