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Peers for Progress: Evaluation of the Implementation and Effectiveness of a Successful Diabetes Peer Mentoring Program

Diabetes is a complex illness to manage for both patients and physicians. Experience has shown that it can be difficult for patients to make necessary lifestyle changes on their own, and while physicians and other health care providers can help educate patients about changes in lifestyle, they often lack the time and knowledge of the patientsí environments to provide substantial assistance in these areas. With this in mind, a peer-to-peer mentoring program was developed at 15 clinics in a large medical group which specializes in senior healthcare in San Antonio, Texas. Over the eighteen-month recruitment period, 485 patients went through an eight-week introduction to diabetes class (Diabetes 101). Following each Diabetes 101 8-week session, 53 patients were selected for a four-day mentor training program and were subsequently matched with patients to mentor that also went through Diabetes 101. De-identified control patients were selected via propensity score to compare medical outcomes.

A mixed methods, non-randomized, comparison group design was used to evaluate the effects of the Care Companion diabetes peer mentoring intervention on patient self-management knowledge and behaviors, quality of life and social isolation, emotional well-being, and health outcomes including HbA1C, LDL, Blood pressure, diabetes distress (DDS, Fisher), and BMI. A propensity score analysis was used to determine if health outcomes improved among Diabetic patients who participated in the Peers program.

Patient characteristic information collected included race, ethnicity, household income, education, as well as information on diabetes self-care ( Summary of Diabetes Self-Care Activities - SDSCA), self-management behaviors ( Behavioral Risk Factor Surveillance System (BRFSS), treatment adherence (Morisky Scale for medication adherence), basic knowledge related to diabetes, and quality of life ( EQ5-D). Bio and socio metric data including HbA1C, LDL, blood pressure, weight and emotional distress related to diabetes (DDS, Fisher) were also obtained from data routinely collected as part of standard diabetes care by the clinical sites.

Presentations and Results

The WellMed Care Companion Program: Selecting and Training Peer Mentors to Empower Patients with Diabetes
Gomez, Margie; Henderson, Cynthia 
STFM Conference on Practice Improvement. Newport Beach, CA. December 1, 2011.

The Care Companions Program: Empowering Patients to Become Managers of their Own Healthcare
Henry, Michelle; Gomez, Margie; Eickhoff, Robin
STFM Conference on Practice Improvement. San Antonio, TX. December 4, 2010.

Dataset Description

Type of Patients Included N Data Elements
Patients with a diagnosis of diabetes 10233
  • Blood Pressure
  • Gender
  • Prescribed Medications
  • Smoking Status
  • Alcohol use
  • Microalbumin
  • A1c
  • Microalbumin/Creatinine ratio
  • LDL
  • HDL
  • Triglycerides
  • Total Cholesterol
  • Age
  • Weight
  • Total direct cost of care
  • PHQ2
  • PHQ9
  • DDS2
  • DDS17
  • History of heart disease
  • History of stroke
  • History of lower extremity amputation
  • Visual Impairment
  • Foot Exam
  • Diabetic Eye Exam
  • Diabetes Education
  • Encounter data
  • Height