A peer support program results in greater health benefits for peer leaders than other participants: evidence from the Kerala diabetes prevention program

• Type of Material: Article
• Authors: Tilahun Haregu, Baker Heart and Diabetes Institute; Zahra Aziz, Monash University; Yingting Cao, Baker Heart and Diabetes Institute; Sathish Thirunavukkarasu, Emory University; Thirunavukkarasu Sathish, Emory University; KRavumpurathu Raman Thankappan, Amrita Institute of Medical Sciences India; Jeemon Panniyammakal, Sree Chitra Tirunal Institute of Medical Science and Technology; Pilvikki Absetz, Tampere University; Elezaebeth Mathews, Central University of Kerala; Sajitha Balachandran, University of Kerala; Edwin B Fisher, The University of North Carolina at Chapel Hill; Brian Oldenburg, Baker Heart and Diabetes Institute
• Language: English
• Date: 2023-12-01
• Publisher: BioMed Central Ltd
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2023
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1186/s12889-023-16049-0
• Title of Journal or Parent Work: BMC Public Health
• Volume: 23
• Issue: 1
• Start Page: 1175
• End Page: 1175
• Grant/Funding Information: K-DPP was funded by the National Health and Medical Research Council, Australia (Project Grant ID 1005324). The funders were not involved in the study design; collection, analysis, and interpretation of data; writing of the report; and the decision to submit the article for publication. The participation of Peers for Progress was supported by the Merck Foundation, Novo Nordisk, the Eli Lilly and Company Foundation, the Bristol-Myers Squibb Foundation, and the Michigan Center for Diabetes Translational Research (NIDDK P30DK092926).
• Keywords: Peer Group; Humans; Quality of Life; Diabetes Mellitus, Type 2; Kerala; Counseling; Health Behavior; Diabetes; Peer support; India; Cardiometabolic risk
• Research Categories: Health Sciences, Public Health; Psychology, General

Abstract

Background: Peer support programs are promising approaches to diabetes prevention. However, there is still limited evidence on the health benefits of peer support programs for lay peer leaders. Purpose: To examine whether a peer support program designed for diabetes prevention resulted in greater improvements in health behaviors and outcomes for peer leaders as compared to other participants. Methods: 51 lay peer leaders and 437 participants from the Kerala Diabetes Prevention Program were included. Data were collected at baseline, 12 months, and 24 months. We compared behavioral, clinical, biochemical, and health-related quality of life parameters between peer leaders and their peers at the three time-points. Results: After 12 months, peer leaders showed significant improvements in leisure time physical activity (+ 17.7% vs. + 3.4%, P = 0.001) and health-related quality of life (0.0 vs. + 0.1, P = 0.004); and a significant reduction in alcohol use (-13.6% vs. -6.6%, P = 0.012) and 2-hour plasma glucose (-4.1 vs. + 9.9, P = 0.006), as compared to participants. After 24 months, relative to baseline, peer leaders had significant improvements in fruit and vegetable intake (+ 34.5% vs. + 26.5%, P = 0.017) and leisure time physical activity (+ 7.9% vs. -0.9%, P = 0.009); and a greater reduction in alcohol use (-13.6% vs. -4.9%, P = 0.008), and waist-to-hip ratio (-0.04 vs. -0.02, P = 0.014), as compared to participants. However, only the changes in fruit and vegetable intake and waist-to-hip ratio were maintained between 12 and 24 months. Conclusion: Being a peer leader in a diabetes prevention program was associated with greater health benefits during and after the intervention period. Further studies are needed to examine the long-term sustainability of these benefits.