The goal of the proposed project is to test an innovative, manualized peer mentorship program for African American women with systemic lupus erythematosus (SLE). The Peer Approaches to Lupus Self- management (PALS) study is designed to provide modeling and reinforcement by peers (mentors) to other African American women with SLE (mentees) to encourage them to engage in activities that promote disease self-management. This study builds on three decades of work conducted in the field of arthritis self- management but differs in that the intervention mode (peer mentoring), the disease (SLE), and the study population (African Americans) are unstudied or understudied. Through a randomized, controlled design, we will assess the efficacy and mechanism(s) of this intervention on self-management and health related quality of life (HRQOL). This program has three specific aims.
The first aim seeks to determine the efficacy of a peer mentorship intervention in African American women with SLE on disease self-management and HRQOL.
The second aim i s to determine the impact of a peer mentorship intervention on patient-reported and clinical indicators of disease activity.
The third aim i s to determine the cost effectiveness of a peer mentorship intervention on disease self-management, disease activity, and HRQOL, in African American women with SLE. An exploratory aim will be to determine the role of mediators and moderators of a peer mentorship intervention on disease activity and HRQOL outcomes in African American women with SLE, to include disease self- management, depression, trust, and social support. The immediate goal of proposed work is to determine the efficacy of the program in a randomized design. The long-term goal is to disseminate this potentially cost- effective intervention in diverse clinical and community settings in an effort to improve disease outcomes in African American women with SLE and reduce morbidity and mortality in this high risk group. This effort could result in a model for other programs that aim to improve disease self-management, disease activity, and HRQOL in African American women suffering from chronic illness.
The peer mentoring approach is uniquely fitted to African Americans, and this intervention has the potential to lead to health improvements for African American women with SLE that have not been attainable with other interventions and serve as a sustainable solution to persistent disparities that has the potential to change care. This would significantly reduce disparities and have considerable public health impact.