Heart Health Buddies: Peer Support to Decrease CVD Risk
| Status: | Completed |
|---|---|
| Conditions: | Peripheral Vascular Disease |
| Therapuetic Areas: | Cardiology / Vascular Diseases |
| Healthy: | No |
| Age Range: | 35 - 64 |
| Updated: | 3/24/2019 |
| Start Date: | September 26, 2018 |
| End Date: | March 15, 2019 |
Heart Health Buddies: Peer Support to Decrease Cardiovascular Risk (CDA 13-263)
This pilot study will use a hybrid reciprocal peer support and peer coach model to initiate
and sustain heart-healthy behavioral changes in Veterans. Veterans who are at-risk for
cardiovascular disease (CVD) will be enrolled in the study and paired with another Veteran to
receive and provide social support around engaging in CVD risk reduction behaviors. Enrolled
participants will be offered a series of 3 group sessions focused on CVD risk reduction, goal
setting and action plan development. Between group sessions, peer partners will be asked to
have weekly calls to discuss action plan challenges, explore options for problem solving, and
provide encouragement and accountability for personal goals. Participants who do not engage
in the group sessions or weekly phone calls, or who request additional help, will receive
support from trained peer coaches. The goal of this pilot study is to evaluate the proof of
concept for a hybrid reciprocal peer support (RPS) and peer coach intervention to improve
heart healthy behaviors among Veterans at risk for CVD.
and sustain heart-healthy behavioral changes in Veterans. Veterans who are at-risk for
cardiovascular disease (CVD) will be enrolled in the study and paired with another Veteran to
receive and provide social support around engaging in CVD risk reduction behaviors. Enrolled
participants will be offered a series of 3 group sessions focused on CVD risk reduction, goal
setting and action plan development. Between group sessions, peer partners will be asked to
have weekly calls to discuss action plan challenges, explore options for problem solving, and
provide encouragement and accountability for personal goals. Participants who do not engage
in the group sessions or weekly phone calls, or who request additional help, will receive
support from trained peer coaches. The goal of this pilot study is to evaluate the proof of
concept for a hybrid reciprocal peer support (RPS) and peer coach intervention to improve
heart healthy behaviors among Veterans at risk for CVD.
A total of 24 Veterans enrolled at the Durham VAMC will be screened and enrolled. Eligible
Veterans are 35-64 years old, with at least one uncontrolled or poorly controlled risk factor
for CVD. In addition, 3-6 veterans will be enrolled and trained as heart health peer coaches,
with eligibility being 35-64 years old, with at least one documented CVD factor who have
sustained improvement in physical activity or dietary change in the previous 3-6 months. All
participants complete a baseline assessment, three structured group meetings, and a 12 week
post-intervention assessment. At the first group, each participant creates a behavioral goal,
and peer partners are paired with another Veteran based on behavioral goal and gender. They
are expected to call their peer once a week to discuss progress or difficulty with their
action plan and support each other with problem solving. Post enrollment and prior to the
first group meeting, Peer coaches will have 3-5 hours of motivational and communication
training with study staff focusing on skills such as active listening, non-directive support,
eliciting change-talk, promoting incremental change, and patient confidentiality. Peer
coaches will interact with peer buddies during a) group sessions, b) at a 6 week phone
check-in, and c) on-going support if needed. Additional support will be initiated if there
are no phone calls between pairs, there is a lack of participant engagement in calls to
partner or attending group sessions, or upon request by the peer. There are two Aims of the
current pilot study. Aim 1: examine the feasibility and acceptability of a 12-week hybrid
peer coach-reciprocal peer support intervention. Feasibility will be evaluated by ease of
recruitment, and enrollment and retention rates. Acceptability will be assessed by
self-report of amount, frequency and modality of contacts, participation rates for group
sessions, and through post-intervention qualitative interviews.
Aim 2: explore gender differences in feasibility/acceptability of the hybrid peer support
model. Gender differences will be evaluated through qualitative comparison of participant
reported experiences with intervention content as well as peer and group interactions by
gender; and, quantitatively via exploration of differences in enrollment, retention, refusal
reasons and frequency of peer contacts.
Veterans are 35-64 years old, with at least one uncontrolled or poorly controlled risk factor
for CVD. In addition, 3-6 veterans will be enrolled and trained as heart health peer coaches,
with eligibility being 35-64 years old, with at least one documented CVD factor who have
sustained improvement in physical activity or dietary change in the previous 3-6 months. All
participants complete a baseline assessment, three structured group meetings, and a 12 week
post-intervention assessment. At the first group, each participant creates a behavioral goal,
and peer partners are paired with another Veteran based on behavioral goal and gender. They
are expected to call their peer once a week to discuss progress or difficulty with their
action plan and support each other with problem solving. Post enrollment and prior to the
first group meeting, Peer coaches will have 3-5 hours of motivational and communication
training with study staff focusing on skills such as active listening, non-directive support,
eliciting change-talk, promoting incremental change, and patient confidentiality. Peer
coaches will interact with peer buddies during a) group sessions, b) at a 6 week phone
check-in, and c) on-going support if needed. Additional support will be initiated if there
are no phone calls between pairs, there is a lack of participant engagement in calls to
partner or attending group sessions, or upon request by the peer. There are two Aims of the
current pilot study. Aim 1: examine the feasibility and acceptability of a 12-week hybrid
peer coach-reciprocal peer support intervention. Feasibility will be evaluated by ease of
recruitment, and enrollment and retention rates. Acceptability will be assessed by
self-report of amount, frequency and modality of contacts, participation rates for group
sessions, and through post-intervention qualitative interviews.
Aim 2: explore gender differences in feasibility/acceptability of the hybrid peer support
model. Gender differences will be evaluated through qualitative comparison of participant
reported experiences with intervention content as well as peer and group interactions by
gender; and, quantitatively via exploration of differences in enrollment, retention, refusal
reasons and frequency of peer contacts.
Inclusion Criteria:
Peer partners and peer coaches:
- Enrolled in a Durham VAHS primary care clinic (including the women's health clinic)
- At risk for CVD as defined by having at least one of the following:
- Uncontrolled hypertension
- history of obesity defined as (BMI >30)
- uncontrolled non-insulin dependent diabetes mellitus
- In addition, Peer coaches have made and sustained a behavioral change in past 3-6
months to improve heart health
- English as preferred language
- no significant hearing impairment
- lives approximately 30 minutes from the Durham VAMC
- agrees to attend regular visits per study protocol
- no contraindication to engage in at least moderate physical activity
- willing to use personal phone for peer and coach contacts
Exclusion Criteria:
- insulin-dependent diabetes
- serious mental illness defined as schizophrenia, bipolar disorder, dementia, active
psychosis psychiatric hospitalization within the last 12 months or current high-risk
suicide flag in their CPRS medical record
- active substance use as documented in CPRS or positive screening during telephone
screening
- limited Life expectancy (<6 months) or severely ill defined as enrolled in hospice or
actively undergoing chemotherapy or radiation therapy for cancer
- currently pregnant or planning to become pregnant in next 6 months
We found this trial at
1
site
Durham, North Carolina 27705
Principal Investigator: Karen Goldstein, MD MSPH
Phone: 919-286-0411
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