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The combination of one-on-one peer support and the instruction of healthy lifestyle behavior methods can have a positive effect on patient self-care, based on a recent study involving Community Care Partners of Greater Mecklenburg.
The study, which followed 17 African-American patients with type 2 diabetes from the Charlotte-based CMC Biddle Point practice between 2016 and 2017, showed significant evidence that peer-supported self-management groups helped those patients achieve better health outcomes. It was conducted by Florence Okoro, Ph.D, RN, an assistant professor at the University of North Carolina at Charlotte School of Nursing, with help from CCPGM’s Provider Services & Population Outreach Program Manager Valencia Davis, MHA, and Community Health Worker Frankie King. Okoro recently published her findings in a research article titled “Culturally Appropriate Peer-Led Behavior Support Program for African Americans with Type 2 Diabetes.” (https://www.frontiersin.org/articles/10.3389/fpubh.2018.00340/full)
After extensive research and conversations with the patients in the Charlotte area, the study revealed that peer support has led to better diabetes self-management outcomes. It also showed that peer support programs tailored to the needs of diabetes patients may be a viable way to reach traditionally underrepresented populations, such as low-income African Americans.
Biddle Point medical director Emily Cooper, MD, was impressed with the results of the study.
“I refer patients to the diabetes class all the time. It’s so much more powerful to have the patients talk to someone who has the same health issues. It’s just phenomenal the attention this class has received,” Cooper said.
She said medical professionals are always looking for ways to get people involved in their own self-care.
“I want this to serve as an example in our healthcare system of the importance of peer support. This shows it’s an important piece of the puzzle. We serve a large financially underserved population who have no insurance and we have to make miracles happen. This class is a way to do that,” she said.
CCPGM Health Educator Janet Ann McAndrews, MPH, CHES, helps coordinate the diabetes peer-supported patient education self-management group, which offers a variety of healthy lifestyle information for patients such as appropriate foods and exercises. The importance of the group is evident in the reaction from patients, she said.
“We have a 40-year-old male patient who attended a few of these self-management groups. He later told us ‘I have learned more in two sessions at Biddle Point as a new patient than during four years as a diabetes patient at another practice,’” McAndrews said. “This type of reaction indicates that patients are learning important healthy lifestyle behaviors for dealing with diabetes and related conditions.”
King said the research study involved many one-on-one conversations with patients. She and Okoro’s research assistant would often meet with patients during and after the group meetings, and later at restaurants or patient homes, to provide additional support.
“We would often visit 2 to 3 patients at their homes each week, sometimes in the evenings or on weekends. It took a whole year to work on the study,” King said.
She hopes the study will encourage doctors to prioritize peer-supported self-management groups.
“I’m excited to show doctors that peer support really works and if they implement it in hospitals and practices, it would help improve the health of patients,” King said. “It was a lot of work, but I enjoyed working with the patients. I’ve come a long way to get my own health under control, so I love to help patients do the same thing.”
Besides the Diabetes class, McAndrews helps coordinate two other self-management classes for CCPGM focusing on Healthy Lifestyles and Chronic Pain.
“We just ventured out this past fall to sites we’ve never been to outside the standard medical practice model. We’ve gone to retirement centers and community housing centers, among other locations. We’ve found that transportation is the biggest barrier, so if we can get to where patients are living, then there is increased attendance and, if needed, we can connect them with a medical home. It’s a win-win for patients and providers,” McAndrews said. “In 2019, as part of our continual growth and commitment to helping population health and community outreach, CCPGM is starting a chronic pain self-management group to help providers and patients with alternative pain management methods as they navigate new opiate regulations.”
Community Care Partners of Greater Mecklenburg is a community-based healthcare network participating in the statewide Community Care of North Carolina (CCNC) physician-led program. Since 2002, CCPGM has provided care coordination and care management for Medicaid recipients and others in Anson, Mecklenburg and Union counties. CCPGM works with primary care providers, hospitals, health departments, behavioral health management entities, Departments of Social Services, housing agencies, crisis providers, and other local community agencies and resources to provide the best coordinated care for its patients. The network has about 190,000 enrollees and 189 medical homes practicing family medicine, obstetrics, internal medicine and pediatrics. To learn more, visit CCPGM online at www.ccpgm.org, or on Facebook, Twitter (CCPGM) and Instagram (CCPGM_NC).