Abstract
BackgroundThe prevalence of diabetes has been growing rapidly in developing countries. This causes devastating economic burdens and increases demands on the health care system. Therefore, there is an urgent need to find a cost-effective and multi-faceted approach for diabetes care. Peer support models provide a potentially low-cost, flexible means which complements the current existing health care services. In this way, trained peer leaders can become qualified extensions to a formal healthcare system, capable of assisting education delivery and bolstering the efforts of professional staff. As such, creating a cultural specific peer support program and determining whether it is acceptable and cost-effective in rural communities of China is crucial. This study aims to implement and evaluate biophysical and psychosocial outcomes of peer support program for people with type 2 diabetes in rural communities, and to explore the program’s feasibility and sustainability in China.Methods/DesignThis study is a cluster randomised controlled trial. All consenting patients will be randomised by community staff members to receive either peer support or the control care. The data collection and analysis including social demographics, health status, psychosocial status, economic status and biomedical measures will be collected at baseline, 6 months, and 12 months. The primary indicator measured is the change in HbA1c, whereas secondary indicators include biophysical, psychosocial functioning and other lifestyle factors. Finally, economic evaluations will determine whether the program is cost effective.DiscussionThis protocol is a cluster randomized, controlled trial of group-based peer support for people with type 2 diabetes in the community settings of rural China. Results from this trial may provide evidence to the effectiveness of peer support; furthermore, they will provide valuable information concerning the acceptability and feasibility of a new approach to improve diabetes self-management among resource-constrained settings.Trial registrationClinicalTrials.gov Identifier: NCT02119572, April 18, 2014.
Highlights
The prevalence of diabetes has been growing rapidly in developing countries
A systematic review showed that diabetes affects 6.8%, or one out of every 15 people living in rural areas worldwide
This study aims to implement and evaluate the biophysical and psychosocial outcomes of a culturally specific peer support program using a cluster randomized controlled trial in patients with type 2 diabetes and to determine whether it is an acceptable, cost effective intervention in the rural community health care centers
Summary
The prevalence of diabetes has been growing rapidly in developing countries. This causes devastating economic burdens and increases demands on the health care system. Peer support models provide a potentially low-cost, flexible means which complements the current existing health care services. In this way, trained peer leaders can become qualified extensions to a formal healthcare system, capable of assisting education delivery and bolstering the efforts of professional staff. There is an urgent need to find innovative and effective solutions to help citizens in rural communities especially in low-middle income countries to successfully manage diabetes [5]
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