Patients' with chronic illnesses willingness to work with peer supporters for chronic medication management
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This study assessed the utility of the theory of planned behavior components [attitude (A), subjective norm (SN), perceived behavioral control (PBC)] in predicting patients’ willingness to work with a peer supporter for medication management, determined if prior experience (PE) with peer support adds to the prediction of willingness, assessed the importance of peer supporter characteristics, and explored patients’ communication preferences. This study also explored medication outcomes important to patients. A 72-item survey was administered to 130 adult patients with diabetes, hypertension, and/or hyperlipidemia. Willingness was measured with a 7-point scale (1-very unwilling to 7-very willing). A (6 items), SN (6 items), and PBC (4 items), were measured with 7-point scales [−3 (e.g., very unlikely) to +3 (e.g., very likely)]. Variable relationships were examined using multiple regression analysis. A plurality of respondents were white (45.3%) and most were female (56.2%). Their mean age was 58.6±11.5 years. Overall, respondents indicated a moderate willingness level (mean=4.76±1.65). A (β = 0.341, P < 0.001), SN (β=0.168, P=0.122), PBC (β=-0.043, P=0.692), and PE (β=0.290, P<0.001), together with age and ethnicity, accounted for 35.8 percent of the variance in willingness (F=9.041, df=8,109, P<0.001). The most important peer supporter characteristic was having experiential knowledge (mean=4.20±0.94; range: 1-very unimportant to 5-very important). Most preferred to communicate by telephone (82.3%) and at a frequency of once a month (34.4%). The most important outcome was preventing future health problems (mean=4.63±0.83; range: 1-very unimportant to 5-very important). Among patients who reported hypertension and hyperlipidemia as most bothersome, “clinical values” was the most endorsed method of judging/deciding control. Among patients who reported diabetes as most bothersome, “how my body responds” was the most endorsed method. A and PE were significant predictors of willingness, and PE significantly increased the explanatory power of the regression model. Peer support programs should focus on informing patients of the value of working with a peer supporter in order to positively modify their beliefs and attitudes. Several findings can be used to tailor peer support programs, including selecting peer supporters who have experiential knowledge, providing telephone-based communication options, and assessing outcomes most important to patients.