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Table 6 Buddies perceptions of intervention feasibility and acceptability

From: A feasibility pilot trial of a peer-support educational behavioral intervention to improve diabetes medication adherence in African Americans

Theme

Quotes

Acceptability

Overall acceptability of peers LEAD

Liked the group education sessions

“Well, the aspect of the program, for me, the most benefit was coming to the group sessions. I like that a lot…and I was able to…get direct information from a pharmacist and a doctor and a diabetes educator.” (Buddy 5)

“This group [education session] was very helpful, you know, because for one thing, you're interacting with people that, in the field of profession, of being diabetic, you know. They help us. They taught us what we can do, give us suggestions . . . and at the same token, you know, they like the feedback…” (Buddy 6)

“You know, I thought the three [group education sessions] meetings were pretty decent. The doctor one, by far, was the most informative and interesting. The pharmacist, pharmacy one was okay...I guess the doctor’s meeting [group education session] where she talked. I guess that information was very, was probably the most beneficial to me.” (Buddy 19)

“I liked the, I really liked the doctor input, and then I liked the educational part, because without education, you can’t proceed and get better. So I liked that really. The education is the key. Because if you educate a person, then they’ll be able to do it even if the doctor or the pharmacist is not around.” (Buddy 24)

Phone calls with ambassadors was helpful

“And then they [Ambassador] told me they was going by their script too, so I thought the script was pretty good. Whatever they got taught, they, I was impressed that they was following what you all had taught them to the letter. And I enjoyed that, you know…Y’all gave them [Ambassadors] stuff to touch on with people [Buddies] and stuff like that…I think that helped a lot that I knew they was trained to do it, right.” (Buddy 2)

“You know, I liked the phone calls, the Ambassador phone call. You know, I, at first, I was skeptical about talking with someone on the phone, because I didn’t know that person. But once I allowed myself to answer the phone to talk to her, it was good.” (Buddy 9)

“They [phone calls] were just pretty helpful. How sometimes, some of them days…I forgot to take my medicine, or, you know, we talked about stuff I needed to do and just different stuff.” (Buddy 23)

Benefits gained from the intervention

Satisfaction with ambassadors

“It's [talking with Ambassador] helpful to me because it's someone that shares something that I’m going through. And I always felt like, you know, it was just me against everything. Nobody else knew what I was going through. Nobody else could relate…But with the peer ambassador understanding that, she has shared what, you know, the same thing, that I'm able to relate to it more where I could say, okay, that makes sense, you know. So just talking with her, period, just made me feel like somebody understands me, and they know what I'm going through, as opposed to my regular primary doctor or a family member.” (Buddy 3)

“It was, because how can I say, she [Ambassador] was there when I needed somebody to be there. I mean, yeah, I spoke with my doctor, but it’s good sometime to have that sounding board…it was good to be able to speak to her [Ambassador]. Again, she’s [Ambassador] had metformin, she knows about metformin, she’s got diabetes. So there’s somebody I could talk to that I could relate to…So… that was great, yeah. I was glad to have her there.” (Buddy 8)

“Oh, he [PA] was wonderful. I mean, you know, like I said, we shared a lot. And I liked the idea that he wasn’t bougie or he didn’t seem like he knew everything. He goes, do this, do that, you know. I mean, he was open to suggestions for himself, you know. And he was open to suggestions that had something to do with me. And I was open to them, I mean, we spoke one to another as if we have known each other all our lives.” (Buddy 25)

Changed or reinforced beliefs about diabetes

“I learned that the stereotype that only black people have it [diabetes] was not true and that it’s not a curse.” (Buddy 1)

“There [in Peers LEAD] was a lot of dispelling of the myths and what people thought diabetes was and what that meant. And that made me more confident. That made me more receptive to…taking my insulin and taking my medication because at first, it was just like, no, no, no, no, no… I'm still working on consistency, but I'm more consistent than I was than when I first started the program.” (Buddy 15)

Increasing awareness and self-efficacy related to communicating with providers

“Since I started the study [Peers LEAD] … because I got more information about talking with like people like [Provider presenter] and the professor and everybody…I think I got a better handle on talking to the doctor now…more confidence.” (Buddy 2)

And then work with my doctor more closely to discuss my needs, that's a goal that I have.…And I need to communicate more effectively with my doctor about all my health issues. (Buddy 5)

Improved communication with provider/pharmacist since program

I think I can communicate with them [provider / pharmacist] better since…did the study [Peers LEAD], because I got a little bit more insight on what the questions to ask.” (Buddy 2)

“When my numbers had started going down, I actually picked up the phone and called my doctor and just let her know the, my numbers had went down, and I was feeling great and doing great. So it [Peers LEAD] kind of encouraged me to give that push to actually call my doctor.” (Buddy 21)

Acceptability of structure and process of intervention

“Only thing I can say, I can give you all five stars. I thought it was five-star treatment. And that’s how, then you got the partnership room, and then, and the space room. So I think y’all have had a five-star layout. I enjoyed that. I thought y’all did good, and y’all had stuff to eat. So I think y’all went out of y’all way to, with the program. I think y’all did great. I thought it was great planning.” (Buddy 2)

Feasibility

Views on intervention for larger population

Great need of the program for other African Americans

Program is essential because there are many who lack knowledge of managing diabetes

“It's a great program [Peers LEAD], and I really hope you all continue it and expand it, because we have a whole lot of people out there that's diabetic, black African-American people that's diabetic and don't know anything about diabetes… they can expand it and continue to draw them in where they can learn more about diabetes and take control of their life with diabetes.” (Buddy 7)

“…it [Peers LEAD] was very helpful, and I think it will help, going forward, I think it will help a lot of people that really don’t know. I didn’t know.” (Buddy 8)

“So, and, like I said, I think it [Peers LEAD] would be great, so please don’t stop, because there’s a lot of people out there like me that don’t know, and they’re focused on one or two things, but there's a whole big picture that they need to see. So please don’t stop.” (Buddy 8)

It’s [Peers LEAD] very educational. Yeah. Very education. Personally, I think they should keep going because there are a lot of people that’s out there that suffer with this disease and don’t know how to, either they don’t know how to deal with it, or they don’t want to deal with it. And a lot of people need to be, you know, reached out at because it’s been around for a long time, you know. (Buddy 25

“So, yes, and I think more people, if they had a chance to go through this [Peers LEAD], they would appreciate …the whole thing, because, I mean, you’ve got a pharmacist, you’ve got a doctor coming in…you got somebody that, an ambassador that can relate to you, not just somebody that’s never had diabetes talking to you and prescribing medications…So I think this, I think the whole program is very informative and would be helpful to those who are on metformin, who have diabetes type 2…” (Buddy 8)

Barriers to the intervention

Feedback on challenges with intervention—recommendations for things they might change

Survey was very long; felt rushed filling it out

Have ambassador help filling it out

Food without labels—difficult for diabetes

More opportunities to mingle and get to know one another/more interaction with other buddies and ambassadors outside of program (e.g., social gatherings)

Would have liked to hear more about other buddies’ life stories

More time for education presenters to ask questions

Handouts to take home from (physician) presentation

Provide evaluation form at beginning of session so they know what to be thinking about