+1 Recommend
1 collections

      To submit your manuscript, please click here

      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Peer Support Self-Management Intervention for Individuals With Type 2 Diabetes in Rural Primary Care Settings: Protocol for a Mixed Methods Study

      , MD, MPH, PhD 1 , , MD, MPH 1 , , , BSc, MSc 2 , , BSc, MSc 1 , , PhD 3
      (Reviewer), (Reviewer)
      JMIR Research Protocols
      JMIR Publications
      type 2 diabetes, peer support, self-management, rural primary care setting, mixed study, rural, primary care, diabetes, diabetic

      Read this article at

          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.



          The increasing prevalence of diabetes is placing important demands on the Chinese health care system. Providing self-management programs to the fast-growing number of people with diabetes presents an urgent need in rural primary care settings in China. Peer support has demonstrated effectiveness in improving self-management for individuals with diabetes in urban communities in China. A priority then becomes developing and evaluating a peer support program in primary care settings in rural communities of China and determining whether it is feasible and acceptable.


          The aims of this study are (1) to evaluate the feasibility and acceptability of a peer support approach to type 2 diabetes self-management in rural primary care settings; (2) to identify enabler and facilitator factors likely to influence the peer support implementation; (3) to provide primary data and evidence for developing a version of the program suitable for a randomized controlled trial in rural primary care settings.


          Three townships will be sampled from 3 different counties of Anhui province as the study setting. Participants will be recruited based on these counties’ local primary care health record system. The peer supporters will be recruited from among the participants. The peer support program will be led by peer supporters who have completed 12 hours of training. It will be guided by primary care providers. The program will include biweekly meetings over 3 months with varied peer support contacts between meetings to encourage the implementation of diabetes self-management. Mixed methods will be used for evaluation. Qualitative methods will be used to collect information from health care system professionals, individuals with diabetes, and peer supporters. Quantitative methods will be used to collect baseline data and data at the end of the 3-month intervention regarding psychosocial factors and self-management practices.


          The results will include (1) quantitative baseline data that will characterize type 2 diabetes self-management practices of individuals with diabetes; (2) qualitative data that will identify enablers of and barriers to self-management practices for individuals with type 2 diabetes in rural communities; (3) both qualitative and quantitative evaluation data, after the 3-month intervention, to demonstrate the feasibility and acceptability of the peer support approach for individuals with type 2 diabetes.


          Our findings will inform the design of a tailored intervention program to improve self-management among individuals with type 2 diabetes in rural primary care settings. If we find that the peer support approach is feasible and acceptable, we will develop a larger randomized controlled trial to evaluate effectiveness in multiple rural settings in the province.

          International Registered Report Identifier (IRRID)


          Related collections

          Most cited references35

          • Record: found
          • Abstract: not found
          • Article: not found

          Self-efficacy mechanism in human agency.

            • Record: found
            • Abstract: not found
            • Article: not found

            The MOS social support survey

              • Record: found
              • Abstract: found
              • Article: not found

              Self-management education: history, definition, outcomes, and mechanisms.

              Self-management has become a popular term for behavioral interventions as well as for healthful behaviors. This is especially true for the management of chronic conditions. This article offers a short history of self-management. It presents three self-management tasks--medical management, role management, and emotional management--and six self-management skills--problem solving, decision making, resource utilization, the formation of a patient-provider partnership, action planning, and self-tailoring. In addition, the article presents evidence of the effectiveness of self-management interventions and posits a possible mechanism, self-efficacy, through which these interventions work. In conclusion the article discusses problems and solutions for integrating self-management education into the mainstream health care systems.

                Author and article information

                JMIR Res Protoc
                JMIR Res Protoc
                JMIR Research Protocols
                JMIR Publications (Toronto, Canada )
                4 September 2023
                : 12
                : e47822
                [1 ] School of Health Management Anhui Medical University Hefei China
                [2 ] Shenzhen People’s Hospital Shenzhen China
                [3 ] Peer for Progress, Department of Health Behavior Gillings School of Global Public Health University of North Carolina–Chapel Hill Chapel Hill, NC United States
                Author notes
                Corresponding Author: Shaohua Li 1425051920@ 123456qq.com
                Author information
                ©Xuefeng Zhong, Shaohua Li, Meng Luo, Xinyu Ma, Edwin B Fisher. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 04.09.2023.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on https://www.researchprotocols.org, as well as this copyright and license information must be included.

                : 3 April 2023
                : 5 June 2023
                : 13 July 2023
                : 24 July 2023

                type 2 diabetes,peer support,self-management,rural primary care setting,mixed study,rural,primary care,diabetes,diabetic


                Comment on this article