Written by: Alicia Rodrigo-Miller, Dietetic Intern
What is Peer Support?
The widespread use of peer support began in the 1970’s and first started to gain traction during the mental health consumer movement of this time. This movement sought to empower mental health service users with the ability to advocate for themselves and help each other (1). As the movement expanded and peer support became more widely recognized it began to find a useful application in the management of chronic diseases like substance abuse, diabetes, heart disease, cancer, and more (1). Peer support has become a successful tool for management and intervention in these conditions and studies have shown that it has been beneficial in improving health-outcomes (1-6). Particular attention has been paid to the efficacy of peer support in navigating complex conditions like diabetes. Diabetes is often a multi-factorial condition and self-management can carry with it a great burden of responsibility that may manifest itself in the form of depression, physical distress, emotional distress, or other like conditions (2). Improved management of these symptoms, improvement of general health markers associated with diabetes, and improvement of skills needed for self-management and care have been shown to be associated with peer support and a community-based approach to diabetes counseling and care (2-6). One study showed significant improvements in markers of depression, hypoglycemia, communication with physicians, reading food labels, patient activation, and self-efficacy (2). There have also been studies to support that when cultural competency meets peer support and community-led diabetes management there are significant improvements in health markers like BMI, weight, healthy eating habits, health distress, hypo- and hyperglycemia, diabetic distress, self-efficacy, and physical activity (3-5).
Some reasons to consider peer support are the sense of community that it may instill, the potential improvement of health markers, and the positive influence it may have in increasing confidence in self-management abilities.
Benefit #1: Community
Patients who participate in peer support groups often find a sense of belonging and community when they are able to connect with individuals that are going through a similar situation and that can relate to their experiences (6). It is an opportunity to build trust with individuals that share a unique first-hand understanding of what it is like to live with diabetes. Peer support is a way to reinforce that you do not have to navigate your condition alone. Peer support offers patients with diabetes an opportunity to discuss the impact of the disease on the totality of their life experiences, which may not be something they are able to discuss with physicians that are often limited in time and availability (6). Peer support may offer an opportunity for compassion understanding, and positive reinforcement, which could potentially lead to positive changes in attitudes, beliefs, and behaviors as they pertain to diabetes management and care (6).
Benefit #2: Confidence
Self-managing diabetes can be confusing. It is a complex diagnosis and the most effective interventions often involve significant lifestyle modifications that may bring about an emotionally or even physically distressful response (2). Having the support of peers may help develop the confidence needed in order to manage diabetes in a successful and sustainable way. Communication with peers may provide new perspectives on how to manage challenging situations. It also promotes the sharing of information and the sharing of successful tactics on how to approach changes in behaviors and more. A relatable and culturally competent approach has been shown to increase self-efficacy and the ability to communicate with physicians in a way that allows an individual to advocate for himself and play a more participatory role in his care (2, 4).
Benefit #3: Health
While there has been no definitive consensus on the overall body of research, there are several studies that support the notion that peer support is a successful way to help with diabetes self-management and care. Many randomized clinical trials have shown improvements in health markers like BMI and weight, blood sugar control, and A1C (2, 3, 4, 6). Other clinical trials have shown improvements in habits and behaviors like physical activity levels, dietary habits, and self-efficacy (2, 3, 5). Both clinical markers and behavior changes are important measures to look at when measuring the success of your diabetes management and care.
How to Find a Diabetes Support Group
There are many outlets available to connect you to the support that you need. Due to the impact of the COVID-19 pandemic many peer support groups have shifted from an in-person model to a virtual forum to accommodate the safety restrictions regarding distance and limited contact that many states have put in place. See below for a number of resources that may offer peer support:
- Hailey Crean Nutrition, LLC: This virtual nutrition and diabetes education practice offers free monthly online diabetes support groups for all individuals living with diabetes. Groups are available for drop-in at your leisure and topics rotate monthly.
- DiabetesSisters: A robust national platform for women with diabetes that offers peer support in a number of different modalities including peer mentorship, in-person peer support meetups, and virtual support groups.
- TuDiabetes: A California-based non-profit that provides online support to men and women living with diabetes.
- American Diabetes Association: The ADA has an extensive directory of educational programs and support groups that are available nationally.
At the end of the day, you must make the final determination regarding whether or not peer support is appropriate for you. Finding successful peer support is also about finding a group that you feel best supports your needs. Diabetes care is highly personal so keep in mind that one size does not fit all. Some key considerations when looking for a diabetes support group are convenience, time commitment, cultural relevance, group structure, and an environment that fosters comfort, trust, growth, encouragement, empathy, and compassion.
Tang, P. (2013). A Brief History of Peer Support: Origins. Retrieved from http://peersforprogress.org/pfp_blog/a-brief-history-of-peer-support-origins/
Lorig, K., Ritter, P., Villa, F., & Armas, J. (2009). Community-Based Peer-Led Diabetes Self-management. The Diabetes Educator, 35, 641-651. Doi: https://doi-org.libproxy1.usc.edu/10.1177/0145721709335006
Anderson-Kiftin, W., Barnett, S., Bunn, P., Sullivan, P., Hussey, J., & Tavakoli, A. (2005). Culturally Competent Diabetes Education. The Diabetes Educator, 31, 555-563. Doi: https://doi-org.libproxy1.usc.edu/10.1177/0145721705278948
Lorig, K., Ritter, P., Villa, F., & Piette, J. (2008). Spanish diabetes self-management with and without automated telephone reinforcement: two randomized trials. Diabetes Care, 31, 408. Retrieved from https://link.gale.com/apps/doc/A176819577/AONE?u=usocal_main&sid=AONE&xid=055722bb
Keyserling, T., Samuel-Hodge, C., Ammerman, A., Ainsworth, B., Henriquez-Roldan, C., & Elasy, T. (2002). A randomized trial of an intervention to improve self-care behaviors of African-American Women with type 2 diabetes: impact on physical activity. Diabetes Care, 25, 1576. Retrieved from https://link.gale.com/apps/doc/A91485346/AONE?u=usocal_main&sid=AONE&xid=1a0cb482
Heisler, M., Vijan, S., Makki, F., & Piette, J. (2010). Diabetes Control With Reciprocal Peer Support Versus Nurse Care Management: A Randomized Trial. Annals of Internal Medicine, 153, 507-515. Doi: https://doi-org.libproxy1.usc.edu/10.7326/0003-4819-153-8-201010190-00007