Annual Letter

Dear Friend of Peers for Progress,

Happy New Year from Peers for Progress, the program of the American Academy of Family Physicians Foundation dedicated to promoting peer support in diabetes, health and health care. Solid research to strengthen the evidence for peer support, networking to promote knowledge sharing among thousands of peer support programs, and resources to facilitate quality improvement all contribute to our goal of increasing peer support programs and improving their quality around the world. In this letter, I would like to share some highlights of the past year with you – our collaborators, advisors, and leaders of peer support programs.

Research
All our activities were energized in February when, with the support provided by the Eli Lilly and Company Foundation, we announced fourteen grants totaling $7 million. This funded programs in nine countries on six continents.

Their locations are depicted on the map. These programs will expand the evidence base for peer support in healthcare. Just as important, they will also provide models for how to integrate peer support into health care in settings around the world.
One of the exciting things about our grantees’ projects is the variety of approaches they take to peer support. Space does not allow describing them all but, reflecting the strengths and traditions of their settings – and the ingenuity of their leaders –a sampling includes:
• Making the peer supporter part of the nurse and doctor treatment team in San Francisco
• Training peer supporters to work with village health workers in Thailand
• Pairing individuals with each other to provide mutual support as part of programs in Cameroon, Uganda and South Africa
• Comparing group based and individually provided peer support in Cambridgeshire, England

Resources for Program Development
Across all our activities, the Peers for Progress Program Development Center at the University of North Carolina at Chapel Hill has provided leadership on a number of key endeavors, with the Peers for Progress website (peersforprogress.org) serving as the hub for this work. Practitioners, program leaders and researchers can use this resource to find out what would be entailed in developing a peer support program and to find models for the details of program development, such as in the recruitment and training of peer supporters or in planning the content and delivery of services. The site offers a number of advanced tools for quality improvement as well as evaluating programs. There are also options for sharing observations and knowledge – “lessons learned” – across the field and around the world. We will continue to add resources to assist programs in building their evidence bases and business cases for their work, and to join with physicians and health care organizations in integrating peer support into health care.

Global Networking
Peer support is probably as old as humankind and, so, is nothing we can claim to have discovered, nothing we can patent, package, or put in a box. But this age old, ubiquitous quality of peer support is also our good news. We do not need to worry about whether we may be dedicating resources to a fad that will go out of style! At the same time, most of the thousands of peer support programs around the world go unevaluated, unpublished, and unshared beyond the organizations in which they operate. With this recognition, a major goal of Peers for Progress has been to bring together the knowledge and lessons learned of all those in the field. We do this by identifying the best knowledge in the field, providing the tools to help groups develop and manage their peer support programs, and then providing the vehicles – through our webpage and international networking – to share observations and approaches, all to improve the quality of peer support programs and increase the numbers they reach. As put well by a friend who was among a group of St. Louis leaders advising us last Fall: our mission is to “accelerate best practices in peer support around the world."


A key perspective that we have learned is the importance of working through regional collaborations. In October, for example, we co-sponsored a meeting initiated by Dr. Juliana Chan, the director of our grant project in Hong Kong, that brought together members of the Western Pacific Declaration on Diabetes, the Western Pacific Region office of the World Health Organization, and about 25 leaders in diabetes and peer support from the region. In addition to rich exchange among wonderful peer support programs, the meeting ended with plans for collaborative efforts to promote comprehensive diabetes programs that include peer support. Working with groups like this is an important model for our role in promoting high quality peer support, adding to their efforts the strength of being part of a global initiative, and actively promoting peer support while collaborating with regional direction of regional programs.

With research and an expanded knowledge base, growing collaborations all over the world, and resources that assist program development and promote quality improvement, Peers for Progress is indeed achieving its mission to “accelerate best practices in peer support around the world.” We want especially to thank you – our collaborators, advisors, and leaders of peer support programs – for your tremendous help in this growth.

In coming months, we will continue to inform you about further developments in Peers for Progress but would welcome your thoughts or suggestions throughout the year. Please feel free to contact me at edfisher@unc.edu or our group through our website, peersforprogress.org (“contact us” in upper right corner of homepage). We will look forward to hearing from you!

