Clinical trial NCT01313949: PLATINUM Program: A Feasibility Study on a Train-the-trainer Course on Peer Support for People With Type 2 Diabetes
Official title: Peer Leaders Accelerated Training Initiative to Unleash Potential of Mentorship (PLATINUM) Program: A Feasibility Study on a Train-the-trainer Course on Peer Support for People With Type 2 Diabetes
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Diabetes
Keywords: Diabetes
Peer Support
Structured Care
Lead sponsor: Asia Diabetes Foundation
Sponsor class: OTHER
First posted: 2011-03-14
Enrollment: 75
Sex: ALL
Minimum age (years): 18
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Primary purpose: SUPPORTIVE_CARE

Brief 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.

Eligibility criteria: Inclusion Criteria:

* Chinese people with type 2 diabetes
* 18-75 years of age
* Good glycaemic control (HbA1c \<7%) and remain stable in past 1 year
* Willing to complete the structured training curriculum to prepare themselves as peer leaders
* Fluent in Cantonese

Exclusion Criteria:

* Known psychiatric disease
* Physically handicapped to the degree that communication with others is significantly impaired impaired, such as deafness, paraplegia.
* Illiterate

Primary outcomes:
measure: To assess the effectiveness of the training program in improving glycemic parameters in diabetic patients before and after the training.
timeFrame: 6 months
Secondary outcomes:
measure: To assess the efficacy of the training on the attitudes, behaviours and self-efficacy of the participants as compared to the control patients
timeFrame: 6 months
measure: To assess the efficacy of the training in improving the participants' knowledge of diabetes, as compared to the control patients.
timeFrame: 6 months
Other outcomes:
Locations:
city: Kwun Tong
country: Hong Kong
facility: Diabetes Ambulatory Care Centre, UCH
state: Kowloon
city: Kwai Chung
country: Hong Kong
facility: Kwai Chung out-patient clinic
state: New Territories
city: Shatin
country: Hong Kong
facility: CUHK YCK, Prince of Wales Hospital
state: New Territories
city: Shatin
country: Hong Kong
facility: Diabetes & Endocrine Centre, Prince of Wales Hospital
state: New Territories
city: Sheung Shui
country: Hong Kong
facility: Diabetes Centre, North District Hospital
state: New Territories
city: Causeway Bay
country: Hong Kong
facility: Diabetes Centre, Tung Wah Eastern Hospital
city: Central
country: Hong Kong
facility: Diabetes Hong Kong
city: Chai Wan
country: Hong Kong
facility: Diabetes Ambulatory Centre, PYNEH
city: Kowloon
country: Hong Kong
facility: Diabetes Centre, Kwong Wah Hospital
city: Kowloon
country: Hong Kong
facility: Diabetes Centre, Queen Elizabeth Hospital
city: Kowloon
country: Hong Kong
facility: PMH, Diabetes Care Centre, Princess Margaret Hospital
city: Lam Tin
country: Hong Kong
facility: Lam Tin Health Clinic
city: Pok Fu Lam
country: Hong Kong
facility: Diabetes Centre, Queen Mary Hospital
city: Sai Wan Ho
country: Hong Kong
facility: Sai Wan Ho Health Centre
city: Wan Chai
country: Hong Kong
facility: Diabetes Centre, Ruttonjee Hospital
Study officials:
affiliation: Prince of Wales Hospital, Shatin, HK
name: Rebecca Wong
role: PRINCIPAL_INVESTIGATOR
affiliation: Ruttonjee & Tang Shiu Kin Hospitals, Wan Chai, HK
name: Shimen Au
role: PRINCIPAL_INVESTIGATOR
References: