Implementing a One-on-One Peer Support Program for Cancer Survivors Using a Motivational Interviewing Approach: Results and Lessons Learned
Allicock M, Carr C, Johnson LS, Smith R, Lawrence M, Kaye L, Gellin M, Manning M
Peer Connect matches cancer survivors and caregivers (guides) with those currently experiencing cancer-related issues seeking support (partners). Motivational interviewing (MI)-based communication skills are taught to provide patient-centered support. There is little guidance about MI-based applications with cancer survivors who may have multiple coping needs. This paper addresses the results and lessons learned from implementing Peer Connect. Thirteen cancer survivors and two caregivers received a 2-day MI, DVD-based training along with six supplemental sessions. Nineteen partners were matched with guides and received telephone support. Evaluation included guide skill assessment (Motivational Interviewing Treatment Integrity Code) and 6-month follow-up surveys with guides and partners.
Guides demonstrated MI proficiency and perceived their training as effective. Guides provided on average of five calls to each partner. Conversation topics included cancer fears, family support needs, coping and care issues, and cancer-related decisions. Partners reported that guides provided a listening ear, were supportive, and nonjudgmental. Limited time availability of some guides was a challenge. MI can provide support for cancer survivors and caregivers without specific behavioral concerns (e.g., weight and smoking). An MI support model was both feasible and effective and can provide additional support outside of the medical system.
J Cancer Educ; Oct 2013 [Full Abstract]
Lessons Learned from Two Peer-Led Mutual Support Groups
Viverito KM, Cardin SA, Johnson LA, Owen RR
This case report and analysis describe the formation of two peer-led mutual support groups conducted within the context of a Veterans Administration Medical Center. Based on our assessment of the success of one of these groups and the failure of the other, we offer several recommendations and suggestions to help promote this modality. More specifically, we hypothesize that such groups are more likely to be successful (1) if participants are transferred en masse from another group, (2) that, at least initially, housing the group in the same context as formal clinician-led groups or overlapping clinician-led and peer-led groups may help smooth the transition from authority-led treatment to a mutual peer support format, and finally, (3) that prior experiences in interpersonal process groups may promote the skills and cohesion to promote successful transition to mutual support.
Int J Group Psychother; Oct 2013 [Full Abstract]
Impact of a Diabetes Control and Management Intervention on Healthcare Utilization in American Samoa
Hamid S, Dunsiger S, Seiden A, Nu’usolia O, Tuitele J, Depue JD, McGarvey ST
To examine the impact of a successful 12-month behavioral intervention to improve diabetes control on health care utilization in American Samoa.
A cluster-randomized design was used to assign 268 diabetes patients to a nurse-community health worker intervention or usual care. Hospitalizations, emergency department, and primary care physician visits were collected retrospectively for 1 year prior to, and during, the intervention to assess changes in health care utilization. The association of utilization changes with change in HbA1c during the intervention was assessed.
Adjusted incidence rate ratios (RR) for primary care physician visits were significantly higher in the community health worker relative to the usual care group (RR = 1.71; 95% CI, 1.25-2.33). There was no main intervention effect on emergency department utilization, but visits in the prior year modified the intervention effect on emergency department visits. Increased primary care physician utilization was associated with greater decreases in HbA1c (b = -0.10, SE = 0.04, p = 0.01).
A culturally adapted community health worker diabetes intervention in American Samoa significantly increased primary care physician visits, and decreased emergency department visits among those with high emergency department usage in the prior year. These changes suggest important and beneficial impacts on health system utilization from the diabetes intervention in a low resource and high-risk population.
Chronic Illness; Oct 2013 [Full Abstract]