Doctor of Philosophy in Experimental Medicine (PhD)
Assessment of Physical Activity and Sedentary time in South Asian adults at risk for diabetes
BACKGROUND: The effects of peer support (PS) on clinical and psychosocial outcomes has been extensively studied in patients with type 2 diabetes, but only minimally examined in the peer leaders (PLs) who deliver support. This thesis’s objectives are to: examine PLs’ sociodemographic and personality characteristics, assess the clinical and psychological benefits of providing support; and identify strategies to improve PS interventions. METHODS: A sequential explanatory mixed-methods research design approach was utilized. The studies conducted for this thesis were extensions of a larger randomized controlled trial assessing the impact of PS on diabetes-related health outcomes. Fifty-two recruits completed PL training and were matched with participants on schedule availability, gender preference, and geographic proximity. PLs and participants had an initial face-to-face meeting, then weekly phone contacts in the first 3 months and bi-weekly phone contacts in the last 9 months. PLs underwent health-related assessments at baseline, 3, and 12 months. The primary outcomes were A1C and diabetes distress (DD). At study completion, PLs were deemed effective if their participants sustained and/or improved A1C and DD from baseline. The PLs’ sociodemographic and personality characteristics were also measured. To explore PLs’ perspectives, 17 PLs were subsequently invited for semi-structured interviews. RESULTS: PLs’ A1C and DD remained stable over the course of the intervention. Effective PLs had significantly lower baseline DD and significantly higher extraversion than ineffective PLs. During the interviews, PLs characterized their experiences with participants as positive, mutually beneficial, and helpful with diabetes management. Suggestions were that PLs be vigorously screened and that the PL-participant matching process take shared characteristics (e.g., demographic characteristics, diabetes-related commonalities, and life experiences) into account. Traits of successful PLs were also identified.CONCLUSION: Delivering PS interventions may offer clinical and psychosocial benefits to the providers themselves. Further research is warranted with regard to the PL recruitment and matching process to maximize benefits for PLs and participants.