The impact of a peer-mentoring intervention on self-reported flare and disease activity among African American women with Systemic Lupus Erythematosus (SLE)

Introduction Systemic Lupus Erythematosus (SLE) disproportionately affects African American women, who experience higher disease severity and face barriers to accessing supportive care. Peer mentoring offers a culturally tailored approach to improving chronic disease self-management and psychosocial well-being in underserved populations. Aims To assess the impact of a peer-mentoring interventions on self-reported disease activity, symptom severity, and flare frequency among African American women with SLE. Methods This study is a sub-analysis of the Peer Approaches to Lupus Self-Management (PALS) randomized controlled trial. Adult African American female participants with SLE were assigned to an intervention, a social support control group, or served as peer mentors. The intervention group received 12 structured biweekly sessions over 24 weeks, delivered by trained peers using a culturally relevant curriculum. Outcomes were measured at baseline, 3, 6, and 12 months after the intervention using the Systemic Lupus Activity Questionnaire (SLAQ). Linear and cumulative logit mixed models were used to assess longitudinal changes, adjusting for sociodemographic covariates. Results The intervention group reported sustained reductions in symptom severity over time, although not statistically significant. Notably, mentors demonstrated significant improvements in symptom severity at 3 months (mean difference: −2.53; 95% CI: −4.95, −0.11), suggesting reciprocal benefits of peer engagement. Employment and insurance status were consistently associated with lower symptom burden and disease activity. Conclusion The results of our study support policy initiatives that invest in peer-based self-management interventions, expand insurance access, and address employment barriers shown to influence disease burden in individuals with SLE. Such efforts are critical to reducing health disparities and improving long-term disease outcomes.