Peer Support for Achieving Independence in Diabetes (Peer AID)

实现糖尿病独立的同伴支持（Peer AID）

• 批准号: 8728823
• 负责人: KARIN M. NELSON
• 金额: $ 43.85万
• 依托单位: SEATTLE-KING COUNTY PUBLIC HEALTH DEPT
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-10 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8728823
• 关键词: Adopted; Adoption; Affect; Age; Behavior; Blood Glucose; Blood Pressure; Caring; Chronic; Chronic Disease; Client; Clinic; Clinical; Communication; Communities; Community Health; Community Health Centers; Cost Effectiveness Analysis; County; County Hospitals; Data; Diabetes Mellitus; Disease; Economics; Education; Effectiveness; Glycosylated hemoglobin A; Goals; Health; Healthcare Systems; Home environment; Home visitation; Hospitals; House Call; Individual; Intervention; Investments; Knowledge; Link; Lipids; Low Income Population; Low income; Maintenance; Measures; Medical; Minority; Modeling; Non-Insulin-Dependent Diabetes Mellitus; Outcome; Participant; Patients; Persons; Physical activity; Planet Mars; Population; Prevalence; Provider; Psyche structure; Public Health; Randomized Clinical Trials; Randomized Controlled Trials; Recruitment Activity; Research; Research Methodology; Resources; Role; SF-12; Sea; Self Efficacy; Self Management; Social support; System; Telephone; Testing; Translating; Translational Research; Translations; Veterans; Vulnerable Populations; Washington; Work; base; blood lipid; community setting; cost effective; cost effectiveness; diabetes education; evidence base; follow-up; glycemic control; group support; health care service utilization; health disparity; health related quality of life; improved; medication compliance; nutrition; peer; primary outcome; programs; safety net; secondary outcome; skills; treatment as usual

DESCRIPTION (provided by applicant): Type 2 diabetes is an important and common health problem and disproportionately affects low income and minority populations. Acquiring diabetes self- management skills and applying them on a daily basis is challenging, especially for individuals with limited resources. Interventions utilizing community health workers (CHWs) improve knowledge and behavior among persons with diabetes, and in some studies have improved health outcomes. CHWs are a theoretically appealing way to reach vulnerable populations, however, additional work is needed to understand how and in what settings CHWs could most effectively impact diabetes care and reduce health disparities. Information regarding cost- effectiveness and return on investment is also needed. OBJECTIVES: We will test the hypotheses that CHWs providing in-home support for self- management of type 2 diabetes, resources for diabetes, and assistance in effective linkage and communication with medical providers will: (1) improve HbA1c (primary outcome) and secondary outcomes including blood pressure and lipid control, health care utilization, and health-related quality of life; (2) improve diabetes self-management, including self-efficacy, physical activity, nutrition, and medication adherence; and (3) be cost-effective and feasible. METHODS: We will implement a 5-year randomized controlled trial that will compare a CHW model consisting of in home diabetes self-management support, links to group support, and telephone support compared to usual care. CHWs will make up to 5 home visits over the course of a year to provide tailored support in the key components of self-management; referral to group activities including disease self-management classes; generate social support through relationships with their clients; and develop skills to navigate the health care system. At the end of the study period, usual care participants will receive a home visit by a CHW and diabetes self-management resources. The participants will be drawn from an ethnically and culturally diverse group of low-income patients age 30-70 who speak English or Spanish with type 2 diabetes and poorly controlled blood sugar and/or blood pressure who reside in King County, Washington. Participants will be recruited from the local Veterans Affairs (VA) hospital, the county hospital (Harborview) and a community health center (Sea Mar). Our primary outcome will be glycemic control as measured by a HbA1c. Secondary outcomes are blood pressure, lipids, health care utilization, health-related quality of life, self-efficacy and diabetes self- management behaviors.

描述（由申请人提供）：2型糖尿病是一个重要且常见的健康问题，并且不成比例地影响低收入和少数群体。获得糖尿病的自我管理技能并每天应用它们是一项挑战，尤其是对于资源有限的人而言。利用社区卫生工作者（CHW）的干预措施改善了糖尿病患者的知识和行为，在某些研究中，改善了健康结果。 CHW是一种理论上吸引脆弱人群的吸引人的方式，但是，需要额外的工作来了解CHW如何以及在哪些环境中最有效地影响糖尿病护理并减少健康差异。还需要有关成本效益和投资回报率的信息。目的：我们将测试CHW为2型糖尿病的自我管理，糖尿病资源提供自我支持的CHW，以及与医疗提供者有效联系和沟通的帮助：（1）改善HBA1C（主要结果）以及包括血压和脂质控制，健康保健利用率，健康质量的次要结果； （2）改善糖尿病的自我管理，包括自我效能，体育锻炼，营养和药物依从性； （3）具有成本效益和可行。方法：我们将实施一项为期5年的随机对照试验，该试验将比较由家庭糖尿病自我管理支持，与小组支持的链接以及与通常的护理相比的电话支持的CHW模型。 CHW在一年的时间内最多可弥补5次家庭访问，以在自我管理的关键组成部分中提供量身定制的支持；转介到包括疾病自我管理课程在内的小组活动；通过与客户的关系来产生社会支持；并开发技能来浏览医疗保健系统。在研究期结束时，通常的护理参与者将获得CHW和糖尿病自我管理资源的家庭访问。参与者将从一组族裔和文化多样化的低收入患者组中汲取30-70岁的低收入患者，他们说英语或西班牙语，患有2型糖尿病和控制不良的血糖和/或血压，他们居住在华盛顿的金县。参与者将从当地退伍军人事务（VA）医院，县医院（Harbourview）和社区健康中心（SEA MAR）招募。我们的主要结果将是通过HBA1C测量的血糖控制。次要结果是血压，脂质，医疗保健利用，与健康相关的生活质量，自我效能感和糖尿病自我管理行为。

项目成果

Peer Support for Achieving Independence in Diabetes (Peer-AID): design, methods and baseline characteristics of a randomized controlled trial of community health worker assisted diabetes self-management support.

• DOI: 10.1016/j.cct.2014.06.011
• 发表时间: 2014-07
• 期刊: Contemporary clinical trials
• 影响因子: 2.2
• 作者: Nelson K;Drain N;Robinson J;Kapp J;Hebert P;Taylor L;Silverman J;Kiefer M;Lessler D;Krieger J
• 通讯作者: Krieger J