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The Center for Health Equity Research and Promotion (CHERP) invites VISN4 investigators to submit an application for our competitive pilot research program. CHERP invites applications for pilot research proposals that seek to identify, understand or intervene to promote equity and quality in health and health care among veterans.
The deadline for submission is Friday, May 18, 2012. Link here for complete instructions, as well as additional details regarding funding priorities, eligibility, and other requirements.
In VA study by CHERP Investigators, African American Veterans with diabetes benefit from peer mentoring
In a study at the Philadelphia Veterans Affairs Medical Center, African American Veterans with hard-to-control diabetes who were matched with peer mentors made significant gains in keeping their blood sugar in check. The results appear in the March 20, 2012 Annals of Internal Medicine. The study included 118 African American Veterans, all of whom were having trouble controlling their diabetes. Dr. Judith Long, lead author, is featured in the New York Times "Health" column: http://well.blogs.nytimes.com/2012/03/22/learning-from-other-patients/ Philadelphia's National Public Radio station, WHYY, also featured Dr. Long and her work: Veterans With Diabetes Battle to Stay Healthy One group received telephone counseling from peer mentors—other African American Veterans with diabetes who had overcome their own struggles to keep their blood sugar at healthy levels. After a brief training session, the mentors earned a small reward—$20 per month— if they contacted the person they were helping at least once a week throughout the six-month study. A second group received usual care—standard medical care, with no additional supports. A third group was assigned to the “financial incentive” arm of the study. These Veterans became eligible for a payment of up to $200 at the end of the study if they were able to significantly lower their blood sugar. Of the three arms, the peer group made the most progress. On average, their hemoglobin A1C—a measure of blood sugar over the past two to three months—dropped about a point, from 9.8 to 8.7 percent. Good control for those with diabetes is considered around 7.5 to 8 percent. The usual-care group saw only a slight drop in their hemoglobin A1C levels, from 9.9 to 9.8 percent. The financial incentive group showed a modest improvement—from 9.5 to 9.1 percent—but it was not statistically significant. Because the pilot study lasted only six months and the study population was relatively small, the authors say further research is needed. On the whole, though, the new results jibe with those from past studies in which mentoring or reciprocal peer support helped patients with diabetes—particularly minorities—improve their medication adherence, diet, exercise, blood glucose monitoring, and glucose control. “Peer mentoring appears to be an excellent way to enhance self-management for this group of patients,” says lead author Judith Long, MD. “Among other reasons for the intervention’s success, we believe there was a strong culture of camaraderie among the Veterans who took part in the study.” She says social support is a critical factor in helping patients to manage chronic illness, but friends and family are often not able to fill the role. Dr. Long and her colleagues are currently designing a study that uses a peer mentor program in the VA’s Patient Aligned Care Teams (PACT). “We will use a diabetes educator to implement the program and have mentees become mentors once they have completed the program with the aim to create sustainability for this successful approach to diabetes care.” One angle to explore in future research, say the investigators, would be transitioning successful mentored Veterans into the role of mentor, which could boost their motivation to maintain their gains and serve as a good example for their peers. According to the researchers, the study focused on African Americans because they have a greater incidence of diabetes, compared with the general population. They also tend to have a harder time self-managing the condition and are at greater risk for complications. Moreover, research has shown that African American patients sometimes harbor mistrust of the health care system and may be more receptive to health-promoting messages from people in their own community. Long, an internist at the Philadelphia VA Medical Center, points out that the mentoring in the study worked well even though it was conducted only by phone; there were no face-to-face meetings between the Veterans. As such, she said, the approach could be especially useful for Veterans who live far from VA clinics. Dr. Long’s Co-Investigators were Kevin G. Volpp, MD, PhD and Diane M. Richardson, PhD, of VA’s Center for Health Equity Research and Promotion in Philadelphia, along with colleagues Erica C. Jahnle, BA, from the University of Pennsylvania, and George Loewenstein, PhD, of Carnegie Mellon University. Funding was provided by VA and the National Institute on Aging.
CHERP is a VA Health Services Research & Development (HSR&D) Center of Excellence. Our mission is to promote equity and quality in health and health care among veterans and other populations. Michael Fine, M.D., M.Sc., (Principal Investigator) Said Ibrahim, M.D., M.P.H., (Co-Principal Investigator) Center for Health Equity Research Center for Health Equity Research CHERP is a collaboration among key entities within Veterans Integrated Service Network Four (VISN 4). The central Web site for all VA Research and Development is www.research.va.gov. For more information, contact Carson Clark: Carson.Clark@va.gov (cut and paste into email browser) |
