Peer support interventions in type 2 diabetes: Review of components and process outcomes

Background This review seeks to identify (a) the various components and process outcomes of type 2 diabetes peer support (PS) interventions and (b) the measures implemented to monitor intervention fidelity and evaluate outcomes in these studies. Methods The MEDLINE, PubMed, EMBASE (Excerpta Medica Database), CENTRAL (Cochrane Central Register of Controlled Trials), CINAHL (Cumulative Index to Nursing and Allied Health Literature), and PsycINFO databases were searched from inception to May 2019. Two reviewers independently screened and extracted data from eligible articles via the Template for Intervention Description and Replication (TIDieR) checklist (why, what, who provided, how, where, when and how much, tailoring, modifications, and how well). Results Twenty‐three trials were included. The total number of participants was 7178. Most interventions were in primary care. Although face‐to‐face was the most common modality of contact, rates of contact were highest for telephone. Potential peer leaders (PLs) were identified primarily through recommendations from health professionals, based on their communication skills, glycosylated hemoglobin (HbA1c), and coaching interest. PLs were mostly female, university educated, and had a long history of diabetes (≥ 10 years). PL training varied significantly in length and content; the two most frequent topics were communication skills and diabetes knowledge. Although several studies implemented methods to evaluate “intervention fidelity,” only few rigorously assessed the two key components of fidelity, “adherence” and “competence,” through audio‐ and video‐taping or direct observations. Conclusions The impact of PS on participants' health outcomes is well investigated; however, the implementation and evaluation strategies vary significantly across these studies. In the present review, we define the various components of PS interventions and propose suggestions for enhancing the implementation and evaluation of future PS models. 摘要 背景 本综述旨在确定 (a)在2型糖尿病同伴支持(peer support , PS)干预中的不同组成部分和效果, 以及 (b) 在这些研究中用于监测干预的忠实度和评估结果的措施。 方法 检索MEDLINE、PubMed、EMBASE (Excerpta Medica Database)、CENTRAL (Cochrane Central Register Of Control Trials)、CINAHL (Cumulative Index to Nursing and Allied Health Literature)和PsycINFO数据库, 检索时间截至2019年5月。两位独立的审阅人通过干预描述(Template for Intervention Description and Replication)核对表(为什么、是什么、谁提供、如何提供、在哪里提供、何时提供、提供的量、特制的、变化以及效果)从筛选符合条件的文章中提取数据 结果 共纳入23个试验入组。总参与人数为7178人。大多数干预措施都是在社区诊所中进行的。虽然面对面的方式是很常见的交流方式, 但电话交流的