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      A Systematic Review of Peer-Support Programs for Smoking Cessation in Disadvantaged Groups

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          Abstract

          The burden of smoking is borne most by those who are socially disadvantaged and the social gradient in smoking contributes substantially to the health gap between the rich and poor. A number of factors contribute to higher tobacco use among socially disadvantaged populations including social (e.g., low social support for quitting), psychological (e.g., low self-efficacy) and physical factors (e.g., greater nicotine dependence). Current evidence for the effectiveness of peer or partner support interventions in enhancing the success of quit attempts in the general population is equivocal, largely due to study design and lack of a theoretical framework in this research. We conducted a systematic review of peer support interventions for smoking cessation in disadvantaged groups. The eight studies which met the inclusion criteria showed that interventions that improve social support for smoking cessation may be of greater importance to disadvantaged groups who experience fewer opportunities to access such support informally. Peer-support programs are emerging as highly effective and empowering ways for people to manage health issues in a socially supportive context. We discuss the potential for peer-support programs to address the high prevalence of smoking in vulnerable populations and also to build capacity in their communities.

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          Most cited references38

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          What is the effect of peer support on diabetes outcomes in adults? A systematic review.

          There is increasing interest in the role that peers may play to support positive health behaviours in diabetes, but there is limited evidence to inform policy and practice. The aim of this study was to systematically review evidence of the impact and effectiveness of peer support in adults living with diabetes. We searched the Cochrane Library, MEDLINE, PubMed, EMBASE and CINHAL for the period 1966-2011, together with reference lists of articles for eligible studies. Data were synthesized in a narrative review. Twenty-five studies, including fourteen randomized, controlled or comparative trials, met the inclusion criteria. There was considerable heterogeneity in the design, setting, outcomes and measurement tools. Peer support was associated with statistically significant improvements in glycaemic control (three out of 14 trials), blood pressure (one out of four trials), cholesterol (one out of six trials), BMI/weight (two out of seven trials), physical activity (two out of five trials), self-efficacy (two out of three trials), depression (four out of six trials) and perceived social support (two out of two trials). No consistent pattern of effect related to any model of peer support emerged. Peer support appears to benefit some adults living with diabetes, but the evidence is too limited and inconsistent to support firm recommendations. There remains a need for further well-designed evaluations of its effectiveness and impact. Key questions remain over its suitability to the needs of particular individuals, populations and settings, how best to implement its specific components and the sustainability of its effects. © 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK.
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            Peer support/peer provided services underlying processes, benefits, and critical ingredients.

            P Solomon (2003)
            The article defines peer support/peer provided services; discusses the underlying psychosocial processes of these services; and delineates the benefits to peer providers, individuals receiving services, and mental health service delivery system. Based on these theoretical processes and research, the critical ingredients of peer provided services, critical characteristics of peer providers, and mental health system principles for achieving maximum benefits are discussed, along with the level of empirical evidence for establishing these elements.
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              A systematic review of the effectiveness of peer-based interventions on health-related behaviors in adults.

              We reviewed 25 randomized clinical trials that assessed the effect of peer-based interventions on health-related behaviors in adults. Effect sizes were calculated as odds ratios or standardized mean differences. We grouped most of the studies by 7 measured outcomes, with effect sizes ranging from -0.50 to 2.86. We found that peer-based interventions facilitated important changes in health-related behaviors, including physical activity, smoking, and condom use, with a small- to medium-sized effect. However, the evidence was mixed, possibly because of the heterogeneity we found in methods, dose, and other variables between the studies. Interventions aimed at increasing breastfeeding, medication adherence, women's health screening, and participation in general activities did not produce significant changes.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                28 October 2013
                November 2013
                : 10
                : 11
                : 5507-5522
                Affiliations
                [1 ]School of Dentistry, The University of Queensland, 200 Turbot St., Brisbane, QLD 4000, Australia
                [2 ]The Institute for Urban Indigenous Health, 23 Edgar Street, Bowen Hills, QLD 4006, Australia; E-Mails: Anton.Clifford@ 123456iuih.org.au (A.C.); Kim.Gussy@ 123456iuih.org.au (K.G.)
                [3 ]School of Population Health, The University of Queensland, Herston Road, Brisbane, QLD 4006, Australia
                [4 ]University of Queensland Centre for Clinical Research, The University of Queensland, Building 71/918 RBWH Site, Herston, QLD 4029, Australia; E-Mail: c.gartner@ 123456uq.edu.au
                Author notes
                [* ] Author to whom correspondence should be addressed; E-Mail: p.ford@ 123456uq.edu.au ; Tel.: +617-3365-8085; Fax: +617-3365-8199.
                Article
                ijerph-10-05507
                10.3390/ijerph10115507
                3863857
                24169412
                782bdb5c-0e26-40da-b213-741d1dc8b912
                © 2013 by the authors; licensee MDPI, Basel, Switzerland.

                This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license ( http://creativecommons.org/licenses/by/3.0/).

                History
                : 04 August 2013
                : 09 October 2013
                : 12 October 2013
                Categories
                Review

                Public health
                smoking,cessation,peer-support,disadvantaged populations
                Public health
                smoking, cessation, peer-support, disadvantaged populations

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