Abstract
Social support is powerful, and epidemiologic reviews show that its absence, social isolation, is as lethal as smoking cigarettes. Thus, harnessing support through peer support programs (community health workers, promotores de salud, lay health advisors, etc.) has been shown to have diverse and reliable benefits. Studies show its feasibility, sustainability, and adoption. Studies also show its effectiveness in reaching those whom health initiatives too often fail to engage, reaching populations, and reducing psychological distress and the avoidable hospital and acute care that so often accompanies it. This chapter reviews the implications for peer support interventions from fundamental knowledge of social support, including research on attachment and social connections, types of social support, especially emotional support, social networks and diversity of connections, and the general importance of contexts in moderating features of peer support and their effects. This chapter also reviews success factors including the importance of proactive contact, dissemination and organizational models for peer support, integration with behavioral health and mental health, dissemination through primary care and digital health, and policy considerations. It closes with discussion of the importance of the continuum of peer support, from informal support among family, friends, or neighbors, to individuals volunteering a few hours a week, to highly trained volunteers such as the Village Health Volunteers of Thailand or clinical staff such as the Lady Health Workers in Pakistan’s primary care system.
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Acknowledgments
The development of this chapter has been supported by Peers for Progress, a program of the Department of Health Behavior in the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill. Much of the work of reported in this chapter was supported through Peers for Progress while it was administered through the American Academy of Family Physicians Foundation (2006–2015) and through contributions from the Eli Lilly and Company Foundation and the Bristol-Myers Squibb Foundation. Additional support is provided by the Michigan-UNC Peer Support Research Core of the Michigan Center for Diabetes Translational Research (P30DK092926 from the National Institute of Diabetes and Digestive and Kidney Diseases, PI: William Herman) and by the Merck Foundation, Sanofi China, and Novo Nordisk.
In particular, this chapter would not be possible without the work of investigators supported by grants from Peers for Progress. In alphabetical order according to organization, they are:
American Academy of Family Physicians National Research Network, LA Net, WellMed
Lyndee Knox, PhD; Wilson Pace, MD; America Bracho, MD, MPH
CENEXA – Centro de Endocrinologia Experimental y Aplicada, Universidad Nacional de La Plata (UNLP-CONICET), La Plata, Argentina
Juan José Gagliardino, MD; Charles M. Clark, Jr., MD
Centre for Population Studies and Health Promotion, University of Yaounde, Cameroon
Paschal Kum Awah, PhD; Andre-Pascal Kengne, MD, PhD
Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital
Juliana C.N. Chan, MD; Rebecca Y.M. Wong, MSC; Gary T.C. Ko, MD; Roseanne O. Yeung, MD,MPH; Suky Junmei Yin, MPH
Institute of Metabolic Science, Cambridge University Hospitals, University of Cambridge, Cambridge, England
David Simmons, FRACP, FRCP, MD; Jonathan P. Graffy, FRCGP, MD
Mahidol University, Bangkok
Boosaba Sanguanprasit, PhD, MPH; Chanuantong Tanasugarn, DrPH, MPH
Monash University and DiabetesVic, Melbourne, Australia
Brian Oldenburg, PhD; Michaela Riddell, PhD
San Diego State University
Guadalupe X. Ayala, PhD, MPH; Andrea Cherrington, MD, MPH; John P. Elder, PhD, MPH; Lucy Horton, MS, MPH; Leticia Ibarrra, MPH
School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
Monika M. Safford, MD; Andrea Cherrington, MD, MPH; Susan Andreae, MPH
School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin; Mulago Hospital, Kampala, Uganda
Linda C. Baumann, RN, PhD; Fred Nakwagala, MD
University of California, Los Angeles; Women for Peace, Western Cape, South Africa
Mary Jane Rotheram-Borus, PhD; Margaret Gwegwe, BA; Neal Kaufman, MD, MPH
University of California, San Francisco
Thomas Bodenheimer, MD, MPH; David H. Thom, MD, PhD; Ellen Chen, MD; Amireh Ghorob, MPH; Danielle Hessler, PhD
University of Michigan
Michele Heisler, MD, MPA; Tricia S. Tang, PhD; Martha M. Funnell, MS, RN, CDE; Robin Nwankwo, RD, MPH, CDE
University of Yaounde and Central Hospital, Yaounde, Cameroon
Jean Claude Mbanya, MD, PhD, FRCP; Felix K. Assah, MD, PhD
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Fisher, E.B. et al. (2018). Peer Support in Prevention, Chronic Disease Management, and Well-Being. In: Fisher, E., et al. Principles and Concepts of Behavioral Medicine. Springer, New York, NY. https://doi.org/10.1007/978-0-387-93826-4_22
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