Open Access Open Badges Study protocol

Peer support for patients with type 2 diabetes in rural communities of China: protocol for a cluster randomized controlled trial

Bo Xie1, Xiu-li Ye1, Zi-lin Sun1*, Min Jia1, Hui Jin2, Chang-ping Ju1, Li Yao1, Carvalho Husni Da Costa De Vladmir1 and Yanxiaoxiao Yang1

Author Affiliations

1 Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, Medical School, Southeast University, Nanjing 210009, China

2 Department of Epidemiology and Health Statistics, Southeast University, Nanjing 210009, China

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BMC Public Health 2014, 14:747  doi:10.1186/1471-2458-14-747

Published: 23 July 2014



The prevalence of diabetes has been growing rapidly in developing countries. This causes devastating economic burdens and increases demands on the health care system. Therefore, there is an urgent need to find a cost-effective and multi-faceted approach for diabetes care. Peer support models provide a potentially low-cost, flexible means which complements the current existing health care services. In this way, trained peer leaders can become qualified extensions to a formal healthcare system, capable of assisting education delivery and bolstering the efforts of professional staff. As such, creating a cultural specific peer support program and determining whether it is acceptable and cost-effective in rural communities of China is crucial. This study aims to implement and evaluate biophysical and psychosocial outcomes of peer support program for people with type 2 diabetes in rural communities, and to explore the program’s feasibility and sustainability in China.


This study is a cluster randomised controlled trial. All consenting patients will be randomised by community staff members to receive either peer support or the control care. The data collection and analysis including social demographics, health status, psychosocial status, economic status and biomedical measures will be collected at baseline, 6 months, and 12 months. The primary indicator measured is the change in HbA1c, whereas secondary indicators include biophysical, psychosocial functioning and other lifestyle factors. Finally, economic evaluations will determine whether the program is cost effective.


This protocol is a cluster randomized, controlled trial of group-based peer support for people with type 2 diabetes in the community settings of rural China. Results from this trial may provide evidence to the effectiveness of peer support; furthermore, they will provide valuable information concerning the acceptability and feasibility of a new approach to improve diabetes self-management among resource-constrained settings.

Trial registration Identifier: NCT02119572, April 18, 2014.

Peer support; Diabetes; Self-management; Rural health