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型糖尿病是一种重要和常见的健康问题，不成比例地影响低收入和少数民族人口。获得糖尿病自我管理技能并每天应用它们是具有挑战性的，特别是对于资源有限的个人。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，在一些研究中改善了健康结果。从理论上讲，CHW是接触弱势群体的一种有吸引力的方式，但是，还需要开展更多的工作来了解CHW如何以及在什么样的环境中最有效地影响糖尿病护理和减少健康差距。还需要关于成本效益和投资回报的信息。目的：我们将检验以下假设：社区卫生工作者为2型糖尿病的自我管理提供家庭支持、糖尿病资源以及与医疗提供者有效联系和沟通的帮助，将：（1）改善HbA 1c（主要结局）和次要结局，包括血压和血脂控制、卫生保健利用和健康相关生活质量;（2）改善糖尿病自我管理，包括自我效能、体力活动、营养和药物依从性;（3）具有成本效益和可行性。方法：我们将实施一项为期5年的随机对照试验，将比较CHW模式，包括家庭糖尿病自我管理支持，与小组支持的链接和电话支持与常规护理。社区卫生工作者将在一年内进行最多5次家访，在自我管理的关键组成部分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团体活动;通过与客户的关系获得社会支持;并发展在医疗保健系统中导航的技能。在研究期结束时，常规护理参与者将接受CHW和糖尿病自我管理资源的家访。参与者将从居住在华盛顿金县的30-70岁的低收入患者中抽取，这些患者讲英语或西班牙语，患有2型糖尿病，血糖和/或血压控制不良。参与者将从当地退伍军人事务部（VA）医院，县医院（Harborview）和社区卫生中心（Sea Mar）招募。我们的主要结局将是通过HbA 1c测量的血糖控制。次要结果是血压、血脂、卫生保健利用、健康相关生活质量、自我效能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