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What is peer support?

Peer support refers to the practical, social, and emotional support from a person sharing similar experiences with a disease, condition, or identity. People with a common condition are able to share knowledge and experiences – including some that many health workers do not have.

Peer support is frequent, ongoing, accessible and flexible. Peer support can take many forms – phone calls, text messaging, group meetings, home visits, going for walks together, and even grocery shopping. It complements and enhances other health care services by creating the emotional, social and practical assistance necessary for managing the disease and staying healthy.

Peer support has five key functions:

Diagram of the 5 Key Functions of Peer Support
Diagram of the 5 Key Functions of Peer Support

Being there
Peer supporters can be relied upon to provide the right kind of support when needed. Do not underestimate the value of simply being there for people!

Assistance in daily management
Peer supporters use their own experiences with diet, physical activity and medicine adherence in helping people figure out how to manage diabetes in their daily lives. They can also help in identifying key resources, such as where to buy healthy foods or pleasant and convenient locations for exercise.

Social and emotional support
Through empathetic listening and encouragement, peer supporters are an integral part of helping patients to cope with social or emotional barriers and to stay motivated to reach their goals.

Linkages to clinical care  and community resources
Peer supporters can help bridge the gap between the patients and health professionals and encourage individuals to seek out clinical and community resources when it is appropriate.

Ongoing support, extended over time
Peer supporters successfully keep patients engaged by providing proactive, flexible, and continual long-term follow-up.

Who is a peer supporter?

Peer support refers to support from a person who has knowledge from their own experiences with a condition. Within the context of diabetes management, peer support is support that typically comes from a person with diabetes or a person affected by diabetes (e.g. immediate family member or caregiver).

What is the role of a peer supporter?

Peer support functions to complement, supplement and extend formal primary care services. The role of peer supporters is distinct and does not replace the role of professional health care providers in diabetes care.

The role of a peer supporter is usually a voluntary role that is formally recognized, but generally not compensated. In certain instances, as informed by cultural or regional context, an honorarium or other acknowledgement of peer-supporter involvement may be appropriate (e.g. reimbursement for transportation).

Why is peer support important?

Social support results in psychological and physical health benefits for both the receiver and provider.

Peer support relies on non-hierarchical, reciprocal relationships, which provide a flexible supplement to formal health system services for people with diabetes. In addition, peer support fosters understanding and trust of health care staff among groups who otherwise may be alienated from or have poor access to health care.

What models exist for using peer support in chronic disease management?

As outlined in a thorough paper on the question by Michele Heisler, they include:

  1. Professional-led group visits with peer exchange
    In this model, patients who share the same condition are brought together with a health care provider or team of providers to address their self-management challenges.
  2. Peer-led face-to-face self-management programs
    In this approach, a person who shares the same condition as the participants leads an interactive format to enhance participants’ sharing and mutual encouragement regarding self management.
  3. Peer coaches
    Also known as peer mentors, peer coaches are individuals who have coped with the same condition and meet one-on-one with patients to listen, discuss concerns and provide support.
  4. Community health workers
    Also known as promotoras, community health workers are community members who work to bridge the gap between their respective communities and health care providers. They do not necessarily have a chronic condition, but they often share language, culture and community with the patients. Oftentimes, the roles of Community Health Worker and Peer Coach are merged.
  5. Support groups
    Support groups are gatherings of people who share common experiences, situations, problems or conditions. In these gatherings, people are able to mutually offer emotional and practical support.
  6. Telephone-based peer support
    This type of peer support is provided through regular phone calls that are either the sole form of an intervention or used to complement other modes of intervention.
  7. Web- and e-mail-based programs
    These programs use the Internet to mobilize peer support, including Internet-based support groups and e-mail reminders. In addition to increasing reach and convenience, they may overcome problems some patients have with face-to-face contact.

Source: Heisler, M. (2006) Building Peer Support Programs to Manage Chronic Disease: Seven Models for Success. California Health Care Foundation.

What are key points to successful peer support?

There’s no single ingredient that is required or that guarantees success, but frequent components of successful peer support programs include:

  • Maintain frequent contact (long-term and ongoing support).
  • Be able to develop and maintain linkages with health systems and primary care providers.
  • Be able to encourage regular care, healthy eating, physical activity and medicine adherence; share experiences and advice for those activities; and assist in completing those activities.
  • Enable daily living with diabetes by engaging in healthy eating and physical activity together, giving reminders for medicine adherence or health care appointments, and providing support in coping with day-to-day stressors.
  • Assist in developing problem-solving, decision-making, and coping skills.
  • Be sensitive to individual, social and cultural characteristics of the patient.
  • Be considerate of individual rights, privacy, and the limits on the role of the peer supporter.
  • Peer supporters are not primary care providers and should not give medical advice or diagnoses. Instead, if people have questions that require clinical expertise to answer, the peer supporter should encourage them to contact their regular source of care and, if necessary, help them do so.