The impact of a face-to-face peer-support intervention on adults with type 2 diabetes: a cluster-randomised trial

Objective: To establish the impact of a face-to-face peer-support intervention on adults with type 2 diabetes in South Africa. Methods: A cluster randomised controlled trial was conducted involving 288 adults with type 2 diabetes from six communities in the Free State province. Individuals (n = 141) in three communities were randomly allocated to the intervention group, and individuals (n = 147) in another three communities were randomly allocated to the control group. Trained community health workers led monthly group sessions and home visits. The control group received the usual care. The primary outcome of the study was glycated haemoglobin (HbA1c), measured at baseline and endpoint after four months. Secondary outcomes included blood pressure, body mass index and waist circumference, measured at baseline and endpoint. Descriptive statistics were calculated per group. Results: No significant changes from baseline were found between groups regarding HbA1c (p = 0.87), body mass index (p = 0.21), waist circumference (p = 0.24) and systolic blood pressure (p = 0.13). Compared with the control group, the intervention group had a significant improvement in diastolic blood pressure (p = 0.02). Conclusions: The face-to-face peer-support intervention delivered by trained community health workers in a semi-urban rural area resulted in a significant improvement in diastolic blood pressure of adults with type 2 diabetes.

[1]  R. Whittaker,et al.  Long‐term follow‐up of a randomized controlled trial of a text‐message diabetes self‐management support programme, SMS4BG , 2019, Diabetic medicine : a journal of the British Diabetic Association.

[2]  M. Nel,et al.  Development of a Sesotho health literacy test in a South African context , 2019, African journal of primary health care & family medicine.

[3]  K. Hofman,et al.  The direct medical cost of type 2 diabetes mellitus in South Africa: a cost of illness study , 2019, Global health action.

[4]  T. Puoane,et al.  Role of community health workers in type 2 diabetes mellitus self-management: A scoping review , 2018, PloS one.

[5]  E. Fisher,et al.  Effect of peer support on diabetes distress: a cluster randomized controlled trial , 2018, Diabetic medicine : a journal of the British Diabetic Association.

[6]  C. Colvin,et al.  “Contract to Volunteer”: South African Community Health Worker Mobilization for Better Labor Protection , 2018, New solutions : a journal of environmental and occupational health policy : NS.

[7]  SA Gesondheid Perceptions of patients regarding diabetes-related health communication strategies in the Free State , South Africa , 2018 .

[8]  J. Raubenheimer,et al.  Development of a health dialogue model for patients with diabetes: A complex intervention in a low-/middle income country , 2018 .

[9]  Heidy N Merius,et al.  An Integrative Review of Factors Associated with Patient Attrition from Community Health Worker Programs that Support Diabetes Self-Care , 2017, Journal of community health nursing.

[10]  C. Rotimi,et al.  Diabetes in sub-Saharan Africa: from clinical care to health policy. , 2017, The lancet. Diabetes & endocrinology.

[11]  C. Leitão,et al.  Efficacy of an education course delivered to community health workers in diabetes control: A randomized clinical trial , 2017, Endocrine.

[12]  Aaron R. Lyon,et al.  The creation and validation of the Measure of Effective Attributes of Trainers (MEAT) , 2017, Implementation Science.

[13]  Renée I. Boothroyd,et al.  Peer support of complex health behaviors in prevention and disease management with special reference to diabetes: systematic reviews , 2017, Clinical Diabetes and Endocrinology.

[14]  T. Puoane,et al.  Training community health workers to screen for cardiovascular disease risk in the community: experiences from Cape Town, South Africa , 2017, Cardiovascular journal of Africa.

[15]  K. Khunti,et al.  Walking Away from Type 2 diabetes: a cluster randomized controlled trial , 2017, Diabetic medicine : a journal of the British Diabetic Association.

[16]  Nclr,et al.  Global Evidence for Peer Support: Humanizing Health Care , 2014 .

[17]  J. Whittle When does peer support improve glycemic control in persons with diabetes mellitus? , 2014, JAMA internal medicine.

[18]  Danielle Hessler,et al.  Impact of Peer Health Coaching on Glycemic Control in Low-Income Patients With Diabetes: A Randomized Controlled Trial , 2013, The Annals of Family Medicine.

[19]  M. Zwarenstein,et al.  Effectiveness of a group diabetes education programme in underserved communities in South Africa: pragmatic cluster randomized control trial , 2012, BMC Family Practice.

[20]  James Dunbar,et al.  Cluster randomized controlled trial of a peer support program for people with diabetes: study protocol for the Australasian peers for progress study , 2012, BMC Public Health.

[21]  A. Kadirvelu,et al.  Reality vs Illusion: Knowledge, Attitude and Practice among Diabetic Patients , 2012 .

[22]  U. Nitzan,et al.  [Motivational interviewing in health care]. , 2011, Harefuah.

[23]  E. O'Shea,et al.  Peer support for patients with type 2 diabetes: cluster randomised controlled trial , 2011, BMJ : British Medical Journal.

[24]  M. Heisler,et al.  Different models to mobilize peer support to improve diabetes self-management and clinical outcomes: evidence, logistics, evaluation considerations and needs for future research. , 2010, Family practice.

[25]  Gary L. Kreps,et al.  Guidelines for International Breast Health and Cancer Control – Implementation Supplement to Cancer Strategic Health Communication Across the Continuum of Breast Cancer Care in Limited-Resource Countries , 2008 .