Abstract
Objectives
Existing peer support literature in diabetes has focussed predominantly on the health
impact it has on the beneficiaries rather than the benefactors. In this mixed-methods
study, we examined the effect of delivering peer support (vs receiving) on glycated
hemoglobin (A1C) and diabetes distress (DD) at 3 and 12 months as part of a larger
diabetes self-management support randomized controlled trial. Maintenance or improvement
of outcomes was expected. We also assessed peer leaders’ experiences with the program.
Methods
We utilized a sequential explanatory mixed-methods research design that included 58
adults with diabetes (i.e. peer leaders) who completed a 30-hour training program.
Peer leaders (n=52) were matched with participants (adults with type 2 diabetes) and
invited to undergo assessments at baseline, 3 months and 12 months. Primary clinical
and psychosocial outcomes included A1C and DD, respectively. Secondary outcomes were
cardiovascular risk factors and depressive symptoms. After the intervention, 17 peer
leaders participated in semistructured interviews about their experience.
Results
Peer leaders had a mean age of 57.5±11 years and a long history of diabetes (13.9±11
years); over half were male (53.8%) and married/partnered (55.8%). At baseline, peer
leaders were at target for A1C (7.0±0.9% [53±10 mmol/mol]) and reported a low level
of DD (1.67±0.52). Of the 43 (82.7%) peer leaders who completed the 12-month study,
A1C and DD remained stable over 12 months. Secondary outcomes also remained within
the normal range from the start to the end of the intervention.
Conclusion
Delivering peer support may help maintain glycemic control and DD over the long term.
Résumé
Objectifs
La littérature actuelle sur le soutien par les pairs en diabète a principalement porté
sur les répercussions sur la santé des bénéficiaires plutôt que sur la santé des aidants.
Dans la présente étude par méthodes mixtes, nous avons examiné les effets de l’offre
de soutien par les pairs (vs l’obtention) sur l’hémoglobine glyquée (A1c) et la détresse liée au diabète (DD)
après 3 et 12 mois dans le cadre d’un essai clinique à répartition aléatoire de plus
grande envergure sur le soutien à la prise en charge autonome du diabète (DSMS, de
l’anglais diabetes self-management support). Les résultats anticipés étaient le maintien ou l’amélioration des résultats.
Nous avons aussi évalué l’expérience qu’avaient les pairs leaders du programme.
Méthodes
Nous avons utilisé un devis de recherche séquentiel explicatif par méthodes mixtes
auprès de 58 adultes diabétiques (c.-à-d. les pairs leaders) qui avaient terminé un
programme de formation de 30 heures. Les pairs leaders (n = 52) étaient appariés aux
participants (des adultes atteints du diabète de type 2) et invités à subir des évaluations
au début, après 3 mois et 12 mois. Les principaux critères d’évaluation cliniques
et psychosociaux étaient respectivement l’A1c et la DD. Les critères secondaires étaient
les facteurs de risque cardiovasculaire et les symptômes de dépression. Après l’intervention,
17 pairs leaders participaient à des entretiens semi-structurés sur leur expérience.
Résultats
Les pairs leaders avaient un âge moyen de 57,5 ± 11 ans et des antécédents de diabète
de longue date (13,9 ± 11 ans); plus de la moitié étaient des hommes (53,8 %), et
étaient mariés ou en couple (55,8 %). Au début, les pairs leaders étaient situés dans
les valeurs cibles de l’A1c (7,0 ± 0,9 % [53 ± 10 mmol/mol]) et avaient déclaré un
faible niveau de DD (1,67 ± 0,52). L’A1c et la DD des 43 (82,7 %) pairs leaders qui
avaient participé à l’étude de 12 mois étaient restées stables au cours des 12 mois.
Les critères secondaires étaient aussi demeurés dans la plage normale du début à la
fin de l’intervention.
Conclusion
L’offre de soutien par les pairs peut aider à maintenir la régulation de la glycémie
et la DD à long terme.
Keywords
Mots clés
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Article Info
Publication History
Published online: February 16, 2022
Accepted:
February 10,
2022
Received in revised form:
January 26,
2022
Received:
July 10,
2021
Identification
Copyright
© 2022 Canadian Diabetes Association.
