684-P: Community-Based Peer Support for Diabetes Management in Shanghai, China—Breadth of Benefits and Processes of Change

by sugaradmin



Introduction and Objective: Characterize breadth of benefits, relationships among changes, and processes of change in Community-Based Peer Support (CPS).Methods: CPS was implemented over 24 months in 12 communities (n=1,018) with 4 Comparison Communities (Comp, n=423) in Shanghai, China. CPS participants were = 59.9% female vs 53.5% among Comp, older (mean 66.64 vs 62.94 years), and had longer duration of diabetes (8.04 vs 6.63 years) (ps ≤.004). Accordingly, all subsequent analyses included site, gender, age, and diabetes duration as covariates.Results: At baseline, CPS scored higher on a 4-item measure of diabetes distress (DD) (1.18 vs 1.09) and PHQ8 measure of depressed mood (Dep) (1.85 vs 1.36) but lower on Hemoglobin A1c (A1c) (7.47% vs 7.72%) (ps <.005).To examine intervention effects, analyses of follow-up measures controlled for corresponding baseline measures in addition to covariates noted above. Among all participants, CPS exceeded Comp in beneficial changes in DD (baseline adjusted follow-up = 1.11 in CPS vs 1.17 in Comp, p =.004), Dep (1.32 vs. 1.89, p <.001), and A1c (7.45 vs 7.82%, p <.001).Changes in DD mediated both changes in Dep and A1c as, reciprocally, changes in each of follow-up Dep and A1c mediated effects on DD. Follow-up Dep and A1c, however, were not associated with each other.Participants rated receipt of 5 key functions of CPS: 1) availability/ongoing support; 2) assistance in daily management; 3) social/emotional support; 4) linkage to clinical care/community resources; and 5) “being there.” The mean of key functions was associated with reductions in DD (partial correlation = -.11), Dep (-.16), and A1c (-.12) (ps ≤.002).Conclusion: CPS improved emotional status – DD and Dep, as well as glycemic control – A1c. Reflecting the breadth of benefits, changes in A1c were independent of changes in Dep although DD mediated the effects of CPS on both A1c and Dep. Process evaluation indicated the importance of key functions of CPS as they were associated with improvements in each of DD, Dep, and A1c.

Disclosure

Y. Liu: None. C. Cai: None. P.Y. Tang: None. M.M. Coufal: None. L. Shen: None. E.B. Fisher: None. W. Jia: None.

Funding

National Institutes of Health (P30DK092926); Merck Foundation



Source link