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Cardiovascular risk outcome and program evaluation of a cluster randomised controlled trial of a community-based, lay peer led program for people with diabetes

Riddell, M.A., Dunbar, J.A., Absetz, P., Wolfe, R., Li, H., Brand, M., Aziz, Z. and Oldenburg, B. 2016, Cardiovascular risk outcome and program evaluation of a cluster randomised controlled trial of a community-based, lay peer led program for people with diabetes, BMC public health, vol. 16, Article number: 864, pp. 1-13, doi: 10.1186/s12889-016-3538-3.

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Title Cardiovascular risk outcome and program evaluation of a cluster randomised controlled trial of a community-based, lay peer led program for people with diabetes
Author(s) Riddell, M.A.
Dunbar, J.A.ORCID iD for Dunbar, J.A. orcid.org/0000-0003-0866-4365
Absetz, P.
Wolfe, R.
Li, H.
Brand, M.
Aziz, Z.
Oldenburg, B.
Journal name BMC public health
Volume number 16
Season Article number: 864
Start page 1
End page 13
Total pages 13
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2016-08-24
ISSN 1471-2458
Keyword(s) diabetes
self-management
peer support
medication adherence
diabetes self-care behaviours
UKPDS
Summary BACKGROUND: The 2013 Global Burden of Disease Study demonstrated the increasing burden of diabetes and the challenge it poses to the health systems of all countries. The chronic and complex nature of diabetes requires active self-management by patients in addition to clinical management in order to achieve optimal glycaemic control and appropriate use of available clinical services. This study is an evaluation of a "real world" peer support program aimed at improving the control and management of type 2 diabetes (T2DM) in Australia.

METHODS: The trial used a randomised cluster design with a peer support intervention and routine care control arms and 12-month follow up. Participants in both arms received a standardised session of self-management education at baseline. The intervention program comprised monthly community-based group meetings over 12 months led by trained peer supporters and active encouragement to use primary health care and other community resources and supports related to diabetes. Clinical, behavioural and other measures were collected at baseline, 6 and 12 months. The primary outcome was the predicted 5 year cardiovascular disease risk using the United Kingdom Prospective Diabetes Study (UKPDS) Risk Equation at 12 months. Secondary outcomes included clinical measures, quality of life, measures of support, psychosocial functioning and lifestyle measures.

RESULTS: Eleven of 12 planned groups were successfully implemented in the intervention arm. Both the usual care and the intervention arms demonstrated a small reduction in 5 year UKPDS risk and the mean values for biochemical and anthropometric outcomes were close to target at 12 months. There were some small positive changes in self-management behaviours.

CONCLUSIONS: The positive changes in self-management behaviours among intervention participants were not sufficient to reduce cardiovascular risk, possibly because approximately half of the study participants already had quite well controlled T2DM at baseline. Future research needs to address how to enhance community based programs so that they reach and benefit those most in need of resources and supports to improve metabolic control and associated clinical outcomes.
Notes Prepared by the authors in conjunction with the Australasian Peers for Progress Diabetes Project Investigators.
Language eng
DOI 10.1186/s12889-016-3538-3
Field of Research 111712 Health Promotion
1117 Public Health And Health Services
Socio Economic Objective 920104 Diabetes
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30086291

Document type: Journal Article
Collections: Population Health
Open Access Collection
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Created: Mon, 10 Oct 2016, 08:32:46 EST

Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.