Lifestyle-Appropriate Peer Supports for Glycemic Control among Type 2 Diabetes Patients in Thailand
Keywords:
glycemic control, lifestyle-appropriate peer supports, self-care managementAbstract
Diabetes, a worldwide health problem, is a chronic, lifelong condition which requires continuous self-care management to keep glycemic level under control. More often than not, self-care management is short-lived if not appropriately supported. This quasi-experimental study, three-group pre-post-test was carried out to assess the effects of context and lifestyle appropriate peer support models in an agricultural and non-agricultural communities. A total of 58 and 30 type 2 diabetes patients were recruited into the intervention and comparison groups, respectively. Out of 58 patients in the intervention group, 29 patients each were selected from an agricultural community and from non-agricultural community to observe different peer support models and glycemic levels between these two groups and in the comparison group. The inclusion criteria included aged 35 – 75 years, fasting blood sugar (FBS) lied between 30 – 300 mg/dl, and systolic blood pressure did not exceed 200 mmHg. Trans-theoretical Model, participatory learning, inclusive planning, and social support were used to guide the intervention activities to increase knowledge and self-care management behaviors. Twenty village health volunteers in the experimental areas were recruited and trained to function as peer supporters. The intervention lasted six months from July to December 2011. After the intervention, patients in both experimental groups significantly improved their self-care management and reduced HbA1C from 8.02 to 7.5% (p-value<0.05) in agricultural and from 8.54 to 7.60% in non-agricultural group (p-value<0.01), while those of the comparison group slightly increased. Two different peer support models were identified in the agricultural and non-agricultural communities. Results from this study showed that peer supports appropriately tailored to the context and lifestyle of diabetes patients could significantly increase knowledge, improve self-care management, reduce BMI and blood sugar levels of the patients. It is suggested that peer support using context and lifestyle appropriate strategies be integrated into country health care system to make self-care management among chronically ill patients sustainable.
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