title: Peer Support for Achieving Independence in Diabetes (Peer-AID): design, methods and baseline characteristics of a randomized controlled trial of community health worker assisted diabetes self-management support.
abstract: OBJECTIVE
  Community health workers (CHWs) may be an important mechanism to provide diabetes self-management to disadvantaged populations. We describe the design and baseline results of a trial evaluating a home-based CHW intervention.
  Peer Support for Achieving Independence in Diabetes (Peer-AID) is a randomized, controlled trial evaluating a home-based CHW-delivered diabetes self-management intervention versus usual care. The study recruited participants from 3 health systems. Change in A1c measured at 12 months is the primary outcome. Changes in blood pressure, lipids, health care utilization, health-related quality of life, self-efficacy and diabetes self-management behaviors at 12 months are secondary outcomes.
  
  
  RESULTS
  A total of 1438 patients were identified by a medical record review as potentially eligible, 445 patients were screened by telephone for eligibility and 287 were randomized. Groups were comparable at baseline on socio-demographic and clinical characteristics. All participants were low-income and were from diverse racial and ethnic backgrounds. The mean A1c was 8.9%, mean BMI was above the obese range, and non-adherence to diabetes medications was high. The cohort had high rates of co-morbid disease and low self-reported health status. Although one-third reported no health insurance, the mean number of visits to a physician in the past year was 5.7. Trial results are pending.
  
  
  CONCLUSIONS
  Peer-AID recruited and enrolled a diverse group of low income participants with poorly controlled type 2 diabetes and delivered a home-based diabetes self-management program. If effective, replication of the Peer-AID intervention in community based settings could contribute to improved control of diabetes in vulnerable populations.
authors: VA Puget Sound Healthcare System, Northwest HSR&D Center of Excellence, United States; VA Puget Sound Healthcare System, General Internal Medicine Service, United States; University of Washington, School of Medicine, Department of Medicine, United States; University of Washington, School of Public Health, United States. Electronic address: Karin.Nelson@va.gov.
authors: Karin
authors: K
authors: Nelson
authors: Public Health - Seattle & King County, United States.
authors: Nathan
authors: N
authors: Drain
authors: Public Health - Seattle & King County, United States.
authors: June
authors: J
authors: Robinson
authors: Public Health - Seattle & King County, United States.
authors: Janet
authors: J
authors: Kapp
authors: VA Puget Sound Healthcare System, Northwest HSR&D Center of Excellence, United States; University of Washington, School of Medicine, Department of Medicine, United States.
authors: Paul
authors: P
authors: Hebert
authors: VA Puget Sound Healthcare System, Northwest HSR&D Center of Excellence, United States.
authors: Leslie
authors: L
authors: Taylor
authors: VA Puget Sound Healthcare System, Northwest HSR&D Center of Excellence, United States; VA Puget Sound Healthcare System, General Internal Medicine Service, United States; University of Washington, School of Medicine, Department of Medicine, United States.
authors: Julie
authors: J
authors: Silverman
authors: VA Puget Sound Healthcare System, Northwest HSR&D Center of Excellence, United States; VA Puget Sound Healthcare System, General Internal Medicine Service, United States; University of Washington, School of Medicine, Department of Medicine, United States.
authors: Meghan
authors: M
authors: Kiefer
authors: University of Washington, School of Medicine, Department of Medicine, United States.
authors: Dan
authors: D
authors: Lessler
authors: University of Washington, School of Medicine, Department of Medicine, United States; University of Washington, School of Public Health, United States; Public Health - Seattle & King County, United States.
authors: James
authors: J
authors: Krieger
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D003150:Community Health Workers / Q000458:organization & administration*; D003376:Counseling; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D011203:Poverty; D011788:Quality of Life; D012107:Research Design; D012648:Self Care / Q000379:methods*; D020377:Self Efficacy; D012959:Socioeconomic Factors
chemical_list: D006442:Glycated Hemoglobin; D008055:Lipids
keywords: Community health workers; Diabetes self-management