Peer Support for Achieving Independence in Diabetes (Peer-AID)

Status: Currently recruiting
	Program overview
	Specific aims
	Recruitment
	Community health worker (CHW) protocols
	Participant educational materials
	Questionnaires and data collection

Program overview

Peer Support for Achieving Independence in Diabetes (Peer-AID), is a five year, randomized trial funded by the National Institutes of Health to provide in-home education and support by community health workers (CHWs) to a low income, ethnically diverse population with type 2 diabetes. 280 participants will be recruited from Harborview Medical Center, the VA Puget Sound Health Care System and Sea Mar Community Health Centers.

Participants will be screened for eligibility during a telephone screening. If eligible, a CHW will perform an in-home baseline diabetes assessment and randomize the participant to the either the intervention group or usual care control group. The intervention group will receive an additional four in-home education and support visits with telephone support as needed. At month twelve, a CHW will conduct an exit questionnaire, which is a subset of questions asked during the baseline visit. Each participant will be called at 18 months to assess self-efficacy, diabetes self-management behaviors, utilization and quality of life. For completing the baseline, exit and 18 month survey phone call, participants will receive incentives as follows:

The goal is to translate evidence-based approaches to diabetes self-management education to community settings. There, they can benefit low-income, and minority people with diabetes, thereby reducing health inequities. We will evaluate the effectiveness of using community health workers (CHW) in improving health outcomes of patients with poorly controlled type 2 diabetes. Our specific aims are outlined below:

• Assess the effectiveness of the CHW intervention for improving outcomes for patients with type 2 diabetes. The primary outcome is reduction in HbA1c from baseline to follow-up at 1-year. Secondary outcomes include blood pressure and lipid control, health care utilization, and physical and mental functioning as measured by the SF-12.
  
  
• Assess the effects of the CHW intervention on intermediate outcomes of patient self-management of diabetes, including self-efficacy, physical activity, nutrition, and medication adherence.
  
  
• Assess additional measures of the translation of self-management support into the home and community setting through examining program reach, adoption, implementation and maintenance, including a cost-effectiveness analysis to determine program economic feasibility.

Participants will be recruited from Harborview Medical Center (HMC), the VA Puget Sound Health Care System and Sea Mar Community Health Centers. HMC is the local public hospital and one of the largest safety net providers in King County, where patients are seen regardless of their ability to pay. The VA Puget Sound Health Care System is a tertiary hospital that serves veterans from a large area including King County and Seattle. Sea Mar Community Health Centers is a community-based organization providing quality, comprehensive health and human services to diverse communities.

Participant selection criteria