Accelerating Best Practices in Peer Support Around the World

heart disease


Dulce Mothers: Promotoras and Mothers with Gestational Diabetes

Clayton Velicer, MPH

For a long time, promotoras have helped improve access to healthcare and self-management of chronic diseases. See our previous coverage of the great work done by promotoras in mental health, improving mother’s dietary intake and improving hypertension outcomes.

In this week’s blog we highlight a recent article by Athena Philis-Tsimikas that examined the effectiveness of the Dulce Mothers program, a promotora intervention designed to lower diabetes and cardiovascular risk in Latinas following gestational diabetes.

All women with a history of gestational diabetes mellitus have a sevenfold higher likelihood of future type 2 diabetes and also have a higher risk for developing cardiovascular disease (CVD) compared to mothers that do not have gestational diabetes. Latinas, in particular, are at higher risk for both gestational diabetes and type 2 diabetes compared to non-Latino whites.
Training and Intervention
The Dulce Mothers intervention adopted the…


Peer Supporters as Transition Coaches for Reducing Hospital Readmissions

Clayton Velicer, MPH

Starting in October 2012, the Affordable Care Act’s Hospital Readmissions Reduction Program began imposing financial penalties on hospitals with excess hospital readmissions for conditions such as acute myocardial infarction, heart failure, and pneumonia. Information on the measures and payment adjustment methodologies are available at the CMS website. Our previous blog discussed the potential role for community health workers and peer supporters in reducing hospital readmissions. In this blog, we’ll look at a care transition program that has successfully used peer supporters to coach patients after being discharged from the hospital.

The California Healthcare Foundation, a grant-making nonprofit based in Oakland, recently released an issue brief on two models being pilot tested for transitioning care from hospitals. One of these models, the Coleman Transitions of Care model, is a four-week process designed to empower and support patients to take a…


Peer Support, Heart Failure and Learning from Past Interventions

Clayton Velicer, MPH

As discussed in our recent blogs analyzing the delivery of peer support in a diabetes program in Australia and reviewing a systematic review of peer support, the dose delivered of peer support can be critical to a program’s success. In a recent publication, Heisler and colleagues conducted a randomized controlled trial to explore whether a reciprocal peer support program found to be successful in diabetes care could be adapted for patients with heart failure (HF) in a community hospital setting. Unfortunately, an intention-to-treat analysis found no difference between patients in the intervention arm versus those in the nurse care management armin re-hospitalizations or deaths. This blog takes a closer look at the dose factors that may have contributed to these findings.

Study Design

All patients in this study had a diagnosis of diastolic or systolic heart failure and were hospitalized or had been in the previous 12 months. Patients in the…

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