Peer Support
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Peer Support Rationale – Key Characteristics Resources
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Peer Support. Rationale – Key Characteristics Resources. Fundamental Role of Social Connections and Support. Human beings are more effective and happier when they have someone They can talk to about personal matters. Who cares about them. Who can help them when they need help. - PowerPoint PPT Presentation
Transcript of Peer Support
Peer Support
Rationale – Key CharacteristicsResources
Human beings are more effective and happier when they have someone
• They can talk to about personal matters.• Who cares about them.• Who can help them when they need help.
The influence of social isolation on the risk of death has been compared to the risk of death associated with well-established factors such as cigarette smoking.
House, Landis & Umberson. Science, 1988 241: 540-544.
Holt-Lunstad, Smith, & Layton PLOSMedicine, 2010, 7: July e1000316 www.plosmedicine.org
Fundamental Role ofSocial Connections and Support
Social Support & Chronic Disease
• Social connections and support are particularly important for managing and preventing chronic diseases.
• While seeing a doctor is important for prevention and support, people spend most of their time outside of a doctor’s office.
• Consider the rule of 8,760…
The rule of 8,760
8,766 = 24 hours X 365.25 days in a year6 hours a year in a doctor’s office or with
other health professional.8,760 hours “on your own” to:
– Maintain a healthy diet– Engage in physical activity– Monitor health status– Take medications– Manage sick days– Manage stress / cope– Arrange medical appointments and testing– Sleep
Diabetes Self Management Education and Diabetes Self Management Support
Diabetes Self Management Education: • Teaches what I need to do.• “Improvements in outcomes diminish after ~ 6
months.”
Diabetes Self Management Support• Helps me plan and do what I need to do.• Support “to implement and sustain the
behaviors needed to manage” diabetes.
Haas, et al. (2013). National Standards for Diabetes Self-Management Education and Support. Diabetes Care 36 Suppl 1, s100-s108.
Strengths of Peer Supporters• Peer supporters are not professionals.• Often have the health problem they are assisting with – e.g.,
people with diabetes helping others with diabetes.• Share perspectives, experience of those they help.• Have credibility regarding attitudes and capability because
they are “like me.”“The doctor tells me something is important. The peer supporter helps me figure out how I feel about it whether I can do it.”
• Can teach how to implement basic self management plans (e.g., healthy diet, physical activity, adherence to medications).
• Peer supporters have time!!!
Key Functions of Peer Support
1. Assistance, consultation in applying management plans in daily life
2. Social and Emotional Support
3. Linkage to clinical care
4. Ongoing support, extended over time
Fisher et al. Fam Pract 2010 27 Suppl 1: i6-16.
KEY FUNCTIONS• Assist in managing
diabetes in daily life• Social and emotional
support• Link to clinical care• Ongoing support
Diverse Implementation
of Key Functions
Local, Regional, Cultural
Influences
“Standardization by function, not content”
Hawe et al. British Medical Journal 328:1561-1563, 2004.Aro et al. Eur J Public Health 18:548-549, 2008
Example: Peer Support in San FranciscoThomas Bodenheimer and colleagues, University of California, San Francisco
Clinical Setting Six Departmentof Public Health safety-net primary care clinics serving patients covered by Medicare/Medical or SanFrancisco’s coverage foruninsured residents.
Majority of patients were non-white, ethnically and culturally diverse.
Patient Contact: 83% of patients had at least 1 interaction and as many as 29 interactions with a health coach. The median number of contacts was 5, 76.6% of these were by telephone.
Outcomes at 6 months:Reduction in HbA1c by ≥ 1.0%: 49.6% in coached patients vs 31.5% of usual care patientsHbA1c < 7.5%: 22% of coached patients vs 14.9% of usual care patients
Thom et al., Annals of Family Medicine 2013 11: 137-144.
Bickel, Jenny
Revise content to read "Patient Contact: 83% of patients had at least 1 interaction and as many as 29 interactions with a health coach. The median number of contacts was 5, 76.6% of these were by telephone."
Community Outreach is Key Component of Patient-Centered Medical Home
• However, several challenges:– Time consuming nurturing of
community relationships.– Imprecise reach of community
outreach:• Community programs and activities
on weight management.• Attended by “vegans who run
marathons.”
Peer Support for Outreach/Engagement from Patient-centered Medical Homes
Peer supporters were recruited from communities the effort intended to reach.
– Community ties then intrinsic to servicesProject found that peer supporters can reliably reach those of greatest importance.
Fisher et al. Arch Pediatr Adolesc Med. 2009 Mar;163(3):225-32.
peersforprogress.org
Resources at peersforprogress.orgLearn About Peer Support – What it is, evidence base,
program examples:peersforprogress.org/learn-about-peer-support
Promote Peer Support – Professional’s role in promotion, communicating for peer support, sharing/networking: peersforprogress.org/promote-peer-support
Get Connected – Be part of the global network or peer support program leaders:peersforprogress.org/get-connected
Take Action – Guides to starting, developing, and managing a program: peersforprogress.org/take-action
Tools & Training – Concrete program resources including for primary care and in Spanish and Chinese: peersforprogress.org/tools-training
