Peer support in Shanghai's Commitment to diabetes and chronic disease self-management: program development, program...

Area of Science:

• Public Health
• Chronic Disease Management
• Community Health

Background:

• Implementing sustainable peer support (PS) programs in community settings presents organizational challenges.
• Diabetes management requires integrated care models, particularly in primary care settings.

Purpose of the Study:

• To develop, evaluate, and expand a peer support program for diabetes patients within Shanghai's integrated care model.
• To assess the impact of PS on clinical markers, diabetes distress, and neighborhood support.

Main Methods:

• A phased approach involving 9 Community Health Centers (CHCs) for development and 12 communities for expansion.
• Peer leaders (PLs) facilitated diabetes management meetings, neighborhood activities, and individual follow-ups.
• Analysis of clinical markers (HbA1c) and diabetes distress among 1,284 participants.

Main Results:

• Significant improvements in HbA1c (e.g., 9.09% to 8.50% for those ≥8% at baseline) and reduced diabetes distress (p < 0.001 to 0.041).
• Implementation ratings correlated with reduced HbA1c, decreased distress, and enhanced neighborhood support.
• Integration with community resources and Residential Committees positively impacted HbA1c outcomes.

Conclusions:

• Peer support programs are feasible and valuable for diabetes self-management in community settings like Shanghai.
• The Shanghai government recognizes PS as a key strategy for chronic disease self-management by 2030.
• Successful implementation involves collaboration with community health staff, self-management groups, and local committees.