A qualitative study in England explores the experiences of group facilitators and nurses
Peer support is when people who have something in common (e.g. living with diabetes) share their experiences and, in so doing, provide each other with emotional and practical support. When peer support groups are held face-to-face, they are usually led by ‘peer support facilitators’. Peer support groups can be very helpful for all people with diabetes, but how can we make sure they are run effectively? And how can we ensure that peer support facilitators receive the training and support they need?
To answer these questions, Dr Holman and colleagues conducted a qualitative study, specifically focused on peer support among adults with type 2 diabetes. This was part of a larger study, the Randomised controlled trial of Peer Support In type 2 Diabetes (RAPSID), conducted in small towns and rural communities in East England. They invited adults with type 2 diabetes to attend a two-day training programme to become peer support facilitators. The facilitators then ran their own peer support groups, aiming to meet every month for six months. Peer support facilitators were unpaid volunteers, and they organised the venue and contacted peers (people with diabetes) themselves. Altogether, 106 people trained to be facilitators, 652 participants engaged in support, and there were 65 peer support groups. Study nurses met with the facilitators monthly and provided support as needed. The researchers collected three types of qualitative data (written reports from facilitators, written reports from nurses, and notes from end-of-study meetings).
The researchers analysed the data and found seven key themes:
- Setting up and running groups: Difficulties included participants not answering calls, lack of interest, and establishing rapport. Peer support facilitators found that arranging chairs in a circle, giving out printed reminders of meeting times, and setting ground rules were helpful strategies.
- Peer support facilitator characteristics: Wanting to learn more about diabetes and help others were motivating factors for peer support facilitators. Nurses thought that successful facilitators were those who were good listeners, empathetic, sociable, sympathetic, caring, and confident.
- Peer characteristics: Some facilitators felt that they were “preaching to the converted” as people who attended the peer groups were already very committed to managing their diabetes. One facilitator suggested, “We need to find a way to attract those people who either don’t know about us or think there is nothing to learn”.
- Relationships between peer support facilitators: Having two or three facilitators worked best. Relationships worked well between facilitators who had the same goals, complementary skills, and divided work effectively.
- Group dynamics: The ideal group size was eight to nine people. Having things in common was fundamental to the group working, but having individuals within groups with different experiences provided learning opportunities.
- Topics covered and group atmosphere: Usually, topics covered day-to-day diabetes self-management. Some structure was helpful to keep discussion on track, but allowing conversations to flow naturally was important too. Positive group atmospheres fostered a sense of friendship, respect and equality.
- Sustaining and ending peer support: Groups that offered social benefits carried on for longer. One facilitator made an important observation that groups need to end appropriately: “because I don’t want to leave people in a dependent state when I stop doing this”.
The authors conclude that groups that worked well were those that were organised, encouraged people to share experiences, and had a supportive and friendly atmosphere. They suggest that outlining what peer support is (and is not) needs to be emphasised in training programmes, and (assuming that groups will not continue indefinitely) there needs to be a plan for how to end groups appropriately. The findings from this study may be helpful for those who are interested in facilitating type 2 diabetes peer support groups in the future.
You can read our other blogs about peer support here.
Holman, D., Simmons, D., Ockenden, N., & Graffy, J. P. Learning from the experience of peer support facilitators and study nurses in diabetes peer support: A qualitative study. Chronic Illness, 2019; https://doi.org/10.1177/1742395319873378