Accelerating Best Practices in Peer Support Around the World

Personal Reflections from the Peers for Progress June Conference

Clayton Velicer, MPH

On June 17th and 18th, I had the wonderful opportunity to hear speakers and engage with experts on peer support when Peers for Progress and the National Council of La Raza hosted a meeting of Peers for Progress investigators and the National Peer Support Collaborative Learning Network in San Francisco, California.

Projects from all over the world were showcased, representing Argentina, Cameroon, Hong Kong, Thailand, Uganda, Australia, the United Kingdom and across the United States. These presentations summarized cutting edge research on peer support for diabetes self-management provided by community health workers, promotoras and peer supporters through a variety of mediums.

One of the topics that I was particularly interested in discussing with this diverse and accomplished group was the role of technology in peer support moving forward. Recent news has covered a peer support app for diabetes care and a number of organizations launching patient-to-patient apps for mental health and other chronic conditions.

When I mentioned these developments to the group, someone raised the question of how peer support apps were being regulated and evaluated before being launched to the general public. I didn’t have a good answer to this question and wanted our readers to share their thoughts on how these technologies could be regulated. While it’s a positive step that peer support is being incorporated into new technologies, we must take care to ensure that the delivery of peer support follows best practices.

For peer support to be effective with smart phone apps, software developers should use the 4 key functions of peer support as a guide. While these technologies can provide linkages to care and ongoing support over time, a tougher challenge may be providing assistance in applying self-management skills in daily life. I am very intrigued by the HealthCrew App currently being developed, as this app may have found an effective method for strengthening self-management skills by tailoring educational messages to the users based on the information entered during intake.

While I am personally very intrigued by the ability of smart phone apps to provide peer support, the conference also reminded me of other forms of telehealth that can be equally useful in providing support for those managing chronic diseases. Brian Oldenburg, a professor at the University of Melbourne, discussed his Telephone-Linked Care system, which provides automated telephone support for diabetes management. The program provides outbound messages to the participants and individually tailors messages in response to the participants’ patterns of self-management behaviors and clinical measures that are monitored through data entered by the patients on smart phones.

The participants in this study were highly engaged, completing an average of 18 calls over 6 months that averaged 10.8 minutes in duration. Clinical effectiveness was also demonstrated by the program with HbA1C values declining from 8.8% to 8.0%. Finally, medication costs were also lower for participants using the telephone system compared to control.

Seeing this information presented helped conceptualize a real-world way of using technology to incorporate support into diabetes self-management and made me wonder if some of the peer support apps currently in development could effectively incorporate automated messages as a means of augmenting patient-to-patient communication.

I encourage our readers and conference participants to add their own thoughts and experiences with technology and peer support. For more information about our meeting, you can check out the Peers for Progress June newsletter. Subscribe to the newsletter to be the first to read the full meeting report when it is released.

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