About a dozen people from the Xiaokunshan community of Shanghai gather around a table where Jinfeng Fan instructs them on a craft project. For the next hour, participants will build decorative boxes while they talk—about children, food, the weather and living with diabetes.
Jinfeng is among more than 100 peer support leaders who hold cooking courses, tai chi classes, trivia games and other group activities at local community health centers in Shanghai. The goal: to help individuals manage their diabetes and improve the quality of their lives. The MSD Foundation has helped make this goal a reality.
“When people share their personal experiences and success stories, everyone benefits,” says Jinfeng, who has lived with diabetes for 20 years. “Through the peer support project, we don’t feel alone, isolated. We feel that someone cares about us.”
Approximately 116 million people in China have diabetes, but 60% of them do not know it, according to a study published in Diabetes. Healthy China 2030 and other initiatives aim to address diabetes and other public health issues by prompting communities to play a bigger role in disease prevention, education, screening and management—areas where peer support programs are proving beneficial.
In 2011, Peers for Progress at the University of North Carolina Gillings School of Global Public Health partnered with researchers and diabetes specialists from Shanghai Jiao Tong University affiliated Sixth People’s Hospital began planning a diabetes peer support program in community health centers in Shanghai.
The effort launched in 2016 after the UNC School of Public Health received a three-year (2016-2019) $781,000 grant from the MSD Foundation to support the first phase of program implementation, targeting nine of Shanghai’s 240 community health centers.
“Program participants have shown improvements in blood sugar levels, body mass index and other diabetes-related health measures,” says Patrick Tang, program manager, Peers for Progress. To date, the program has reached more than 2,700 adults with prediabetes or living with diabetes.
“The complexity of diabetes management can be difficult for people to grasp. Doctors and nurses can give people tools and advice, but peer supporters can help people put it all into practice,” says Professor Weiping Jia, director of the Shanghai Diabetes Institute, Shanghai Jiao Tong University.
Professor Edwin Fisher, global director of Peers for Progress at UNC, adds, “The program works because participants interact with people from their community, who share similar stresses. Peer support leaders offer practical and emotional support that will help individuals better manage their health for the rest of their life.”
Jumei Chai is one of more than 100 diabetes peer support leaders in Shanghai. “My group likes to organize unique activities to share our knowledge. For example, we put together a talent show with skits and poetry to help people learn about diabetes self-management.”
Jumei, who has managed her diabetes for nearly 20 years, has also organized lectures at the community health center, health trivia games and other gatherings to give people a place to share their experiences and encourage each other.
“I’ve seen people build their confidence in self-management after attending several activities,” says Jumei. “Through peer support, we’re helping people face the challenges of diabetes head on.”
Program leaders continue to gather data on the impact of the diabetes peer support program and are looking at ways to broaden the effort. In addition, the Shanghai Municipal Health Commission is promoting the model for other programs in chronic disease management and prevention.
“We think we’ve developed a model that can be good for diabetes management across China, and we hope it may be helpful to people in other countries as well,” says Professor Jia.