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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.
- Source :
- BMC Public Health; 8/24/2016, Vol. 16 Issue 1, p1-13, 13p, 1 Diagram, 4 Charts
- Publication Year :
- 2016
-
Abstract
- <bold>Background: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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.<bold>Conclusions: </bold>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.<bold>Trial Registration: </bold>Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12609000469213 . Registered 16 June 2009. [ABSTRACT FROM AUTHOR]
- Subjects :
- CARDIOVASCULAR diseases
TYPE 2 diabetes treatment
HEALTH education
QUALITY of life
EDUCATIONAL evaluation
PSYCHOSOCIAL factors
RANDOMIZED controlled trials
CARDIOVASCULAR disease prevention
TYPE 2 diabetes complications
COMPARATIVE studies
COUNSELING
HEALTH promotion
LONGITUDINAL method
RESEARCH methodology
MEDICAL cooperation
PRIMARY health care
RESEARCH
HEALTH self-care
AFFINITY groups
GROUP process
RESIDENTIAL patterns
SOCIAL support
EVALUATION research
EVALUATION of human services programs
Subjects
Details
- Language :
- English
- ISSN :
- 14712458
- Volume :
- 16
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- BMC Public Health
- Publication Type :
- Academic Journal
- Accession number :
- 117695918
- Full Text :
- https://doi.org/10.1186/s12889-016-3538-3