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“Tis Better to Give Than to Receive?” Health-related Benefits of Delivering Peer Support in Type 2 Diabetes: An Explanatory Sequential Mixed-methods Study

Published:February 16, 2022DOI:https://doi.org/10.1016/j.jcjd.2022.02.006

      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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