PLATINUM Program: A Feasibility Study on a Train-the-trainer Course on Peer Support for People With Type 2 Diabetes

NCT ID: NCT01313949

Last Updated: 2014-07-23

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 75 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2009-02-28
• Study Completion Date: 2011-08-31

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.

Conditions

Diabetes

Study Design

• Allocation Method: NON_RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: SUPPORTIVE_CARE
• Blinding Strategy: NONE

Study Groups

Usual Care

A total of 90 patients with diabetes will be recruited. Thirty will be selected for the training course and the other 60 will be compared as controls. These controls will receive their usual diabetes care.

Group Type: NO_INTERVENTION

No interventions assigned to this group

Peer leader training

Peer leaders are people with diabetes who had volunteered to undertake an extensive program of training. The purpose of this training is to make them effective in the provision of support and advice to their peers on a one-to-one basis via telecommunication.

These diabetes patients will undergo a 32-hour 'Train the trainer' program (4 workshops, 8-hours each) led by health care experts in nutrition, physical activity, psychology and neuro-linguistic program [NLP] trainer to ensure the adequacy of knowledge and skills of these mentors.

Group Type: EXPERIMENTAL

Training program

Intervention Type: OTHER

These diabetes patients will undergo a 32-hour 'Train the trainer' program (4 workshops, 8-hours each) led by health care experts in nutrition, physical activity, psychology and neuro-linguistic program \[NLP\] trainer to ensure the adequacy of knowledge and skills of these mentors.

Interventions

Training program

These diabetes patients will undergo a 32-hour 'Train the trainer' program (4 workshops, 8-hours each) led by health care experts in nutrition, physical activity, psychology and neuro-linguistic program \[NLP\] trainer to ensure the adequacy of knowledge and skills of these mentors.

Intervention Type: OTHER

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

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 75 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Asia Diabetes Foundation

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Rebecca Wong

Role: PRINCIPAL_INVESTIGATOR

Prince of Wales Hospital, Shatin, HK

Shimen Au

Role: PRINCIPAL_INVESTIGATOR

Ruttonjee & Tang Shiu Kin Hospitals, Wan Chai, HK

Locations

Diabetes Ambulatory Care Centre, UCH

Kwun Tong, Kowloon, Hong Kong

Kwai Chung out-patient clinic

Kwai Chung, New Territories, Hong Kong

CUHK YCK, Prince of Wales Hospital

Shatin, New Territories, Hong Kong

Diabetes & Endocrine Centre, Prince of Wales Hospital

Shatin, New Territories, Hong Kong

Diabetes Centre, North District Hospital

Sheung Shui, New Territories, Hong Kong

Diabetes Centre, Tung Wah Eastern Hospital

Causeway Bay, , Hong Kong

Diabetes Hong Kong

Central, , Hong Kong

Diabetes Ambulatory Centre, PYNEH

Chai Wan, , Hong Kong

Diabetes Centre, Kwong Wah Hospital

Kowloon, , Hong Kong

Diabetes Centre, Queen Elizabeth Hospital

Kowloon, , Hong Kong

PMH, Diabetes Care Centre, Princess Margaret Hospital

Kowloon, , Hong Kong

Lam Tin Health Clinic

Lam Tin, , Hong Kong

Diabetes Centre, Queen Mary Hospital

Pok Fu Lam, , Hong Kong

Sai Wan Ho Health Centre

Sai Wan Ho, , Hong Kong

Diabetes Centre, Ruttonjee Hospital

Wan Chai, , Hong Kong

Countries

Hong Kong

Related Links

http://www.adf.org.hk

For more information on this trial and others conducted by the Asia Diabetes Foundation.

Other Identifiers

CRE-2009-087

Identifier Type: -

Identifier Source: org_study_id