Peer-Led Self-Management Support in "Real World" Clinical and Community Settings

In phase one we will develop and evaluate a theoretically-driven program to train peer leaders to facilitate longer-term empowerment-based interventions that, when led by health care professionals, have been associated with improved diabetes-related health and psychosocial outcomes.1-8 In phase two we will examine the impact of a sustained peer-led, empowerment-based self-management intervention on improving and maintaining diabetes-related health outcomes. We propose to develop and test the training and program simultaneously in two distinct cultural and linguistic communities with which the team already has strong working relationships and a track record of prior work: African-American (AA) adults in a community-based setting (Ypsilanti, Michigan) and Latino adults (Spanish- and English-speaking) in a clinic-based setting (Southwest Detroit). This will allow us to compare and contrast the translations of the training and program in these two different contexts and to better refine and understand effective methods and develop culturally tailored training and program materials in both English and Spanish.

Inclusion criteria

• the study will recruit African Americans and Latinos with type 2 diabetes, - at least 21 years old, and
• who have a regular health care provider, and
• will commit to attend the 12 session DSME program.

Exclusion criteria

• having physical limitations preventing participation, and
• other serious health conditions (e.g., terminal cancer),
• serious psychiatric illness, self-reported excessive alcohol or illicit drug use, and
• serious diabetes complications (e.g., blindness) that would impede meaningful participation in the program