Talking with other diabetics on a regular basis helped a group of black veterans improve their poorly-controlled sugar levels.
The study looked at 118 African-American men in a Veterans Affairs clinic, who were divided into three groups: one that received monetary incentives for lowering blood sugar levels, a peer mentoring group, and a group receiving the usual diabetes care. The peer-mentoring group was most effective.
“The peer mentors were chosen because they were once out of control [of their diabetes and sugar levels] and were now in good control,” says Dr. Judith A. Long, lead author on the study and associate professor of medicine at the Veteran’s Administration Medical Center. “They had to be able to relate. We wanted them to talk from their own experience.”
Long focused on African-American men because of the higher rates of poorly-controlled diabetes in this group. Black diabetics are also more affected by the complications of diabetes, such as blindness, heart disease, end-stage kidney disease, and amputations.
She says her model was inspired by the notion of pulling from a community’s own strength — especially using mentors who already struggled with the disease. The mentors were also black male veterans who were receiving care for their diabetes in the same clinic.
“There is some indication from past studies that peer mentoring may be particularly effective in minority communities where there is a history of distrust of the health care system,” Long says, “Studies have also shown that compared to whites, African-Americans are more likely to trust information from community contacts than they are from health care providers.”
The peer mentoring group received at least one phone call per week from a mentor, who used motivational interview techniques and personal anecdotes to guide the men toward healthier lifestyles and behaviors. Those in the monetary incentives group, alternatively, were rewarded amounts of either $100 or $200 if they maintained well-controlled sugar levels over six months. Only the peer mentoring group showed a significant decrease.
“If programs of this nature are this effective in African-American diabetics, they have the potential to not only improve [diabetes] control for African-Americans, but decrease complications in the population as well,” says Long.
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