Xuxi Zhang

Practice Implications Peer support programs for diabetes should be extended. Peer support provided by patients themselves as a group or provided by nonprofessionals like community workers may have significantly better effect. Other suggestions from the present subgroup analyses include that the advantages of Curriculum ‐ combined ‐ reinforcement ‐ intervention and Home ‐ visit ‐ intervention, duration of peer support should last >3& ≤ 6 months, and ways to provide ongoing support should be developed. Moreover, more studies are needed to verify the results of our subgroup analyses or to study several subgroups with high heterogeneity in our analyses (e.g. Telephone ‐ dominant ‐ intervention and Home ‐ visit ‐ intervention). In addition, peer support should be studied explicitly from the aspects of its providers, types, intervention location, intensity, duration of intervention, duration of effect, behavior theories, cost ‐ effectiveness, etc. Peer support is complicated and could be influenced by many factors like culture, psychology, emotion and social environment. Therefore, it is necessary to take these contextual factors into consideration to implement peer support. However, there is little systematic study on peer support to provide theoretical guidelines. 38 Many problems need to be resolved, for example, “What kind of peer support should we choose when we want to intervene in specific populations or achieve specific targets?” “What is the best way of expressing or teaching in the process of peer support to help patients change their behavior?” “How should we train and manage the peer supporters?” “What is the long ‐ term influence of peer support on peer support providers?” and “What is the negative influences of peer support on patients?” etc. 146 Chapter 6