The effectiveness of peer and community health worker-led self-management support programs for improving diabetes health-related outcomes in adults in low- and-middle-income countries: a systematic review

Simple item page
dc.contributor.authorWerfalli, Mahmoud
dc.contributor.authorRaubenheimer, Peter J
dc.contributor.authorEngel, Mark
dc.contributor.authorMusekiwa, Alfred
dc.contributor.authorBobrow, Kirsten
dc.contributor.authorPeer, Nasheeta
dc.contributor.authorHoegfeldt, Cecilia
dc.contributor.authorKalula, Sebastiana
dc.contributor.authorKengne, Andre P
dc.contributor.authorLevitt, Naomi S
dc.date.accessioned2020-06-10T08:43:20Z
dc.date.available2020-06-10T08:43:20Z
dc.date.issued2020-06-06
dc.date.updated2020-06-07T03:46:23Z
dc.description.abstractObjective Community-based peer and community health worker-led diabetes self-management programs (COMP-DSMP) can benefit diabetes care, but the supporting evidence has been inadequately assessed. This systematic review explores the nature of COMP-DSMP in low- and middle-income countries’ (LMIC) primary care settings and evaluates implementation strategies and diabetes-related health outcomes. Methods We searched the Cochrane Library, PubMed-MEDLINE, SCOPUS, CINAHL PsycINFO Database, International Clinical Trials Registry Platform, Clinicaltrials.gov, Pan African Clinical Trials Registry (PACTR), and HINARI (Health InterNetwork Access to Research Initiative) for studies that evaluated a COMP-DSMP in adults with either type 1 or type 2 diabetes in World Bank-defined LMIC from January 2000 to December 2019. Randomised and non-randomised controlled trials with at least 3 months follow-up and reporting on a behavioural, a primary psychological, and/or a clinical outcome were included. Implementation strategies were analysed using the standardised implementation framework by Proctor et al. Heterogeneity in study designs, outcomes, the scale of measurements, and measurement times precluded meta-analysis; thus, a narrative description of studies is provided. Results Of the 702 records identified, eleven studies with 6090 participants were included. COMP-DSMPs were inconsistently associated with improvements in clinical, behavioural, and psychological outcomes. Many of the included studies were evaluated as being of low quality, most had a substantial risk of bias, and there was a significant heterogeneity of the intervention characteristics (for example, peer definition, selection, recruitment, training and type, dose, and duration of delivered intervention), such that generalisation was not possible. Conclusions The level of evidence of this systematic review was considered low according to the GRADE criteria. The existing evidence however does show some improvements in outcomes. We recommend ongoing, but well-designed studies using a framework such as the MRC framework for the development and evaluation of complex interventions to inform the evidence base on the contribution of COMP-DSMP in LMIC.
dc.identifier.apacitationWerfalli, M., Raubenheimer, P. J., Engel, M., Musekiwa, A., Bobrow, K., Peer, N., ... Levitt, N. S. (2020). The effectiveness of peer and community health worker-led self-management support programs for improving diabetes health-related outcomes in adults in low- and-middle-income countries: a systematic review. <i>Systematic Reviews</i>, 9(1), 133. http://hdl.handle.net/11427/32058en_ZA
dc.identifier.chicagocitationWerfalli, Mahmoud, Peter J Raubenheimer, Mark Engel, Alfred Musekiwa, Kirsten Bobrow, Nasheeta Peer, Cecilia Hoegfeldt, Sebastiana Kalula, Andre P Kengne, and Naomi S Levitt "The effectiveness of peer and community health worker-led self-management support programs for improving diabetes health-related outcomes in adults in low- and-middle-income countries: a systematic review." <i>Systematic Reviews</i> 9, 1. (2020): 133. http://hdl.handle.net/11427/32058en_ZA
dc.identifier.citationWerfalli, M., Raubenheimer, P.J., Engel, M., Musekiwa, A., Bobrow, K., Peer, N., Hoegfeldt, C. & Kalula, S. et al. 2020. The effectiveness of peer and community health worker-led self-management support programs for improving diabetes health-related outcomes in adults in low- and-middle-income countries: a systematic review. <i>Systematic Reviews.</i> 9(1):133. http://hdl.handle.net/11427/32058en_ZA
