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Peer Mentoring and Financial Incentives to Improve Glucose Control in African American Veterans FREE

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The full report is titled “Peer Mentoring and Financial Incentives to Improve Glucose Control in African American Veterans. A Randomized Trial.” It is in the 20 March 2012 issue of Annals of Internal Medicine (volume 156, pages 416-424). The authors are J.A. Long, E.C. Jahnle, D.M. Richardson, G. Loewenstein, and K.G. Volpp.

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Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians.

Ann Intern Med. 2012;156(6):I-50. doi:10.7326/0003-4819-156-6-201203200-00002
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What is the problem and what is known about it so far?

It is difficult for patients with diabetes to make changes in their diet, exercise, and other activities that would result in better disease control. Diabetes is more common and more severe in African Americans, making this population an important target for specific glucose control programs.

Why did the researchers do this particular study?

To see if patients with diabetes who had poor glucose control could lower their hemoglobin A1c (HbA1c) levels by talking on a regular basis with other patients with diabetes who had successfully controlled their glucose levels. Levels of HbA1c are considered to be a good indicator of glucose control. The researchers also wanted to see if offering a small monetary incentive to patients with diabetes would help them lower their HbA1c levels.

Who was studied?

African American patients with diabetes who were receiving care in a Veterans Affairs clinic who had not been successful in lowering their HbA1c levels. The peer mentors were African American patients with diabetes who were receiving care in the same clinics but had successfully lowered their HbA1c levels.

What did the researchers find?

Patients with diabetes who talked with a peer mentor on a regular basis achieved the greatest decreases in HbA1c level. Patients with diabetes who received a small monetary incentive for good control had smaller decreases in HbA1c level that were not considered clinically important.

What are the limitations of the study?

Almost all of the patients with diabetes were men, and all were veterans. Peer mentors were also veterans, and this may have created an especially close bond based on common experience that would not be the same for patients with diabetes in other settings.

What are the implications of the study?

Talking with peers who have successfully managed their disease may be an effective intervention in improving glucose control in patients with diabetes.





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