Peer-led, Empowerment-based, Approach to Self-management Efforts in Diabetes

Diabetes self-management education: In the first three months of PLEASED, patients with type 2 diabetes will participate in 12 weekly sessions: 6 sessions will focus on diabetes education and be delivered by a health professional and 6 sessions will focus on lifestyle change and be delivered by a peer leader. Education sessions will be 2-hours long and be facilitated by nurses, dieticians, and pharmacists. Patients will learn about the diabetes disease process, lifestyle modification, healthy eating, physical activity, medications, monitoring, short- and long- complications, diabetes distress, and coping. Lifestyle change sessions will be 1-hour long and start with 30 minutes of physical activity followed by 30 minutes of goal-setting, action planning, and problem solving. Additional activities such as recipe makeovers and exchanges will also be included.

Diabetes self-management support: In the next nine months of the PLEASED program, patients will be invited to attend 32 weekly self-management support sessions (1-hour long) facilitated by a peer leader. The goal of these sessions is to help patients continue making positive lifestyle changes. Each support session will start with 30 minutes of physical activity led by the peer leader followed by a discussion where participants are invited to (1) discuss self-management challenges, (2) share thoughts and feelings about these challenges, (3) ask self-management questions, (4) engage in problem solving, and (5) set self-management goals and design behavioral experiments to achieve those goals. Patients are invited to attend as frequently as they need or as they are able to given other competing life demands. While these sessions focus on lifestyle change and emotional support, participants will be able to obtain responses to medical and clinical questions from 811 or the PLEASED hotline (hosted by dieticians, nurses, and pharmacists).

All patients enrolled in the PLEASED program will undergo three free health assessments: at the start of the program, at 3 months, and at 12 months. Health assessments will include measuring glycemic control, ApoB, blood pressure, waist circumference, weight, and body mass index. All patients will also complete a survey assessing quality of life, social support, depression, and self-efficacy.

To be eligible to participate as a subject in this study, individuals must

• Have type 2 diabetes,
• Be of South Asian background,
• Live in the Metro Vancouver area,
• Be at least 21 years old,
• Have transportation to attend group sessions.

To be eligible to participate as a peer leader in this study, individuals must

• Have diabetes or are a caregiver to someone who has diabetes,
• Are of South Asian background,
• Live in the Greater Vancouver area,
• Are at least 21 years old,
• Are bilingual in English and Punjabi,
• Have transportation to attend training,
• Are able and willing to commit to 6 sessions of training (5 hours each, over a 6 week period)

Exclusion criteria

for both participants and peer leaders include:

• Serious health conditions
• Addictions to alcohol or drugs, which would hinder meaningful participation in the study.