Intervention Mapping and the Development of a Peer Supported Diabetes Self-Management Program in Rural Alabama

Researchers at the University of Alabama-Birmingham used intervention mapping to develop a peer-supported diabetes self-management program. Intervention mapping consists of six steps: (1) Needs Assessment, (2) Outcomes and Objectives Identification, (3) Model and Theory Selection, (4) Intervention Development, (5,6) Intervention Testing and Intervention Implementation. (1) Researchers identified 18 counties in Southern Alabama with significantly higher rates of type 2 diabetes among the lowest socio-economic groups, in addition to limited access to appropriate healthcare. After contact with community partners, it was clear that the community was receptive to a diabetes self-management program. (2) The objectives of the intervention were to normalize glycemic levels, lower blood pressure, and lower lipid levels through the improvement of self-care behaviors, such as diet modification, increased physical activity, and weight loss. (3) Peer advisers helped support these objectives by providing social support and connecting clients with type 2 diabetes to community and healthcare resources. (4) Peer advisers were selected based on a prior history of either personal experience with type 2 diabetes or personal experience caring for a loved one with type 2 diabetes. (5,6) The intervention was tested with a small group of peer advisers and clients and the final intervention was modified to address the feedback from the pilot trial.

The intervention is a diabetes self-management program that utilizes peer advisers to reach patients who have poor health literacy, are physically isolated, and require assistance with managing their diabetes.

The result of the intervention mapping was a peer supported diabetes self-management program that currently has 60 advisors and 424 clients enrolled in Alabama. Peer advisers assist clients in setting goals, solving problems, and accessing resources. Due to physical constraints and the isolation of clients, the intervention utilizes telephones to connect advisers to clients. By including community partners in the development of the intervention, there is a higher likelihood for retention of peer advisers and clients alike.