Heart Health Buddies: Peer Support to Decrease CVD Risk
Condition: Cardiovascular Disease
MeSH terms: Cardiovascular Diseases
Study type: Interventional

Summary: 
      This pilot study will use a hybrid reciprocal peer support and peer coach model to initiate
      and sustain heart-healthy behavioral changes in Veterans. Veterans who are at-risk for
      cardiovascular disease (CVD) will be enrolled in the study and paired with another Veteran to
      receive and provide social support around engaging in CVD risk reduction behaviors. Enrolled
      participants will be offered a series of 3 group sessions focused on CVD risk reduction, goal
      setting and action plan development. Between group sessions, peer partners will be asked to
      have weekly calls to discuss action plan challenges, explore options for problem solving, and
      provide encouragement and accountability for personal goals. Participants who do not engage
      in the group sessions or weekly phone calls, or who request additional help, will receive
      support from trained peer coaches. The goal of this pilot study is to evaluate the proof of
      concept for a hybrid reciprocal peer support (RPS) and peer coach intervention to improve
      heart healthy behaviors among Veterans at risk for CVD.
    

Detailed description: 
      A total of 24 Veterans enrolled at the Durham Veterans Affairs Medical Center will be
      screened and enrolled. Eligible Veterans are 35-64 years old, with at least one uncontrolled
      or poorly controlled risk factor for CVD. In addition, 3-6 veterans will be enrolled and
      trained as heart health peer coaches, with eligibility being 35-64 years old, with at least
      one documented CVD factor who have sustained improvement in physical activity or dietary
      change in the previous 3-6 months. All participants complete a baseline assessment, three
      structured group meetings, and a 12 week post-intervention assessment. At the first group,
      each participant creates a behavioral goal, and peer partners are paired with another Veteran
      based on behavioral goal and gender. They are expected to call their peer once a week to
      discuss progress or difficulty with their action plan and support each other with problem
      solving. Post enrollment and prior to the first group meeting, Peer coaches will have 3-5
      hours of motivational and communication training with study staff focusing on skills such as
      active listening, non-directive support, eliciting change-talk, promoting incremental change,
      and patient confidentiality. Peer coaches will interact with peer buddies during a) group
      sessions, b) at a 6 week phone check-in, and c) on-going support if needed. Additional
      support will be initiated if there are no phone calls between pairs, there is a lack of
      participant engagement in calls to partner or attending group sessions, or upon request by
      the peer. There are two Aims of the current pilot study. Aim 1: examine the feasibility and
      acceptability of a 12-week hybrid peer coach-reciprocal peer support intervention.
      Feasibility will be evaluated by ease of recruitment, and enrollment and retention rates.
      Acceptability will be assessed by self-report of amount, frequency and modality of contacts,
      participation rates for group sessions, and through post-intervention qualitative interviews.

      Aim 2: explore gender differences in feasibility/acceptability of the hybrid peer support
      model. Gender differences will be evaluated through qualitative comparison of participant
      reported experiences with intervention content as well as peer and group interactions by
      gender; and, quantitatively via exploration of differences in enrollment, retention, refusal
      reasons and frequency of peer contacts.
    

Intervention name(s): reciprocal peer support and non reciprocal coach support
Intervention type(s): Behavioral
Intervention description(s): Peers and peer coaches provide mutual or one-way support to initiate and sustain behavioral improvements for cardiovascular health, with additional education from study staff.
Allocation: Non-Randomized
Intervention model: Single Group Assignment
Intervention model description: single group assignment
Masking: None (Open Label)
Primary purpose: Health Services Research
Keywords: cardiovascular disease; social support