Peer supporters for cardiac patients with diabetes: a randomized controlled trial.

AIMS To determine whether incorporation of patient peer supporters in a Cardiac-Diabetes Self-Management Program (Peer-CDSMP) led to greater improvement in self-efficacy, knowledge and self-management behaviour in the intervention group compared to a control group. BACKGROUND Promoting improved self-management for those with diabetes and a cardiac condition is enhanced by raising motivation and providing a model. Peer support from former patients who are able to successfully manage similar conditions could enhance patient motivation to achieve better health outcomes and provide a model of how such management can be achieved. While studies on peer support have demonstrated the potential of peers in promoting self-management, none have examined the impact on patients with two co-morbidities. METHODS A randomized controlled trial was used to develop and evaluate the effectiveness of the Peer-CDSMP from August 2009 to December 2010. Thirty cardiac patients with type 2 diabetes were recruited. The study commenced in an acute hospital, follow-up at participants' homes in Brisbane, Australia. RESULTS While both the control and intervention groups had improved self-care behaviour, self-efficacy and knowledge, the improvement in knowledge was significantly greater for the intervention group. CONCLUSIONS Significant improvement in knowledge was achieved for the intervention group. Absence of significant improvements in self-efficacy and self-care behaviour represents an inconclusive effect; further studies with larger sample sizes are recommended.

[1]  M. Courtney,et al.  Using user-friendly telecommunications to improve cardiac and diabetes self-management programme: a pilot study. , 2012, Journal of evaluation in clinical practice.

[2]  K. Kostner,et al.  Development and pilot test of a peer-support based Cardiac-Diabetes Self-Management Program: A study protocol , 2011, BMC health services research.

[3]  Paul Dendale,et al.  Secondary prevention through cardiac rehabilitation: from knowledge to implementation. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation , 2010, European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology.

[4]  A. Chang,et al.  Innovative self-management programme for diabetics following coronary care unit admission. , 2009, International nursing review.

[5]  E. Balas,et al.  Healthcare via cell phones: a systematic review. , 2009, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[6]  Tim Friede,et al.  Telephone peer-delivered intervention for diabetes motivation and support: the telecare exploratory RCT. , 2009, Patient education and counseling.

[7]  B. Fjeldsoe,et al.  Behavior change interventions delivered by mobile telephone short-message service. , 2009, American journal of preventive medicine.

[8]  A. Chang,et al.  Audit of patients with type 2 diabetes following a critical cardiac event. , 2008, International nursing review.

[9]  A. Chang,et al.  Perspectives of patients with type 2 diabetes following a critical cardiac event - an interpretative approach. , 2008, Journal of clinical nursing.

[10]  Gail D'Eramo Melkus Reducing Risks in Diabetes Self-management , 2007 .

[11]  M. Heisler Overview of Peer Support Models to Improve Diabetes Self-Management and Clinical Outcomes , 2007 .

[12]  Hee-Seung Kim,et al.  A randomized controlled trial of a nurse short-message service by cellular phone for people with diabetes. , 2007, International journal of nursing studies.

[13]  C. Griffiths,et al.  How effective are expert patient (lay led) education programmes for chronic disease? , 2007, BMJ : British Medical Journal.

[14]  K. Joekes,et al.  Self-efficacy and Overprotection Are Related to Quality of Life, Psychological Well-being and Self-management in Cardiac Patients , 2007, Journal of health psychology.

[15]  T. Horsley,et al.  Effectiveness of community health workers in the care of persons with diabetes , 2006, Diabetic medicine : a journal of the British Diabetic Association.

[16]  C. Jackson,et al.  A systematic review of interactive computer-assisted technology in diabetes care: interactive information technology in diabetes care , 2006 .

[17]  J. Piette,et al.  I Help You, and You Help Me , 2005, The Diabetes educator.

[18]  M. Courtney,et al.  Validation of the Australian/English version of the Diabetes Management Self-Efficacy Scale. , 2005, International journal of nursing practice.

[19]  John P. Allegrante,et al.  A review and synthesis of research evidence for self-efficacy-enhancing interventions for reducing chronic disability: implications for health education practice (part II). , 2005, Health promotion practice.

[20]  S. Ebrahim,et al.  Improving uptake and adherence in cardiac rehabilitation: literature review. , 2005, Journal of advanced nursing.

[21]  Stephanie J. C. Taylor,et al.  Self management education by lay leaders for people with chronic conditions , 2005 .

[22]  K. Lorig,et al.  A Review and Synthesis of Research Evidence for Self-Efficacy-Enhancing Interventions for Reducing Chronic Disability: Implications for Health Education Practice (Part I) , 2005, Health promotion practice.

[23]  Stephen D. Persell,et al.  Relationship of diabetes-specific knowledge to self-management activities, ambulatory preventive care, and metabolic outcomes. , 2004, Preventive medicine.

[24]  K. King,et al.  Peer Support. An Under-Recognized Resource in Cardiac Recovery , 2004, European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology.

[25]  A. Bandura Swimming against the mainstream: the early years from chilly tributary to transformative mainstream. , 2004, Behaviour research and therapy.

[26]  B. Riegel,et al.  Is Individual Peer Support a Promising Intervention for Persons With Heart Failure? , 2004, The Journal of cardiovascular nursing.

[27]  Kathleen Krichbaum,et al.  Exploring the Connection Between Self-Efficacy and Effective Diabetes Self-f Management , 2003, The Diabetes educator.

[28]  S. Norris,et al.  Effectiveness of self-management training in type 2 diabetes: a systematic review of randomized controlled trials. , 2001, Diabetes care.

[29]  R. Glasgow,et al.  The summary of diabetes self-care activities measure: results from 7 studies and a revised scale. , 2000, Diabetes care.

[30]  S. Sidani,et al.  Evaluating Nursing Interventions: A Theory-Driven Approach , 1997 .

[31]  J. Gray Evidence-Based Healthcare , 1997 .

[32]  Jacob Cohen,et al.  A power primer. , 1992, Psychological bulletin.

[33]  A. Bandura Self-efficacy: toward a unifying theory of behavioral change. , 1977, Psychological review.

[34]  H. Cole-Lewis,et al.  Messaging as a Tool for Behavior Change in Disease Prevention and Management , 2010 .

[35]  Shari Bolen,et al.  A systematic review of interactive computer-assisted technology in diabetes care , 2006, Journal of General Internal Medicine.

[36]  J. Teasdale Self-efficacy: Toward a unifying theory of behavioural change? , 1978 .