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Published in: Trials 1/2019

Open Access 01-12-2019 | Study protocol

Using peer education to improve diabetes management and outcomes in a low-income setting: a randomized controlled trial

Authors: Till Seuring, Marthoenis, Sabrina Rhode, Lisa Rogge, Holger Rau, Stéphane Besançon, Hendra Zufry, Hizir Sofyan, Sebastian Vollmer

Published in: Trials | Issue 1/2019

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Abstract

Background

Diabetes is an important health burden in Indonesia. However, diabetes management and treatment remain poor, with most people with diabetes in Indonesia not achieving the recommended blood glucose levels. Peer education may have particular potential in low-income settings in complementing diabetes care without being a large additional strain on the health system.

Methods/design

This cluster randomized controlled trial aims to identify the effect of the implementation of peer education for patients with type 2 diabetes on diabetes-related outcomes in Aceh, Indonesia, which will complement the diabetes treatment provided at primary-care health posts (puskesmas). Altogether, 29 puskesmas were recruited in Banda Aceh and Aceh Besar, each of which was randomly assigned to either the control or the intervention group. Then, 534 people with diabetes were identified and recruited through their respective puskesmas. The intervention consists of up to two peer education groups per puskesmas, which are led by previously trained people with diabetes. Peer education sessions are held every month for 18 months, with follow-up data being collected 9 and 18 months after the first peer education session.
The main objective is to improve diabetes management and the health behavior of participants receiving peer education to reduce their average blood glucose levels as measured by glycated hemoglobin (HbA1c) levels. Secondary outcomes are the effects of peer education on lipid levels, waist circumference, blood pressure, quality of life, treatment adherence, diabetes knowledge, physical activity, and dietary diversity. Data sources for the measurement of outcomes include patient and health facility surveys and biomarker measurements. An economic evaluation will be conducted to assess the cost-effectiveness of the intervention.

Discussion

This trial will contribute to the evidence on the effectiveness and cost-effectiveness of peer education in improving diabetes management in a low-income setting in Indonesia and in other comparable contexts.

Trial registration

ISRCTN registry, ISRCTN68253014. Registered on 18 February 2019.
Appendix
Available only for authorised users
Footnotes
1
A regency is an administrative unit in Indonesia comparable to municipalities, just below the level of provinces. Like cities (e.g., Banda Aceh), regencies have their own local governments and parliaments.
 
2
There are 39 puskesmas in total, of which seven were excluded ex ante for practical reasons as they are located either in the remote mountainous area or on an island, so that it would not have been feasible to conduct either the survey or the training of the peer educators with the given resources.
 
3
Namely, either the Prolanis or the Posbindu program, which are two puskesmas-based national programs targeted at better preventing and managing diabetes and hypertension.
 
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Metadata
Title
Using peer education to improve diabetes management and outcomes in a low-income setting: a randomized controlled trial
Authors
Till Seuring
Marthoenis
Sabrina Rhode
Lisa Rogge
Holger Rau
Stéphane Besançon
Hendra Zufry
Hizir Sofyan
Sebastian Vollmer
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Trials / Issue 1/2019
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-019-3656-1

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