P-381: Improving glycemic control, knowledge, and self-management practices through a peer educator training program for young adults with type 1 diabetes in Uganda
M Gimono, O Nabeta, T Kirya, J Ojilong, M Nakitto, M Egesa, D Mubangizi, V Nabeta, A MurrayAbstract
Introduction
In low resource settings, health worker capacity is limited and often geographically distant from patients. Peer educators extend clinical care into the community by reinforcing treatment plans, supporting education and access, and providing psychosocial support. This bridge between clinic and daily life is critical to improving outcomes of children with type 1 diabetes (T1D).
Objectives
The objective was to assess effectiveness of a peer educator program and determine if participation in a structured educational curriculum on diabetes self-management improves participants’ glycemic control and knowledge, ultimately enhancing pediatric diabetes care.
Methods
This prospective mixed methods cohort study assessed 49 young adults aged 21-25 years with T1D ≥ 5 years who participated in the Peer Training Program. The program involves a 5-day workshop followed by monthly case discussions for 6 months, and field assessment by a clinic nurse during a clinic day and home visit. Pre- and post-workshop and 3 month follow up knowledge scores and HbA1c were analyzed.
Results
Mean HbA1c decreased from 8.7% at baseline to 8.4% at 3 months post workshop. Repeated measures ANOVA showed a statistically significant change in knowledge score (F(2,47)=162.38, p<0.001). Means and SD are seen in Table 1. Post hoc analysis showed significantly increased scores from pre- to post-workshop (p<0.001) and to 3 month follow up (p<0.001) but not from post workshop to 3 month follow up (p=1.00). Questions about insulin therapy and long-term management were most difficult for participants, with improvements seen related to DKA management and nutrition.
Conclusions
Peer educator training significantly improved diabetes knowledge, maintained at 3 months, with early HbA1c reductions. Further analysis will evaluate long term glycemic outcomes, confirm if knowledge gains are sustained and further assess the enhancement of pediatric clinical care by peer educators.