Building Competency in Diabetes Education THE ESSENTIALS

FOUNDATIONS OF DIABETES SELF-MANAGEMENT EDUCATION AND SUPPORT| 2-41

Peer mentoring Mentoring strategies have been used successfully to provide emotional and role model support (132). By developing a structured supportive partnership with the patient, peer mentoring has been effective in motivating behavioural change and in dealing with complex treatment regimens (22,84,95). In families with children with type 1 diabetes, pairing newly diagnosed families with more experienced families has resulted in improved coping skills and improved quality of life (133). Community health workers Community health workers have proven to be very effective, especially in regards to culturally specific communities where they share the same values, customs and language as the target population. For example, in the USA’s “promotora model”, health-care workers in the Latino community have been found to be more successful at promoting self-care practices. They also serve as a vital link for their community to the health-care system (20). The CoDE program used a community health worker in the primary role of diabetes educator in a clinic serving uninsured Mexican Americans. The care was evaluated to be comparable to other primary care settings (134). A comparative study using usual care versus bilingual promotoras to assist with depression and self-care management in a Latino community also validated that the outcomes were similar in both groups (135). These are only a few examples of the many peer-led community support programs. Family The involvement of family members is crucial to the successful management of diabetes (10,51,52). The DAWN2 study has highlighted the significance of family support and yet it showed evidence that we have made little progress in integrating family members into the care team (51,52,84). In this study, 25% of the family members reported worrying about the future and the possibility of family members developing complications (51). Fifty % of family members surveyed were concerned about the risk of hypoglycemia (51). Family members have specifically expressed interest in acquiring more knowledge about diabetes and its treatment, about how to effectively communicate with their loved ones and how to engage appropriately in conflict resolution. With the patient’s permission, every opportunity should be taken by the care team to actively involve these supporters (10).