PLATINUM Program: A Feasibility Study on a Train-the-trainer Course on Peer Support for People With Type 2 Diabetes

Diabetes Clinical Trial

— PLATINUM  

Official title:

Peer Leaders Accelerated Training Initiative to Unleash Potential of Mentorship (PLATINUM) Program: A Feasibility Study on a Train-the-trainer Course on Peer Support for People With Type 2 Diabetes

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01313949
• Other study ID #: CRE-2009-087
• Status: Completed
• Phase: N/A
• First received: March 7, 2011
• Last updated: July 21, 2014
• Start date: February 2009
• Est. completion date: August 2011

Study information

• Verified date: July 2014
• Source: Asia Diabetes Foundation
• Contact: n/a
• Is FDA regulated: No
• Health authority: Hong Kong: Joint CUHK-NTEC Clinical Research Ethics Committee
• Study type: Interventional

Clinical Trial Summary

The investigators hypothesize that a training course to people with diabetes on peer support and empowerment will improve their glycemic parameters, knowledge on diabetes and level of self efficacy. This group of trained patients (peer leaders) should be competent to teach and help other patients with diabetes through peer support and empowerment on better self management of their diabetes.

Description:

In our attempt to improve diabetes self care, one important component is the diabetes patients who should have the best incentive to improve their care levels and reduce their complication risk, provided that they are appropriately trained, informed, educated and supported. According to the World Health Organization (WHO) Innovative Care for Chronic Conditions framework, expert patients are recommended to be included in the health care team to make them prepared, motivated and informed decision makers to preserve health and improve clinical outcomes. In a recent report on WHO consultation, peer support interventions are considered to have enormous potentials to make self management an effective component of chronic care.

Peer support is defined as support from a person who has experiential knowledge of a specific behavior or stressor and similar characteristics as the target population. Thus people with common illness experience can share knowledge and experience in a less hierarchical and reciprocal relationship compared to that between patients and health care professionals. A number of programs including health worker-led groups with peer exchange, peer-led face-to-face self management programs, peer coaches and remote peer support have reported encouraging results with short term improvement in metabolic or cognitive-psychological-behavioral dimensions, although these results are often limited by non-sustainability of changes and insufficient reach or adoption of programs by patients or health care workers. In the WHO report, health care experts from various disciplines concluded that whilst peer support is a promising approach for diabetes management, issues regarding methods of organization, types of programs and their integration with other clinical and outreach services remain to be addressed. Of note, there is a paucity of similar data in developing and low income areas which are hit hardest by this epidemic and where peer support program may offer great promise to make diabetes prevention and care program more sustainable and accessible, if implemented and evaluated systematically.

Health professionals, especially diabetes nursing specialists, have been training diabetes patients on the understanding and self-caring of diabetes. However, with the emerging concept and preliminary evidence of success in the role of "peer advisors" in diabetes to lead self care courses for other fellow patients, a train-the-trainer program to develop "expert patients" is essential. On top of factual knowledge on diabetes as a disease, context of this program needs to cover include communication and empowerment skill, basic knowledge on psychology, stress management, social support, empowerment, healthy lifestyle including diet and physical activity.

In the evaluation of the programs, there is a need to define the qualities and roles of the peer supporter, design programs which integrate and complement formal health services, identify optimal mix of modalities of intervention, types and dose response of these interventions and evaluate acceptability and effectiveness of these programs in different cultures. Other evaluation indexes include effects of programs on behavioral changes, knowledge and attitudes, functionality, clinical care as well as their cost effectiveness, reach, implementation-consistency, adoption and maintenance of effects over time.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 75
• Est. completion date: August 2011
• Est. primary completion date: February 2011
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years to 75 Years

Eligibility

Inclusion Criteria:

• Chinese people with type 2 diabetes

• 18-75 years of age

• Good glycaemic control (HbA1c <7%) and remain stable in past 1 year

• Willing to complete the structured training curriculum to prepare themselves as peer leaders

• Fluent in Cantonese

Exclusion Criteria:

• Known psychiatric disease

• Physically handicapped to the degree that communication with others is significantly impaired impaired, such as deafness, paraplegia.

• Illiterate

Study Design

Allocation: Non-Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Supportive Care

Related Conditions & MeSH terms

• Diabetes

Intervention

Other:
• Training program
These diabetes patients will undergo a 32-hour 'Train the trainer' program (4 workshops, 8-hours each) led by health care experts in nutrition, physical activity, psychology and neuro-linguistic program [NLP] trainer to ensure the adequacy of knowledge and skills of these mentors.

Locations

Country	Name	City	State
Hong Kong	Diabetes Centre, Tung Wah Eastern Hospital	Causeway Bay
Hong Kong	Diabetes Hong Kong	Central
Hong Kong	Diabetes Ambulatory Centre, PYNEH	Chai Wan
Hong Kong	Diabetes Centre, Kwong Wah Hospital	Kowloon
Hong Kong	Diabetes Centre, Queen Elizabeth Hospital	Kowloon
Hong Kong	PMH, Diabetes Care Centre, Princess Margaret Hospital	Kowloon
Hong Kong	Kwai Chung out-patient clinic	Kwai Chung	New Territories
Hong Kong	Diabetes Ambulatory Care Centre, UCH	Kwun Tong	Kowloon
Hong Kong	Lam Tin Health Clinic	Lam Tin
Hong Kong	Diabetes Centre, Queen Mary Hospital	Pok Fu Lam
Hong Kong	Sai Wan Ho Health Centre	Sai Wan Ho
Hong Kong	CUHK YCK, Prince of Wales Hospital	Shatin	New Territories
Hong Kong	Diabetes & Endocrine Centre, Prince of Wales Hospital	Shatin	New Territories
Hong Kong	Diabetes Centre, North District Hospital	Sheung Shui	New Territories
Hong Kong	Diabetes Centre, Ruttonjee Hospital	Wan Chai

Sponsors (1)

Lead Sponsor	Collaborator
Asia Diabetes Foundation

Country where clinical trial is conducted

Hong Kong, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	To assess the effectiveness of the training program in improving glycemic parameters in diabetic patients before and after the training.	Metabolic parameters, such as HbA1c, Body Mass Index (BMI), Lipid Profile, etc. will be measured at specific time points before and after the training	6 months	No
Secondary	To assess the efficacy of the training on the attitudes, behaviours and self-efficacy of the participants as compared to the control patients	The psychosocial-behavior assessment will include using the Summary of Diabetes Self- Care Activities (SDSCA), Diabetes Empowerment Scale (DES), Depression Anxiety Stress Scale-21 (DASS21), General Health Questionnaire (GHQ12), Euro Quality of Life (EQ5D) & Patient Health Questionniare (PHQ9).	6 months	No
Secondary	To assess the efficacy of the training in improving the participants' knowledge of diabetes, as compared to the control patients.	An evaluation feedback form will be completed by all participants after each workshop	6 months	No

External Links

•   For more information on this trial and others conducted by the Asia Diabetes Foundation.