title: Peer Support for Diabetes Management in Primary Care and Community Settings in Anhui Province, China.
abstract: OBJECTIVE
  We evaluated a peer leader-support program (PLSP) for diabetes self-management in China in terms of acceptability and feasibility; implementation; perceived advantages; disadvantages and barriers; reach and recruitment; effectiveness in terms of diabetes knowledge and clinical impacts; adoption; and sustainability.
  
  
  METHODS
  Within each of 3 cities in Anhui Province, 2 subcommunities were randomly assigned to usual care or PLSP. Peer leaders and staff of Community Health Service Centers (CHSCs) co-led biweekly educational meetings. Peer leaders also led biweekly discussion meetings, promoted regular care through the CHSCs, organized informal health promotion activities (eg, walking and tai chi groups), and provided informal individual support to participants through casual contact.
  
  
  RESULTS
  Qualitative evaluations indicated acceptance of and positive responses to the program among patients, peer leaders, and CHSC staff. Implementation was successful in 2 of 3 subcommunities, the third failing for lack of staff resources. Reported advantages included peer support as a bridge between CHSCs and their patients. In 2 sites where the PLSP was implemented, analyses controlling for baseline differences and site showed significant benefits for PLSP relative to controls (P <0.05) for knowledge, self-efficacy, BMI, systolic blood pressure, diastolic blood pressure, and both fasting and 2-hour post-prandial blood glucose. The Anhui Provincial Health Bureau has extended the PLSP model to other communities and to cardiovascular disease prevention and management.
  
  
  CONCLUSIONS
  The PLSP was well accepted, feasible given sufficient administrative and staff resources, effective for those who participated, and generalizable to other sites and health problems.
authors: Anhui Provincial Center for Disease Control and Prevention, Hefei, Anhui Province, China.
authors: Xuefeng
authors: X
authors: Zhong
authors: Anhui Provincial Center for Disease Control and Prevention, Hefei, Anhui Province, China.
authors: Zhimin
authors: Z
authors: Wang
authors: Department of Health Behavior, University of North Carolina at Chapel Hill Peers for Progress, American Academy of Family Physicians Foundation, Leawood, Kansas edfisher@unc.edu.
authors: Edwin B
authors: EB
authors: Fisher
authors: Department of Health Education and Behavioral Science, Faculty of Public Health, Mahidol University, Bangkok, Thailand.
authors: Chanuantong
authors: C
authors: Tanasugarn
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D015992:Body Mass Index; D002681:China; D003153:Community Health Services / Q000379:methods; D003376:Counseling / Q000379:methods*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000523:psychology / Q000628:therapy*; D005069:Evaluation Studies as Topic; D005215:Fasting / Q000097:blood; D005240:Feasibility Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods; D006801:Humans; D008297:Male; D010379:Peer Group; D019518:Postprandial Period; D011320:Primary Health Care / Q000379:methods; D012648:Self Care / Q000379:methods / Q000523:psychology*; D020377:Self Efficacy; D012944:Social Support; D055815:Young Adult
chemical_list: D001786:Blood Glucose
keywords: community; diabetes; peer support