Teachers College, Columbia University, New York (Ms Comellas)
Albert Einstein College of Medicine, Bronx, New York (Dr Walker, Dr Zonszein)
Diabetes Educ. 2010 Jan-Feb;36(1):141-51. doi: 10.1177/0145721709354606. Epub 2009 Dec 4.
To develop, implement, and evaluate a peer-led diabetes self-management support program in English and Spanish for a diverse, urban, low-income population. The program goals and objectives were to improve diabetes self-management behaviors, especially becoming more physically active, healthier eating, medication adherence, problem solving, and goal setting.
After a new training program for peers led by a certified diabetes educator (CDE) was implemented with 5 individuals, this pilot evaluation study was conducted in 2 community settings in the East and South Bronx. Seventeen adults with diabetes participated in the new peer-led 5-session program. Survey data were collected pre- and postintervention on diabetes self-care activities, quality of well-being, and number of steps using a pedometer.
This pilot study established the acceptance and feasibility of both the peer training program and the community-based, peer-led program for underserved, minority adults with diabetes. Significant improvements were found in several physical activity and nutrition activities, with a modest improvement in well-being. Feedback from both peer facilitators and participants indicated that a longer program, but with the same educational materials, was desirable.
To reduce health disparities in urban communities, it is essential to continue program evaluation of the critical elements of peer-led programs for multiethnic adults with diabetes to promote self-management support in a cost-effective and culturally appropriate manner. Practice Implications A diabetes self-management support program can be successfully implemented in the community by peers, within a model including remote supervision by a CDE.
为了提高不同种族、城市、低收入人群的糖尿病自我管理能力，以英语和西班牙语为媒介，开发、实施并评估一个同辈主导的糖尿病自我管理支持计划。该计划的目标是改善糖尿病自我管理行为，特别是增加身体活动、更健康的饮食、药物依从性、解决问题和设定目标。
在由认证糖尿病教育者（CDE）领导的 5 名同伴进行新的培训计划后，在东布朗克斯和南布朗克斯的两个社区环境中进行了这项试点评估研究。17 名糖尿病成年人参加了新的同伴主导的 5 节课程计划。在干预前和干预后，使用计步器收集糖尿病自我护理活动、幸福感质量和步数的调查数据。
这项试点研究确立了同伴培训计划和面向服务不足的少数族裔糖尿病成年人的社区为基础的同伴主导计划的接受度和可行性。在一些身体活动和营养活动方面取得了显著的改善，幸福感也有适度的提高。来自同伴促进者和参与者的反馈表明，更长的计划但使用相同的教育材料是可取的。
为了减少城市社区的健康差异，必须继续对多民族成年糖尿病患者的同伴主导计划的关键要素进行方案评估，以经济有效的、文化适宜的方式促进自我管理支持。实践意义糖尿病自我管理支持计划可以由同伴在社区中成功实施，该计划包括 CDE 的远程监督。
