PLATINUM Program: A Feasibility Study on a Train-the-trainer Course on Peer Support for People With Type 2 Diabetes
Condition: Diabetes
MeSH terms: Diabetes Mellitus
Study type: Interventional

Summary: 
      The investigators hypothesize that a training course to people with diabetes on peer support
      and empowerment will improve their glycemic parameters, knowledge on diabetes and level of
      self efficacy. This group of trained patients (peer leaders) should be competent to teach and
      help other patients with diabetes through peer support and empowerment on better self
      management of their diabetes.
    

Detailed description: 
      In our attempt to improve diabetes self care, one important component is the diabetes
      patients who should have the best incentive to improve their care levels and reduce their
      complication risk, provided that they are appropriately trained, informed, educated and
      supported. According to the World Health Organization (WHO) Innovative Care for Chronic
      Conditions framework, expert patients are recommended to be included in the health care team
      to make them prepared, motivated and informed decision makers to preserve health and improve
      clinical outcomes. In a recent report on WHO consultation, peer support interventions are
      considered to have enormous potentials to make self management an effective component of
      chronic care.

      Peer support is defined as support from a person who has experiential knowledge of a specific
      behavior or stressor and similar characteristics as the target population. Thus people with
      common illness experience can share knowledge and experience in a less hierarchical and
      reciprocal relationship compared to that between patients and health care professionals. A
      number of programs including health worker-led groups with peer exchange, peer-led
      face-to-face self management programs, peer coaches and remote peer support have reported
      encouraging results with short term improvement in metabolic or
      cognitive-psychological-behavioral dimensions, although these results are often limited by
      non-sustainability of changes and insufficient reach or adoption of programs by patients or
      health care workers. In the WHO report, health care experts from various disciplines
      concluded that whilst peer support is a promising approach for diabetes management, issues
      regarding methods of organization, types of programs and their integration with other
      clinical and outreach services remain to be addressed. Of note, there is a paucity of similar
      data in developing and low income areas which are hit hardest by this epidemic and where peer
      support program may offer great promise to make diabetes prevention and care program more
      sustainable and accessible, if implemented and evaluated systematically.

      Health professionals, especially diabetes nursing specialists, have been training diabetes
      patients on the understanding and self-caring of diabetes. However, with the emerging concept
      and preliminary evidence of success in the role of "peer advisors" in diabetes to lead self
      care courses for other fellow patients, a train-the-trainer program to develop "expert
      patients" is essential. On top of factual knowledge on diabetes as a disease, context of this
      program needs to cover include communication and empowerment skill, basic knowledge on
      psychology, stress management, social support, empowerment, healthy lifestyle including diet
      and physical activity.

      In the evaluation of the programs, there is a need to define the qualities and roles of the
      peer supporter, design programs which integrate and complement formal health services,
      identify optimal mix of modalities of intervention, types and dose response of these
      interventions and evaluate acceptability and effectiveness of these programs in different
      cultures. Other evaluation indexes include effects of programs on behavioral changes,
      knowledge and attitudes, functionality, clinical care as well as their cost effectiveness,
      reach, implementation-consistency, adoption and maintenance of effects over time.
    

Intervention name(s): Training program
Intervention type(s): Other
Intervention description(s): These diabetes patients will undergo a 32-hour 'Train the trainer' program (4 workshops, 8-hours each) led by health care experts in nutrition, physical activity, psychology and neuro-linguistic program [NLP] trainer to ensure the adequacy of knowledge and skills of these mentors.
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: Diabetes; Peer Support; Structured Care