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

Abstract

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. PRR1-10.2196/47822.