Peer support provides benefits across varied health concerns. As opposed to simple offer of support, however, predictors of and importance of levels of participation are not well understood. Analyses of 7 peer support interventions, with 1,612 participants address these questions, first identifying characteristics that predict participation, and then examining whether, controlling for those characteristics, participation itself predicts benefit, using reduced HbA1c as an indicator of benefit.
From the U.S. (5 sites), Hong Kong, and the UK, interventions shared emphases on peer supporters helping adults with type 2 diabetes improve disease management. Common data included pre/post hemoglobin A1c (HbA1c), contacts of participants with peer supporters, health literacy, availability/satisfaction with support for diabetes management from family/clinical team, and gender, age, education, and years with diabetes.
From structural equation modeling, significant findings indicated 1) older age and lower levels of support for diabetes management predicted more contacts with peer supporters, and 2) more contacts predicted lower levels of final HbA1c. Effects of contacts on HbA1c included those with baseline HbA1c > 7.5% or > 9%. No contacts and tertiles of low, moderate, and high contacts showed a linear, dose-response relationship with final HbA1c (p < 0.001). Baseline and covariate-adjusted, final HbA1c was 8.19% versus 7.85% for those with no and high contacts, respectively. Among those using insulin (29.7%), only those in the high group achieved greater benefit than those with no contacts.
Reflecting other findings that peer support reaches/benefits those at greater disadvantage, those reporting less social support for diabetes management were more likely to participate in peer support. Participation in turn predicted better glycemic control across levels of baseline glycemic control and in a dose response relationship across levels of participation.
G.X. Ayala: None. J.C. Chan: None. A. Cherrington: None. J.P. Elder: None. E.B. Fisher: Research Support; Self; Merck Foundation, Sanofi China. M. Heisler: None. A. Howard: None. H. Parada: None. M. Safford: None. D. Simmons: None. T.S. Tang: None.
Merck Foundation; Eli Lilly and Company Foundation; Bristol-Myers Squibb Foundation