Peer Support for Diabetes Management in Primary Care and Community Settings in Anhui Province, China.
PURPOSE
We evaluated a peer leader-support program (PLSP) for diabetes self-management in China in terms of acceptability and feasibility; implementation; perceived advantages; disadvantages and barriers; reach and recruitment; effectiveness in terms of diabetes knowledge and clinical impacts; adoption; and sustainability.


METHODS
Within each of 3 cities in Anhui Province, 2 subcommunities were randomly assigned to usual care or PLSP. Peer leaders and staff of Community Health Service Centers (CHSCs) co-led biweekly educational meetings. Peer leaders also led biweekly discussion meetings, promoted regular care through the CHSCs, organized informal health promotion activities (eg, walking and tai chi groups), and provided informal individual support to participants through casual contact.


RESULTS
Qualitative evaluations indicated acceptance of and positive responses to the program among patients, peer leaders, and CHSC staff. Implementation was successful in 2 of 3 subcommunities, the third failing for lack of staff resources. Reported advantages included peer support as a bridge between CHSCs and their patients. In 2 sites where the PLSP was implemented, analyses controlling for baseline differences and site showed significant benefits for PLSP relative to controls (P <0.05) for knowledge, self-efficacy, BMI, systolic blood pressure, diastolic blood pressure, and both fasting and 2-hour post-prandial blood glucose. The Anhui Provincial Health Bureau has extended the PLSP model to other communities and to cardiovascular disease prevention and management.


CONCLUSION
The PLSP was well accepted, feasible given sufficient administrative and staff resources, effective for those who participated, and generalizable to other sites and health problems.
['Zhong|Xuefeng|X|', 'Wang|Zhimin|Z|', 'Fisher|Edwin B|EB|', 'Tanasugarn|Chanuantong|C|']
D000293:Adolescent D000328:Adult D001786:Blood Glucose D001794:Blood Pressure D015992:Body Mass Index D002681:China D003153:Community Health Services D003376:Counseling D003924:Diabetes Mellitus, Type 2 D005069:Evaluation Studies as Topic D005215:Fasting D005240:Feasibility Studies D005260:Female D007722:Health Knowledge, Attitudes, Practice D006293:Health Promotion D006801:Humans D008297:Male D010379:Peer Group D019518:Postprandial Period D011320:Primary Health Care D012648:Self Care D020377:Self Efficacy D012944:Social Support D055815:Young Adult
peer support diabetes community