Warm regards,

Edwin B. Fisher, Ph.D.
Global Director, Peers for Progress

Peers for Progress edited update

The Peers for Progress was formally introduced to the world at the WHO consultative conferene held in Geneva, Switzerland on November 5-7 with an overview of the evidence as it exists n the world today. The nearly 50 invited guests participated in three very interactive days discussing the knowledge as it exists from various peer support programs around the world.
We are very grateful to Dr. SEge Resnikoff adn Dr Gojka Roglic for their support as WHO hosts for this significant, event. A thank you as well goes to the co chairs ( Linda Siminerio, Marty Funnell), the speakers ( Leoski, Lorig, Simmons, Less, Soegondo, Baksi) and the discussion group chairs ( Ed Fisher, David Marrero, Marty Funnell, Frank Snoek/ Simmons). They have a good handle on what is effecting change in their communities.
The six regions of the WHO world were represented: the attendees represente a corss section of health professionals, organizations and individuals with diabetes. This led to some high level and emotional discussions trying to determine the "right" next steps for the peer supporters in trying to answer the questions: Who can be a peer supporter? Who needs the support? What can peers do and how will they be trained and monitored? How will the peers sustain their viability in the community in which they work?
There were several important consensus conclusions at teh end of the meeting. It was concluded that peer supporters should have diabetes or a close relationship to someone with diabetes. They need to be recognized in some way for what they do. The community should define the role of teh peers. The role of the peer supporter could evolve in the health service system or community based system of care. There needs to be more evidence provided to further clarigy the value of the peer in the health care system and community which may mean more clinical study adn / or demonstration projects. The programs need to be global as the exploding demand for resources are needed in teh low resource communitities.
The central hypothesis of the Peers for Progress (PfP or P4P) program is that "sustainable indiviual behavioral changes are nedessary to improve long-term outcomes that will occur through peer to peer interactions mentoring and role modeling. PfP will devleop international programs to identify and train lay volunteers with diabetes to become "Peer Supporters". A Per Supporter will have the cognitive, behavioral, and interpersonal skills to assist another person with diabetes in adating to the consideralbe emotional, social and daily self-care demands of diabetes. It is belived that one percent of teh people with diabetes have teh capacity and desire to become Peer Supporters. LKE

Peers for Progress kicks off in Geneva

The Peers for Porgress formal introduction to the world happened at the WHO Consultative Conference held in Geneva, NOvember 5-7 with an overview of the evidence asof peer support programs in the world to date. The nearly 50 invited guests participated in a very interactive discussion groups talking about the knowledge that exists from teh arious peer support programs in the six WHO regions around the world.

We are very grateful to Dr. Serge Resnikoff and Dr. Gojka Roglic of the WHO for their suppor in hosting this fine event. A thank you as well to the co-chairs ( Siminerio and Funnell), speakers ( Leonski, Lorig, Simmons, Less, Soegondo, Baksi) and Chairs of the discussion groups( Fisher, Marerro, Funnell, Snoek). They have a good experience in these activies and the impact the programs could have in the communities around the world. The six regions of the WHO world were represented by their leadership as well as leaders from the health professional groups, organizations with interests in diabets and patients themselves. This led to some hight level and emotional discussions trying to answer the sqsuestions: WHo can be a peer supporter? WHo needs the support? What can peers do and how will they trained and monitored? HOw will the peers sustain their viability in th ecommunities in which they live and serve?

It was determined that peer supporters should have diabetes or a close relationship to diabetes. They need to be recognized in some way for what they do. The community should define the role of the peer supporter. The Role of the peer supporter could evolve in the health service system or community based system of care. There needs to be more evidence generated to further clarify the value of the peer in the health care system and community which means more clinical studies and / or demonstration projects. The programs needs to be global as the exploding demand for resouces are needed in the lor resource communities.

The Central hypothesis of the Peers for Progress program is that
sustainable individual behavioral chagnes are necessary to improve lon-term outcomes and will occur through peer to peer interactions, mentoring and role-modeling. Peers ror Progress will develop nationwide programs to identify, train lay volunteers with diabetes to become "peer supporters". A Peer Supporter will have the cognitive, behavioral, and interpersonal skills to assist another person with diabetes in adapting to the considerable emotional, social and daily self-care demands of diabetes. It is believed that one percent of teh peole with diabetes have the phenotype and desire to become a Peer Supporter.