Alabama leads the nation in diabetes with more than 440,000 citizens diagnosed with the disease. African Americans are more than twice as likely to have diabetes as Caucasians and are more likely to suffer the devastating effects of the disease, including kidney failure and blindness.

February 23, 2009

BIRMINGHAM, Ala. -- Alabama leads the nation in diabetes with more than 440,000 citizens diagnosed with the disease. African Americans are more than twice as likely to have diabetes as Caucasians and are more likely to suffer the devastating effects of the disease, including kidney failure and blindness. One in three African Americans over age 50 in Alabama has diabetes.

UAB Associate Professor of Preventive Medicine Monika Safford, M.D., has received $805,000 from Peers for Progress, a program of the American Academy of Family Physicians Foundation, to evaluate the effectiveness of community peer advisors in improving diabetes outcomes among persons with diabetes living in rural Alabama. The study is called "Encourage," or Evaluating Community Peer Advisors and Diabetes Outcomes in Rural Alabama.

Safford and her team will enroll 400 patients at community health centers in rural, impoverished areas in the state's Black Belt to participate in this peer-to-peer education program. Using a randomized control design, 200 of these patients will be teamed with about 70 peer advisors, to be recruited from the same targeted communities as patients. Peer advisors will themselves have diabetes or have helped a family member with diabetes, and have succeeded with self-management.

Day-to-day struggles like taking medicines on time and finding ways to pay for them, testing blood sugar, eating right and exercising can be daunting. With additional support, it is hoped that patients will manage their diabetes more effectively and as a result, lower their blood sugar, blood pressure and blood cholesterol levels.

Each peer advisor will be paired with three to five diabetes patients who are not achieving guideline targets, providing support for their diabetes self-management over a 12-month period.

"Ultimately, the goal is to improve health outcomes and quality of life for persons with diabetes," Safford said. "By improving their risk factor levels, risks for heart attack, stroke, blindness, amputation and kidney failure can be reduced."

The Encourage study, Safford said, will create important tools for Alabama's diabetes community. The curriculum developed to train peer advisors will be made available as a resource for other programs wishing to use peer advisors for diabetes. Based on the success of this intervention, the research team plans to conduct future studies testing peer advisors in other communities, and expand UAB's partnership with communities to combat diabetes.

Peers for Progress awarded grants totaling $7 million to researchers on six continents to fund 14 research projects that will examine the contributions of peer support to diabetes management, and demonstrate models for peer support programs around the world. The grants were made available through a gift from the Eli Lilly Company Foundation.

The goals of Peers for Progress are to demonstrate the value of peer support in diabetes management, extend the evidence base for peer support interventions, work to establish peer support as an accepted, core component of diabetes care, and promote peer support programs and networks around the world. For more information, visit www.peersforprogress.org.

About the American Academy of Family Physicians Foundation

The Foundation serves as the philanthropic arm of the American Academy of Family Physicians. Its primary goal is to enhance health care delivered to the American people by developing and providing philanthropic resources for the promotion and support of family medicine. For more information, please visit www.aafpfoundation.org.