dc.identifier.ris TY - Journal Article AU - Werfalli, Mahmoud AU - Raubenheimer, Peter J AU - Engel, Mark AU - Musekiwa, Alfred AU - Bobrow, Kirsten AU - Peer, Nasheeta AU - Hoegfeldt, Cecilia AU - Kalula, Sebastiana AU - Kengne, Andre P AU - Levitt, Naomi S AB - Objective Community-based peer and community health worker-led diabetes self-management programs (COMP-DSMP) can benefit diabetes care, but the supporting evidence has been inadequately assessed. This systematic review explores the nature of COMP-DSMP in low- and middle-income countries’ (LMIC) primary care settings and evaluates implementation strategies and diabetes-related health outcomes. Methods We searched the Cochrane Library, PubMed-MEDLINE, SCOPUS, CINAHL PsycINFO Database, International Clinical Trials Registry Platform, Clinicaltrials.gov, Pan African Clinical Trials Registry (PACTR), and HINARI (Health InterNetwork Access to Research Initiative) for studies that evaluated a COMP-DSMP in adults with either type 1 or type 2 diabetes in World Bank-defined LMIC from January 2000 to December 2019. Randomised and non-randomised controlled trials with at least 3 months follow-up and reporting on a behavioural, a primary psychological, and/or a clinical outcome were included. Implementation strategies were analysed using the standardised implementation framework by Proctor et al. Heterogeneity in study designs, outcomes, the scale of measurements, and measurement times precluded meta-analysis; thus, a narrative description of studies is provided. Results Of the 702 records identified, eleven studies with 6090 participants were included. COMP-DSMPs were inconsistently associated with improvements in clinical, behavioural, and psychological outcomes. Many of the included studies were evaluated as being of low quality, most had a substantial risk of bias, and there was a significant heterogeneity of the intervention characteristics (for example, peer definition, selection, recruitment, training and type, dose, and duration of delivered intervention), such that generalisation was not possible. Conclusions The level of evidence of this systematic review was considered low according to the GRADE criteria. The existing evidence however does show some improvements in outcomes. We recommend ongoing, but well-designed studies using a framework such as the MRC framework for the development and evaluation of complex interventions to inform the evidence base on the contribution of COMP-DSMP in LMIC. DA - 2020-06-06 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - Systematic Reviews LK - https://open.uct.ac.za PY - 2020 T1 - The effectiveness of peer and community health worker-led self-management support programs for improving diabetes health-related outcomes in adults in low- and-middle-income countries: a systematic review TI - The effectiveness of peer and community health worker-led self-management support programs for improving diabetes health-related outcomes in adults in low- and-middle-income countries: a systematic review UR - http://hdl.handle.net/11427/32058 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s13643-020-01377-8
dc.identifier.urihttp://hdl.handle.net/11427/32058
dc.identifier.vancouvercitationWerfalli M, Raubenheimer PJ, Engel M, Musekiwa A, Bobrow K, Peer N, et al. The effectiveness of peer and community health worker-led self-management support programs for improving diabetes health-related outcomes in adults in low- and-middle-income countries: a systematic review. Systematic Reviews. 2020;9(1):133. http://hdl.handle.net/11427/32058.en_ZA
dc.language.rfc3066en
dc.rights.holderThe Author(s)
dc.sourceSystematic Reviews
dc.source.journalissue1
dc.source.journalvolume9
dc.source.pagination133
dc.source.urihttps://systematicreviewsjournal.biomedcentral.com/
dc.titleThe effectiveness of peer and community health worker-led self-management support programs for improving diabetes health-related outcomes in adults in low- and-middle-income countries: a systematic review
dc.typeJournal Article
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Mahmoud_2020_Article.pdf
Size:
1018 KB
Format:
Adobe Portable Document Format
Description:
Download
License bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
license.txt
Size:
0 B
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
Journal Articles