Program Development Guide
1. Key Messages
Key messages in Peer Support
|Video: What is Peer Support?
|In this video, an international assembly of medical and public health experts explain why peer support is important to the present and future of chronic disease self-management, prevention, and health.|
- Peer support is NOT cheap health care for poor people, but good health care for all people.
- If the average individual with a disease like diabetes spends as many as 6 hours in a doctor’s or health professional’s office, that leaves 8,760 hours a year they are “on your own” to manage their disease or condition. This is where peer support comes in!
- Self-management is point of care and beyond.
- Standardization by functions, not content: The key functions of peer support are global, but how they are addressed needs to be worked out within each setting.
Arguments for Peer Support
- Peer support increases access to care, improves quality of care, decreases costs, and increases reach to populations
- Peer Support is Cost Effective — Growing evidence of the cost effectiveness of peer support includes a study in a Federally Qualified Health Center in Denver. A peer support program encouraging a variety of healthy patterns, from routine mammography to diabetes management, showed a return on investment of $2.28 to $1 (Whitley et al. J Hlth Care Poor Underserved 2006 17: 6-15). In the Robert Wood Johnson Foundation Diabetes Initiative, programs that emphasized peer support showed a cost per “quality adjusted life year” of $39,563 (Brownson et al., The Diab Educator. 2009 35: 761-769).
- Peer Support Reaches those Too Often Missed — An “Asthma Coach” engaged 89% of unmarried, low-income mothers of children covered by Medicaid who had been hospitalized for asthma and held their engagement for 2 years (Fisher et al. Arch Ped and Adol Med 2009 163 (3), 225-232). In a successful Coach intervention for low-income patients of “safety net” clinics in San Francisco, the added benefit of peer support was most pronounced among those who reported lowest levels of medication adherence at the start of the program (Moskowitz et al. J Gen Intern Med. 2013 28: 938-942). Rather than cherry picking, these programs reach and engage those whom other approaches often miss.
- Peer Support Reduces Hospitalizations — The same “Asthma Coach” intervention reduced re-hospitalization by 50% over a 2-year period. In a program for people with “serious mental illness” (schizophrenia, depression, bipolar disorder), Recovery Mentors provided individualized support and, compared to controls, achieved lower rates of hospitalization — 0.89 vs 1.53 hospitalizations per person over 9 months, 10.08 vs 19.08 days in hospital (Sledge et al., Psychiatr. Serv. 2011 62:541–44).
- Peer Support is Traditional Care
- Peer Support is as old as Homo sapiens — Peer support is as old as humankind and engrained in many cultures, such as the promotora tradition in Latin American culture. Further, it rests on the fundamental importance of social support, the absence of which is as lethal as smoking cigarettes (5, 48). Thus, peer support can be understood as a traditional bedrock of care and helping.
|Peers for Progress Policy Factsheet||This factsheet tailored to policy makers highlights key messages with supported evidence of peer support.|
|The Case for Peer Support in Diabetes Self-Management by the NPSCLN Sustainability and Advocacy Workgroup||This issue brief makes the case for peer support as an effective method for improving patients’ experiences with the health care system, reducing the burden of chronic disease and the per capita cost of health care, and improving health outcomes.|
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