Effect of Peer Group Support Educational Intervention on the HgA1c Level and Self-care Behaviors of Adolescents with Type 1 Diabetes Referred to Zahedan Diabetes Clinics

Abstract

Background: Diabetes is a chronic and costly disease that is very common in adolescents. Improving self-care behaviors will be a motivation to continue treatment. On the other hand, peer support and education have been used as an effective method in reducing behavioral and attitudinal disorders caused by chronic diseases. Objectives: Determining the effect of peer group support educational intervention on the HgA1C level and self-care behaviors of adolescents with type 1 diabetes. Methods: This quasi-experimental research was conducted on adolescents aged 11-18 years with type 1 diabetes who were referred to the Diabetes Clinic in Zahedan city, Iran, in 2019. A total of 189 samples were included in the study using the convenience sampling method and were randomly assigned to two intervention groups and one control group (63 people in each group). The researcher used two methods of educational intervention, including peer support intervention and individual training by the researcher. Individuals in the intervention groups were subjected to separate educational interventions during 4 sessions of 60 minutes, one session every week. The control group received routine care. Demographic information, self-care behaviors, and HbA1c questionnaires were completed and recorded before, immediately, and 2 months after the end of the intervention. The data were analyzed using the Shapiro-Wilk test, chi-square test, repeated measures analysis of variance, one-way analysis of variance, and Bonferroni post hoc test using the SPSS version 26 software. The significance level of the tests was considered 0.05. Results: Peer support training significantly improved self-care behavior (P < 0.001) and decreased HbA1c level (P < 0.001) in the intervention group compared to the control group. Moreover, in the intervention group, the self-care score and HbA1c level were significantly different between the pre-test, post-test, and follow-up stages (P < 0.001). The permanence of the effect of peer education in the follow-up phase was not confirmed for the variables self-care (P < 0.001) and HbA1c (P < 0.001). Conclusions: Our findings showed that using peer groups and the experiences of similar people as educators can improve self-care behaviors and also record lower average glycosylated hemoglobin in type 1 diabetic patients. Therefore, it is recommended that peer support training be used as an effective method in diabetes and other chronic diseases.