Evaluation of a Structured Self-Management Training for Peer Supporters with Type 2 Diabetes and Arterial Hypertension, led by a Specialist Nurse

Abstract

Abstract Introduction: Training of peer supporters is critical because the success of the entire peer support intervention depends on the knowledge and experience that peer supporters can share with other patients. The objective was to evaluate the pilot implementation of a specialist nurse-led self-management training for peer supporters with type 2 diabetes (T2D), with or without coexistent arterial hypertension (AH), in terms of feasibility, acceptability, and effectiveness. Methods: A prospective pre-post interventional pilot study was conducted in two Community Health Centres in Slovenia from May 2021 to August 2022. Purposive sampling was performed to recruit eligible patients to become trained peer supporters volunteers. Training was led by an educator, a specialist nurse, and was based on the comprehensive curriculum using the Diabetes Conversation MapsTM. Data were collected from medical records, by clinical measurements, and using questionnaires on sociodemographic and clinical data, the Theoretical Framework of Acceptability, knowledge of T2D and AH, and the Appraisal of Diabetes Scale, and evaluation forms. Results: Participants evaluated the training as highly acceptable and satisfactory. After training, peer supporters’ knowledge of T2D (p<0.001) and AH (p=0.024) improved significantly compared with baseline knowledge. 6 months after training, their weight decreased significantly (p=0.022) from 85.8 (SD 19.5) kg at baseline to 84.2 (SD 20.0) kg and body mass index (BMI) decreased (p=0.020) from 30.4 (SD 6.2) at baseline to 29.8 (SD 6.2). Conclusion: Self-management training for peer supporters, led by a specialist nurse, proved feasible, acceptable, and effective. It resulted in improved knowledge and positive changes in self-management behavior of peer supporters, as evidenced by the decrease in their BMI over a six-month period. This suggests that ongoing self-management training for peer supporters could be an important component of a successful peer support intervention for people with T2D and AH at the primary healthcare level. Trial registration: The research is part of the international research project SCUBY: Scale up diabetes and hypertension care for vulnerable people in Cambodia, Slovenia and Belgium, which is registered in ISRCTN registry (https://www.isrctn.com/ISRCTN41932064).