This randomized controlled trial sub-analysis examined a culturally relevant peer-mentoring intervention for adult African American women with systemic lupus erythematosus. Participants received 12 structured biweekly sessions over 24 weeks, compared to a social support control group. Outcomes including self-reported symptom severity were assessed at baseline, 3, 6, and 12 months.
The intervention group reported sustained reductions in symptom severity over time, though these changes were not statistically significant. Peer mentors showed significant improvement in symptom severity at 3 months, with a mean difference of -2.53 (95% CI: -4.95, -0.11). Employment and insurance status were consistently associated with lower symptom burden and disease activity, though these associations are observational within the trial context.
Safety and tolerability data were not reported. The main limitation is that the primary intervention effect on symptom severity was not statistically significant. All outcomes were self-reported using the Systemic Lupus Activity Questionnaire. As a sub-analysis, findings should be interpreted cautiously.
For clinical practice, these results support policy initiatives that invest in peer-based self-management interventions while highlighting the importance of addressing social determinants like employment and insurance access. The mentor benefit suggests potential value in structured peer support roles, but the lack of significant main effects indicates more research is needed before recommending this specific intervention.
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IntroductionSystemic Lupus Erythematosus (SLE) disproportionately affects African American women, who experience higher disease severity and face barriers to accessing supportive care. Peer mentoring offers a culturally tailored approach to improving chronic disease self-management and psychosocial well-being in underserved populations.AimsTo assess the impact of a peer-mentoring interventions on self-reported disease activity, symptom severity, and flare frequency among African American women with SLE.MethodsThis study is a sub-analysis of the Peer Approaches to Lupus Self-Management (PALS) randomized controlled trial. Adult African American female participants with SLE were assigned to an intervention, a social support control group, or served as peer mentors. The intervention group received 12 structured biweekly sessions over 24 weeks, delivered by trained peers using a culturally relevant curriculum. Outcomes were measured at baseline, 3, 6, and 12 months after the intervention using the Systemic Lupus Activity Questionnaire (SLAQ). Linear and cumulative logit mixed models were used to assess longitudinal changes, adjusting for sociodemographic covariates.ResultsThe intervention group reported sustained reductions in symptom severity over time, although not statistically significant. Notably, mentors demonstrated significant improvements in symptom severity at 3 months (mean difference: -2.53; 95% CI: -4.95, -0.11), suggesting reciprocal benefits of peer engagement. Employment and insurance status were consistently associated with lower symptom burden and disease activity.ConclusionThe results of our study support policy initiatives that invest in peer-based self-management interventions, expand insurance access, and address employment barriers shown to influence disease burden in individuals with SLE. Such efforts are critical to reducing health disparities and improving long-term disease outcomes.