Peer support in Shanghai’s Commitment to diabetes and chronic disease self-management: program development, program expansion, and policy

Author:

Liu Yuexing1,Wu Xiaoyu2,Cai Chun1,Tang Patrick Y3,Coufal Muchieh Maggy4,Qian Yiqing3,Luu Samantha Ling3,Fisher Edwin B3ORCID,Jia Weiping1

Affiliation:

1. Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, National Office for Primary Diabetes Care, Shanghai, China

2. Department of Health Promotion, Shanghai Municipal Health Commission, Shanghai, China

3. Peers for Progress, Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC

4. Asian Center for Health Education, Plano, TX

Abstract

Abstract Identifying organizational settings for sustainable, scalable implementation of peer support (PS) is a challenge. Development, initial evaluation, and community expansion of PS for populations with diabetes staged in the context of the Shanghai Integration Model integrating primary and specialty care for diabetes. Development Phase with 9 Community Health Centers (CHCs) leading to Community Expansion Phase with additional 12 communities. Development Phase peer leaders (PLs) co-led meetings on diabetes management, led neighborhood activities, and followed up with individuals and families. Among 1,284 participants, changes in HbA1c, other clinical markers, and diabetes distress were significant (ps from 0.001 to 0.041), pronounced among those with elevated levels, for example, HbA1c reduction from 9.09% to 8.50% among those ≥8% at baseline (p < 0.001). Ratings of Implementation were associated with reduced HbA1c and diabetes distress and increased neighborhood support. In particular, linking with community resources and utilization of neighborhood Residential Committees were associated with improved HbA1c, indicating the value of PS programs including community resources. Thus, the Community Expansion Phase includes district- and community-level health staff, Community Self Management Groups, and Residential Committees along with CHCs in 12 communities, all of which have implemented activities during the first 6 months. PS programs are feasible and appear to add value among populations with diabetes in community settings such as Shanghai. Recognition by the Shanghai government has included PS as a key strategy for achieving self-management of chronic disease in its 2030 health goals.

Funder

National Institutes of Health

Publisher

Oxford University Press (OUP)

Subject

Behavioral Neuroscience,Applied Psychology

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