A Review of Volunteer-Based Peer Support Interventions in Diabetes

Given the complexity of diabetes self-management activities and patients' resultant need for lifelong diabetes self-management support (DSMS), peer support has been increasingly examined as a potential model for diabetes self-management education (DSME) and ongoing DSMS.1 Dennis2 defines peer support as “the provision of emotional, appraisal, and informational assistance by a created social network member who possesses experiential knowledge of a specific behavior or stressor and similar characteristics as the target population, to address a health-related issue of a potentially or actually stressed focal person.” During the past decade, there has been a proliferation of research examining the feasibility, acceptability, and health-related impact of peer support interventions in the context of diabetes care.3–14 Based on a review of peer support interventions for patients with diabetes, Heisler15,16 identified five models of peer support, including 1 ) face-to-face group self-management programs, 2 ) peer coaches or mentors, 3 ) community health workers (CHWs), 4 ) telephone-based peer support, and 5 ) Internet or e-mail–based peer support. Face-to-face group support typically involves a peer supporter or a team of peer supporters delivering DSME or DSMS in a group-based setting such as the diabetes-specific version of the chronic disease self-management program of Lorig and Gonzales.17 Peer coaching or mentoring usually involves individuals working with patients on a less structured basis providing emotional support and serving as a role model.18 CHWs are individuals who live in the same community and share the same cultural background, values, and customs as the target patient population.19,20 CHWs provide informational, instrumental, and emotional support and often function as a bridge between community members and the health care system.19,20 In fact, some studies in a 2007 systematic review of diabetes interventions21 involving CHWs reported improvements in clinical (glycemic control, …