Peer Support To Enhance The Shanghai Integration Model Of Diabetes Care: Dissemination To 12 Communities

Shanghai Jiao Tong University

Status: Completed

Conditions: Type2 Diabetes; PreDiabetes

Treatments: Behavioral: Peer Support Integrated with Primary Care

Study type: Interventional

Funder types: Other

Identifiers

NCT03958838

2019-028

Details and patient eligibility

About

This project will disseminate a community-level intervention that integrates peer support from Community Self-Management Groups (CSMGs) and primary care through Community Health Centers (CHC). The model and program materials were developed and refined from the first year of implementation within community health centers in Shanghai. This project will be implemented in 12 communities in 6 districts across Shanghai, representing a diverse cross section of the population. A total of 1440 subjects will be recruited from the 12 intervention communities and 720 control subjects will be recruited from 4 control communities.

Full description

The development of contemporary diabetes care offers new hope for long and satisfying lives of those with the disease, but also provides increased challenges for integration across the many dimensions of care (varied medications in addition to insulin, specialty services, diet, physical activity, stress management, etc.) and across the many who contribute to care (specialists, primary care providers, nurses, dietitians and patient educators, family members, friends, worksites). The Shanghai Integration Model (SIM) has made great strides to integrating specialty/hospital care with primary/community care. The addition of peer support can enhance patient engagement within that integrated care. Peer support can also integrate care with the daily behaviors and patterns that optimal diabetes management requires and with the family members and others in individuals' daily lives who can support diabetes management.

This project will disseminate a community-level intervention that integrates peer support from Community Self-Management Groups (CSMGs) and primary care through Community Health Centers (CHC). The model and program materials were developed and refined from the first year of implementation within community health centers in Shanghai. This project will be implemented in 12 communities in 6 districts across Shanghai, representing a diverse cross section of the population. A total of 1440 subjects will be recruited from the 12 intervention communities and 720 control subjects will be recruited from 4 control communities.

The program is a collaboration among the Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, the Shanghai Diabetes Institute, the National Office for Primary Diabetes Care, the Shanghai Municipal Health Commission, the Shanghai Municipal Center for Disease Control and Prevention, and, at the University of North Carolina-Chapel Hill, Peers for Progress, widely recognized for its leadership in promoting peer support in health care and prevention.

Collaborators:

Shanghai Sixth People's Hospital Shanghai Jiao Tong University Shanghai Diabetes Institute National Office for Primary Diabetes Care Shanghai Municipal Health Commission Shanghai Municipal Center for Disease Control and Prevention University of North Carolina at Chapel Hill, Peers for Progress

Enrollment: 2,160 patients

Sex: All

Ages: 18 to 99 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adults age ≥ 18

• Chinese

• Has type 2 diabetes or prediabetes

• Patient at participating CHC

  • Intervention group: 120 subjects at each of 12 CHCs

• ~40 patients (Pre-diabetes including IFG or IGT)

• ~40 patients (Diabetics with poor control, FPG≥9.7 mmol/L)

• ~40 patients (Newly-diagnosed diabetics within 2 years)

  • Control group: 240 control subjects at each of 2 CHCs (Yichuan and Zhaoxiang) and 120 control subjects at each of 2 CHCs (Xuhang and Waigang)

  o (Yichuan and Zhaoxiang)

• ~80 patients (Pre-diabetes including IFG or IGT)

• ~80 patients (Diabetics with poor control, FPG≥9.7 mmol/L)

• ~80 patients (Newly-diagnosed diabetics within 2 years)

  o (Xuhang and Waigang)

• ~40 patients (Pre-diabetes including IFG or IGT)

• ~40 patients (Diabetics with poor control, FPG≥9.7 mmol/L)

• ~40 patients Newly-diagnosed diabetics within 2 years)

Exclusion criteria

• No serious mental illness (i.e. major depression, schizophrenia, bipolar disorder, obsessive compulsive disorder, panic disorder, post-traumatic stress disorder, borderline personality disorder)

Withdrawal criteria:

• No longer a patient at participating CHC (moved, deceased, extended hospitalization)

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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2,160 participants in 2 patient groups

Intervention Group

Experimental group

Description:

Subjects will receive usual care from community health center staff. In addition, they will also receive a variety of community-level and individual-level interventions, categorized broadly into three levels. At the community level, subjects will receive the 5 Key Diabetes Messages that Everyone Should Know and the 6 Modules of Basic Diabetes Education. At the individual level, subjects and their families will be invited to participate in group activities, co-organized by community health staff, CHC staff, and CSMG peer leaders. Subjects will receive in-person peer support through these group activities, with follow up through telephone calls and text messaging. For subjects that have poorly controlled diabetes or are experiencing emotional distress related to their diabetes, CSMG peer leaders will work closely with them to help them solve problems around their diabetes.

Treatment:

Behavioral: Peer Support Integrated with Primary Care

Control Group

No Intervention group

Description:

Subjects in the control group will receive usual care from community health center staff.