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Effectiveness of a peer leader supported diabetes self-management support program on patient assessment of care for chronic conditions (PACIC)

Xue, Lingshu (2014) Effectiveness of a peer leader supported diabetes self-management support program on patient assessment of care for chronic conditions (PACIC). Master's Thesis, University of Pittsburgh. (Unpublished)

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Diabetes is a complex chronic disease which requires patients to integrate numerous actions into their daily lives for successful management. Peer leader supported diabetes self-management support (DSMS) is a promising efficient method for delivery of diabetes education in high risk communities.
The objective of this study was to evaluate the effectiveness of a peer leader supported DSMS program on the Patient Assessment of Care for Chronic Conditions (PACIC). This paper specifically focused on the impact of peer leaders on patient-rated experience of self-management support as measured by the PACIC. The study was a prospective, multisite, cluster randomized controlled trial. The intervention group received diabetes self-management education (DSME) plus peer leader supported DSMS, while in the control group, patients participated in DSME and DSMS conducted by diabetes educators. Two-hundred-twenty-one patients with diabetes were recruited from seven primary care practices at baseline, 119 in the intervention group and 102 in the control group.
The overall PACIC score was not significantly associated with the peer leaders support, however the model revealed a significant positive interaction between the groups and the change in the slope of the PACIC score throughout the study (p=0.004). This indicated that
there was a steeper increase in total PACIC scores over time in the intervention group than in the control group. PACIC scores increased with baseline PACIC scores, but the increasing rate declined as baseline scores increased. In this study, there were no associations between the PACIC score and age or education level. However, there was a relationship between overall Diabetes Empowerment Scale score and total PACIC score. Associations were also seen in the subscales of patient activation, delivery system design, collaborative problem solving and follow up.
This study provided a patient-centered approach to assess the quality of service in a peer support DSMS program. Additionally, given limited health resources, this study has public health significance in confirming that peer leader supported DSMS can make greater use of community resources and gain similar effectiveness at lower cost.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairZgibor, Janice C.edcjan@pitt.eduEDCJAN
Committee MemberCostacou, TinaCostacouT@edc.pitt.eduCOSTACOU
Committee MemberNolan, Bethban17@pitt.eduBAN17
Committee MemberPiatt, Gretchen
Date: 27 June 2014
Date Type: Publication
Defense Date: 18 April 2014
Approval Date: 27 June 2014
Submission Date: 22 April 2014
Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
Number of Pages: 91
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Epidemiology
Degree: MS - Master of Science
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: Peer, Diabetes self-management support, Patient assessment of care for chronic conditions
Date Deposited: 27 Jun 2014 22:04
Last Modified: 01 May 2019 05:15


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