Training peers to deliver ongoing self-management support in church-based setting

培训同伴在教会环境中提供持续的自我管理支持

• 批准号: 8105870
• 负责人: Martha M Funnell
• 金额: $ 23.33万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-08-01 至 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8105870
• 关键词: Address; Adult; African American; Area; Behavior; Blood Pressure; Cardiovascular system; Chronic Disease; Church; Clinical; Communication; Communities; Complex; Diabetes Mellitus; Education; Educational Curriculum; Educational Intervention; Effectiveness; Financial cost; Health; Health Professional; Health Promotion; Healthcare Systems; Intervention; Knowledge; Light; Lipids; Measures; Metabolic; Michigan; Modeling; Morbidity - disease rate; Non-Insulin-Dependent Diabetes Mellitus; Outcome; Participant; Patients; Phase; Pilot Projects; Preparation; Quality of life; Randomized Controlled Trials; Recruitment Activity; Research Infrastructure; Resources; Self Care outcome; Self Management; Structure; Testing; Time; Training; Training Programs; Training and Education; United States; base; behavior change; design; disability; effective intervention; empowerment; experience; follow-up; improved; motivational enhancement therapy; peer; primary outcome; programs; psychosocial; satisfaction; skills; theories

DESCRIPTION (provided by applicant): Without continued follow-up and support, professionally-led diabetes self-management education (DSME) interventions only have a short-term impact on improving diabetes-related outcomes. In light of resource constraints, peer-led interventions are a promising approach to sustain self-management efforts and health gains achieved in short-term DSME programs. However, sustainable models of self-management support need to be ongoing, patient-driven, responsive to change, and embedded in existing community infrastructures. African-American (AA) churches are a potentially effective venue for delivering community- based, peer-led health promotion interventions. This study proposes to train Peer Leaders (PLs) to facilitate a theoretically-driven, empowerment-based intervention and pilot a church-based, peer-led (CBPL) self- management support intervention delivered in a group setting. Specific aims are: (1) to determine the feasibility and acceptability of training PLs recruited from 10 AA churches in the greater Ypsilanti, Michigan area to facilitate an empowerment-based self-management support intervention, (2) to determine the feasibility and acceptability of conducting a 12-month CBPL intervention for AAs with type 2 diabetes, and (3) to establish estimates of parameters needed to design and power a study of the effectiveness of the CBPL intervention by estimating the effect size of the change in A1C due to the intervention and the intraclass (within group) correlation of A1C and other outcomes. In Phase I, we will implement a 12-week training program recruiting adults with type 2 diabetes from 10 AA churches and equipping them with the knowledge and skills to facilitate an ongoing diabetes self-management support (DSMS) intervention. PLs must fulfill the pre-established competency-based criteria to successfully graduate. Competency-based areas include diabetes-related knowledge, empowerment-based facilitation skills, and motivational interviewing (MI)-based communication skills. In Phase II, we will use a single-group repeated measures design to conduct a 12-month CBPL intervention with 3 months of DSME training followed by 9 months of ongoing DSMS. Participants will be recruited from the 10 AA churches in the greater Ypsilanti, Michigan area. Using peer leaders to facilitate empowerment-based interventions in church-based settings may serve as a viable and sustainable model for ongoing self-management support in "real-world" settings. PUBLIC HEALTH RELEVANCE: Without continued follow-up and support, professionally-led diabetes self-management education programs only improve diabetes-related health outcomes in the short-term. Sustainable models of ongoing diabetes self- management support (DSMS) are needed and should be ongoing, patient-driven, responsive to change, and embedded in existing community infrastructures. Training peer leaders to facilitate theory-driven, empowerment-based DSMS interventions in church-based settings may be a viable and promising approach.

描述（由申请人提供）：如果没有持续的随访和支持，专业领导的糖尿病自我管理教育（DSME）干预措施对改善糖尿病相关结局仅具有短期影响。鉴于资源的限制，同侪领导的干预措施是一个有前途的办法，以维持自我管理的努力和健康收益取得的短期DSME方案。然而，自我管理支持的可持续模式需要持续，患者驱动，对变化做出反应，并嵌入现有的社区基础设施。非洲裔美国人（AA）教堂是一个潜在的有效场所，提供社区为基础的，同行领导的健康促进干预措施。本研究建议训练同侪领导者（PL），以促进理论驱动，授权为基础的干预和试点教会为基础，同侪领导（CBPL）的自我管理支持干预提供了一个小组设置。具体目标是：（1）确定从密歇根州大伊普西兰蒂地区的10个AA教会招募的培训PL的可行性和可接受性，以促进基于赋权的自我管理支持干预，（2）确定对患有2型糖尿病的AA进行12个月CBPL干预的可行性和可接受性，和（3）通过估计干预和组内A1C变化的效应量，建立设计和支持CBPL干预有效性研究所需的参数估计值。（组内）A1C和其他结果的相关性。在第一阶段，我们将实施一项为期12周的培训计划，从10个AA教会招募2型糖尿病成年人，并为他们提供知识和技能，以促进持续的糖尿病自我管理支持（DSMS）干预。PL必须满足预先制定的基于能力的标准才能成功毕业。基于能力的领域包括糖尿病相关知识、基于授权的促进技能和基于动机面试（MI）的沟通技能。在第二阶段，我们将采用单组重复测量设计，进行为期12个月的CBPL干预，其中3个月的DSME培训，随后9个月的持续DSMS。参与者将从密歇根州大伊普西兰蒂地区的10个AA教堂招募。利用同侪领导人，以促进赋权为基础的干预措施，在教会为基础的设置可以作为一个可行的和可持续的模式，在“现实世界”的设置正在进行的自我管理的支持。 公共卫生关系：如果没有持续的随访和支持，专业领导的糖尿病自我管理教育计划只能在短期内改善糖尿病相关的健康结果。持续糖尿病自我管理支持（DSMS）的可持续模式是必要的，应该是持续的，患者驱动的，对变化做出反应，并嵌入现有的社区基础设施。培训同侪领导人，以促进理论驱动，赋权为基础的DSMS干预措施，在教会为基础的设置可能是一个可行的和有前途的方法。