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

Contemp Clin Trials. 2014 Jul;38(2):361-9. doi: 10.1016/j.cct.2014.06.011. Epub 2014 Jun 21.

Abstract

Background & objectives: Community health workers (CHWs) may be an important mechanism to provide diabetes self-management to disadvantaged populations. We describe the design and baseline results of a trial evaluating a home-based CHW intervention.

Methods & research design: Peer Support for Achieving Independence in Diabetes (Peer-AID) is a randomized, controlled trial evaluating a home-based CHW-delivered diabetes self-management intervention versus usual care. The study recruited participants from 3 health systems. Change in A1c measured at 12 months is the primary outcome. Changes in blood pressure, lipids, health care utilization, health-related quality of life, self-efficacy and diabetes self-management behaviors at 12 months are secondary outcomes.

Results: A total of 1438 patients were identified by a medical record review as potentially eligible, 445 patients were screened by telephone for eligibility and 287 were randomized. Groups were comparable at baseline on socio-demographic and clinical characteristics. All participants were low-income and were from diverse racial and ethnic backgrounds. The mean A1c was 8.9%, mean BMI was above the obese range, and non-adherence to diabetes medications was high. The cohort had high rates of co-morbid disease and low self-reported health status. Although one-third reported no health insurance, the mean number of visits to a physician in the past year was 5.7. Trial results are pending.

Conclusions: Peer-AID recruited and enrolled a diverse group of low income participants with poorly controlled type 2 diabetes and delivered a home-based diabetes self-management program. If effective, replication of the Peer-AID intervention in community based settings could contribute to improved control of diabetes in vulnerable populations.

Keywords: Community health workers; Diabetes self-management.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Aged
  • Blood Pressure
  • Community Health Workers / organization & administration*
  • Counseling
  • Diabetes Mellitus, Type 2 / therapy*
  • Female
  • Glycated Hemoglobin A
  • Health Services / statistics & numerical data
  • Humans
  • Lipids / blood
  • Male
  • Middle Aged
  • Poverty*
  • Quality of Life
  • Research Design*
  • Self Care / methods*
  • Self Efficacy
  • Socioeconomic Factors

Substances

  • Glycated Hemoglobin A
  • Lipids