We need to ‘up the ante’ on peer support

Peer support is a powerful but underused strategy that can help the 1.7 million people living with diabetes in Australia, a conference has heard.

Just one in ten people with the condition are engaging in peer support programs, yet one in three want to, according to Dr Jessica Browne (PhD), a former senior research fellow at The Australian Centre for Behavioural Research in Diabetes.

Dr Browne, who is now principal program officer at VicHealth, spoke to the limbic ahead of her presentation on the topic at the ADS and ADEA Annual Scientific Meeting in Perth.

She said a survey by the centre suggests lack of awareness of both face-to-face and online peer support programs was largely behind the low uptake, but a shortage of options in pockets of Australia also played a role.

“Many people didn’t know that peer support was available until they completed the survey,” she told the limbic.

“We really need to up the ante, not only with promotion perhaps through the NDSS or state member organisations but also to increase awareness among health professionals so they can start referring in.”

Peer support programs can range from face-to-face meetings to online forums, but share the key features of enabling peers to problem solve and share experiences and  provide one another with ongoing social support.

The American Academy of Family Physicians program ‘Peers for Progress’ (www.peersforprogress.org) has identified four key functions of diabetes peer support:

  1.    Assistance with daily management: Peer supporters share their experiences with self-management activities
  2.    Social and emotional support: Peer supporters offer an empathetic, non-judgmental ‘listening ear’ and encouragement to help others cope with the social and emotional burdens of living with diabetes.
  3.    Linkages to clinical care and community resources: Peer supporters can help ensure others are aware of the clinical and community resources in their local area.
  4.    Ongoing support over time: Peer supporters keep others engaged over the long-term, and provide ongoing follow-up, proactively and flexibly.

It is also a useful adjunct to formal medical care, said Dr Browne.

“The reality is health care professionals don’t have the availability, and often even the hands-on knowledge, to help patients to problem-solve, for example give advice on how to squeeze in so many blood glucose tests in their life while at work or how to manage their hypoglycaemia while they are exercising vigorously.”

“Sometimes people with diabetes can find that they really need to talk to somebody who’s lived through that experience.”

Research has identified a range of benefits for people with diabetes, from improvements in self efficacy and self-management behaviours, to reduction in stress and depression and reduction in HbA1c and other cardiovascular risk factors, she said.

But Dr Browne admits the evidence for peer support is mixed, with some research suggesting it has little benefit.

“Part of the reason I think we are seeing such mixed results is because different programs define and operationalise peer support in different ways.”

“I would say a common-sense reading of the literature shows that peer support can have impact for people who are highly engaged with it.”

With most peer support groups concentrated on the eastern seaboard, and the majority of online offerings based overseas, Dr Browne wants more investment into research to investigate “what works in peer support and for whom and why”.

“The next step is to develop and tailor evidence based programs for roll out and delivery nation-wide,” she said.

In the long term “what we want is a suite of evidence based options that might cater to a wide range of people so everyone who wants to participate in peer support can, in terms of accessibility, and can find an option that suits them,” she added.

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