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      The Effect of Peer Education on Self-Care Behaviors and the Mean of Glycosylated Hemoglobin in Adolescents with Type 1 Diabetes: A Randomized Controlled Clinical Trial

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          A BSTRACT

          Background:

          Diabetes control in adolescents is a difficult and tedious process. Diabetic teens need training to control it and prevent its complications. This study aimed to investigate the effect of peer education on self-care behaviors and glycosylated hemoglobin among adolescents with type 1 diabetes

          Methods:

          This controlled clinical trial was conducted in Iran from July 2018 to June 2019. 84 teenagers with type 1 diabetes were selected using a simple random sampling and randomly divided into control and intervention groups using block randomization. The intervention group received 4 sessions of training by peers on self care behaviors in diabetes. The control group received the routine training. The self-care questionnaire was filled out, and glycosylated hemoglobin was measured before and three months after the intervention. Data were analyzed using SPSS version 23.0. The significance level was set at P<0.0

          Results:

          Three months after the intervention, the intervention group reported significantly higher levels of score of self-care behaviors (P<0.001) and lower levels of mean glycosylated hemoglobin (P<0.001), as compared with the control. Also, the mean self-care score was not significantly different in the control group before and three months after the intervention (P>0.05). Besides, the mean glycosylated hemoglobin significantly increased three months after the intervention in the controls (P<0.001)

          Conclusion:

          The implementation of peer education can improve the self-care behaviors and glycosylated hemoglobin in adolescents. Hence, regarding its low cost and high safety, it is suggested that this approach should be established in the control of other chronic diseases in order to strengthen the self-care behaviors in adolescents.

          Trial Registration Number: IRCT20180904040944N1.

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          Most cited references31

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          A systematic review of the effectiveness of peer-based interventions on health-related behaviors in adults.

          Allison Webel, William L Holzemer, Joyce Trompeta … (2010)
          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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            ISPAD Clinical Practice Consensus Guidelines 2014. Definition, epidemiology, and classification of diabetes in children and adolescents.

            Maria E Craig, Craig Jefferies, Dana Dabelea … (2014)
            Article 0 comments Cited 75 times – based on 0 reviews     Review now
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              Peer support for patients with type 2 diabetes: cluster randomised controlled trial

              S M Smith, K G Paul, Narcie Kelly … (2011)
              Objective To test the effectiveness of peer support for patients with type 2 diabetes. Design Cluster randomised controlled. Setting 20 general practices in the east of the Republic of Ireland. Participants 395 patients (192 in intervention group, 203 in control group) and 29 peer supporters with type 2 diabetes. Intervention All practices introduced a standardised diabetes care system. The peer support intervention ran over a two year period and contained four elements: the recruitment and training of peer supporters, nine group meetings led by peer supporters in participant’s own general practice, and a retention plan for the peer supporters. Main outcome measures HbA1c; cholesterol concentration; systolic blood pressure; and wellbeing score. Results There was no difference between intervention and control patients at baseline. All practices and 85% (337) of patients were followed up. At two year follow-up, there were no significant differences in HbA1c (mean difference −0.08%, 95% confidence interval −0.35% to 0.18%), systolic blood pressure (−3.9 mm Hg, −8.9 to 1.1 mm Hg), total cholesterol concentration (−0.03 mmol/L, −0.28 to 0.22 mmol/L), or wellbeing scores (−0.7, −2.3 to 0.8). While there was a trend towards decreases in the proportion of patients with poorly controlled risk factors at follow-up, particularly for systolic blood pressure (52% (87/166) >130 mm Hg in intervention v 61% (103/169) >130 mm Hg in control), these changes were not significant. The process evaluation indicated that the intervention was generally delivered as intended, though 18% (35) of patients in the intervention group never attended any group meetings. Conclusions A group based peer support intervention is feasible in general practice settings, but the intervention was not effective when targeted at all patients with type 2 diabetes. While there was a trend towards improvements of clinical outcomes, the results do not support the widespread adoption of peer support. Trial registration Current Controlled Trials ISRCTN42541690.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Int J Community Based Nurs Midwifery
                Journal ID (iso-abbrev): Int J Community Based Nurs Midwifery
                Title: International Journal of Community Based Nursing and Midwifery
                Publisher: Shiraz University of Medical Sciences (Iran )
                ISSN (Print): 2322-2476
                ISSN (Electronic): 2322-4835
                Publication date (Print): July 2020
                Volume: 8
                Issue: 3
                Pages: 209-219
                Affiliations
                [1 ] Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
                [2 ] Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
                [3 ] Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
                [4 ] Department of Pediatrics, School of Medicine, Shiraz University of Medical Science, Shiraz, Iran
                Author notes
                Corresponding author: Mitra Soltanian, PhD; Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Zand Blv, Namazi Square, Postal code: 71936-13119, Shiraz, Iran. Tel: +98 71 36474254; Fax: +98 71 36474252. Email: Soltanian@ 123456sums.ac.ir , Mitsoltan@ 123456yahoo.com
                Article
                Publisher ID: IJCBNM-8-3
                DOI: 10.30476/ijcbnm.2020.82296.1051
                PMC ID: 7334744
                PubMed ID: 32656273
                SO-VID: a96a424d-5351-4273-86e0-172a786a495b
                Copyright © Copyright: © 2019 The Author(s); Published by International Journal of Community Based Nursing and Midwifery
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 Unported License, ( http://creativecommons.org/licenses/by-nc/4.0/ ) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date revision received : 4 February 2020
                Date accepted : 27 February 2020
                Date received : 14 July 2019
                Categories
                Subject: Original Article

                Keywords: adolescent, diabetes, education, glycosylated hemoglobin, peers, self-care
                Data availability:
                Keywords: adolescent, diabetes, education, glycosylated hemoglobin, peers, self-care

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