Diabetes education delivered by Peer Advisers, Turkey

Objectives

According to IDF's Diabetes Atlas 5th edition Turkey has more than 3,5 million people with diabetes and another 3,1 million people have impaired glucose intolerance.

Around one third of the Turkish population lives in rural areas and diabetes education is very limited in these areas. Therefore this project initiates a peer advisor programme, in order to increase the awareness and knowledge of diabetes in areas with limited outreach activities.

Using peer advisors to disseminate awareness of diabetes is believed to have a great effect, since peers can be a trusted and credible source of information. They share similar experiences and norms; and can provide relevant and meaningful information on self-care and hopefully have a beneficial effect on outcomes. While the peer advisors educate other people in diabetes self-care management, it also gives them a chance to benefit from the education.

The objective is to create a nationwide diabetes education programme where peer advisers will disseminate awareness about diabetes in rural areas of Turkey.

Approach

The Turkish Diabetes Foundation is implementing this project. They will collaborate with Living With Diabetes Association, Diabetes Dieticians Association and National Nutrition Platform Association in order to carry out the project's aim of improving self-management of people with diabetes and empowering patient organisations.

The project consists of three components:

Training of peer advisors
Two people from 10 project centers will be appointed as peer educators and will participate in a two-day training session. The training sessions will focus on both type 1 and type 2 diabetes mellitus.

The peer advisors will be provided with material like slideshows, flipcharts, films, evaluation and assessment forms, instructor's manuals, handouts and booklets to give to people with diabetes.

Education of patients
Educational sessions will be organised by the trained peer advisors three days a week, 46 weeks a year in the 10 health centers for people with diabetes mainly in rural settings. Each trainee group will consist of 20 people and each session will last for approximately 45-60 minutes each time. Each patient has to attend 10 educational sessions on different topics to complete the Diabetes Education Course.

The sessions will mainly be interactive and contain general principles and facts, along with problem solving and questions and answers. Patients will be encouraged to raise issues from their own experiences.

The knowledge gained in the course will be evaluated by testing the participant's knowledge before and after the Diabetes Education Course. If a participant is not answering sufficiently on the questions, repetition of the Diabetes Education Course will be offered.

Secondary outcomes that will be measured will include changes in biological measures, like blood pressure, HbA1c, BMI, cholesterol levels, and adherence to treatment.

Organisation of support groups
After completion of the Diabetes Education Course several activities will be organised and the participants will meet regularly in order to support each other in maintaining good practices of diabetes treatment. This will among other involve social activities, seminars and educational programmes.

Results at completion

•33 peer educators and 23 educators from 21 cities trained in self-monitoring, diabetes care and teaching models (+ 2 refresher training sessions)
•13,710 patient education sessions conducted
•34,093 patients benefit from the education sessions
•9 project coordination meetings conducted