John D. Piette|Ken Resnicow|Hwajung Choi|Michele Heisler
A diabetes peer support intervention that improved glycemic control: mediators and moderators of intervention effectiveness
VA Center for Clinical Management Research|University of Michigan–Ann Arbor|University of Michigan–Ann Arbor|University of Michigan–Ann Arbor|VA Center for Clinical Management Research|University of Michigan–Ann Arbor
objective randomized trial guided diabetes peer support intervention improved glycemic control a1c difference a1c change groups 058 p 0004 current study examined whether improvements insulin uptake perceived diabetes social support mediated interventions impact a1c also examined potential moderation patients health literacy diabetes social support diabetes distress methods conducted secondary analyses 212 type 2 diabetes patients participating trial using accepted methods testing mediation moderation effects results roughly half 49 95 ci 380 a1c effect mediated increased insulin use changes diabetes social support negligible impact a1c impacts varied across subgroups defined baseline diabetes social support functional health literacy p lt 001 intervention particularly beneficial among patients low baseline diabetes support literacy levels intervention greater impact a1c among patients frequent engagement peer support calls p lt 001 discussion patients receiving increased peer support improved glycemic control largely due greater likelihood initiating insulin greater intervention engagement associated stronger effects intervention greatest benefits among patients low support poorer health literacy