New study on benefits of peer mentoring in chronic care

Williams, E. M., Hyer, J. M., Viswanathan, R., Faith, T. D., Voronca, D., Gebregzaibher, M., … & Egede, L. (2018). Peer‐to‐Peer Mentoring for African American Women With Lupus: A Feasibility Pilot. Arthritis care & research70(6), 908-917. doi:10.1002/acr.23412

Summarized by Rachel Thompson

Notes of Interest: Overall, this study demonstrates that peers can be instrumental in promoting self-management and improving a patient’s ability to cope with the diagnosis of a chronic disease for African-American women. Peer support encourages the sharing of experiences between participants with personalized and flexible content, it facilitates social support and functions an useful adjunct to standard rheumatologic care.

Introduction (Reprinted from the Abstract)

Objective. To examine the feasibility and potential benefits of peer mentoring to improve the disease self-management and quality of life of individuals with systemic lupus erythematosus (SLE).

Methods. Peer mentors were trained and paired with up to 3 mentees to receive self-management education and support by telephone over 12 weeks. This study took place at an academic teaching hospital in Charleston, South Carolina. Seven quads consisting of 1 peer mentor and 3 mentees were matched, based on factors such as age, area of residence, and marital and work status. Mentee outcomes of self-management, health-related quality of life, and disease activity were measured using validated tools at baseline, mid-intervention, and post-intervention. Descriptive statistics and effect sizes were calculated to determine clinically important (>0.3) changes from baseline.

Results. Mentees showed trends toward lower disease activity (P = 0.004) and improved health-related quality of life, in the form of decreased anxiety (P = 0.018) and decreased depression (P = 0.057). Other improvements in health-related quality of life were observed with effect sizes >0.3, but did not reach statistical significance. In addition, both mentees and mentors gave very high scores for perceived treatment credibility and service delivery.

Conclusion. The intervention was well received. Training, the peer-mentoring program, and outcome measures were demonstrated to be feasible with modifications. This result provides preliminary support for the efficacy, acceptability, and perceived credibility of a peer-mentoring approach to improve disease self-management and health-related quality of life in African American women with SLE. Peer mentoring may augment current rheumatologic care.

Implications (Reprinted from the Discussion)

The peer mentoring approach provides a viable solution to address persistent engagement and compliance issues in standardized programs. Peer mentoring also may circumvent barriers to participation and approach this problem in a real-world fashion, as it incorporates the documented needs and desires of the target population into the design.

Future iterations of the peer-mentoring program should include biweekly sessions, since weekly mentee/mentor contact was challenging. Finally, also a 1-month run-in period for mentors to work through call scheduling, practice intervention delivery over the phone, and establish processes for follow up may be beneficial to the success of the program, as study procedures had to be revisited with mentors a number of times at the outset of the study, following training.

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