Examining Peer Support as Defined by Adults with Diabetes

Diabetes is a complex health condition which, in United States health care, has been treated primarily with simple solutions that focus exclusively on medication adherence, exercise, and diet. National spending on diabetes care is at an all time high, but still 15 million of the 30 million diagnosed with diabetes in America do not meet even the basic health outcome goals. Further, despite a recent push by Diabetes advocacy organizations, traditional healthcare has failed to address the diabetes-related psychosocial needs of this ever-growing population. To address this gap, the present study examines community-governed peer support as a potential management strategy for adults with diabetes in the United States. Peer support serves as a promising complex solution to diabetes-related distress and declining health outcomes in the diabetes population. The aims of this paper were 1) to generate a working definition of peer support as described by self-declared diabetes advocates, and 2) build a conceptual model of peer support best delivered based on the generate definition. Four focus groups with diabetes advocates and leaders were held over the course of one year at three diabetes community peer support events. Borrowing from Participatory Action Research (PAR) methods, all participants were offered continued participation during the design, data collection, and data analysis stages of research. Through a process of member checking and qualitative coding, common themes around peer support included lurking and observational participation, the need for peer support work to be treated as paid work, and recognition of community-generated peer support as a form of wellness promotion. The conceptual model of peer support developed herein is explicitly distinguished from previous models by accounting for an online observer or “lurker” role. Findings indicate that peer-support is needed and desired on a full-time basis by diabetes advocates which necessitates a new formulation of the concept of peer support as it relates to diabetes.