Peer education and patient empowerment

This is another post in our series Reflections Careum Congress 2014. Here, guest author Diane Levin-Zamir shares her thoughts and experiences on peer education.

The Careum Congress 2014/2nd ENOPE Conference on patient empowerment was a very inspiring experience. I was happy to be invited to share in our practical work and research on Health Literacy and Patient Empowerment. Yet, I was even happier to have learned so much from the short time with colleagues and experts that I formerly had not had direct contact.

Peer education and empowerment

The Conference provided a unique opportunity to meet Kate Lorig from Stanford and to be able hear not only her insights but also from those who are using the Stanford Model in different parts of the world: US, Denmark, New Zealand and more. It was particularly interesting to learn how the model is being implemented outside of the healthcare system, using community facilities as meeting places, and advertising in the media to publicize and recruit participants with chronic diseases. I learned that countries like Denmark have allocated full time staff to support and promote the program. How exciting to learn of the grants offered by US Council on Aging to States that are implementing the model.

In Israel, we are looking to find ways of augmenting our peer empowerment work by adopting the Stanford model in a way that is appropriate for Israel. We are hoping even to find a way that Kate herself can come to help train leadership in this area in Israel, and discover ways that it can help meet the particular needs in this part of the world.

Patient involvement in advancing knowledge

The final panel of the conference included the editor of the BMJ – who shared her experience regarding involving patients in the editorial board of the journal. I was incredibly impressed with her vision, after which I reflected on whether or not there is similar involvement in health promotion journals. I certainly “took the message home” and am now encouraging journals that I am involved with to follow the lead of such a prestigious journal and to consider establishing policy that would require patients/member of civil society to also review. The challenge of course is how to choose the right person; who is “the” representative of civil society? I would love to learn of colleagues perspectives on this query, and of the experience that has accrued in different countries/organizations.

What are your thoughts on the event? I am looking forward to your comments!

Guest author

Levin-Zamir_DDr. Diane Levin-Zamir, PhD, MPH, MCHES
Director of the National Department of Health Education and Promotion of Clalit, Israel

Send me an email or follow me on ResearchGate


8 thoughts on “Peer education and patient empowerment

  • 2014-07-15 at 06:09

    The good thing about the Stanford programme especially if you are just starting in this area is that it is perfect for getting peer leaders involved as it is so well formulated to support them without needing lots of additional training on managing groups.
    I am constantly surprised just how powerful it is when people with different long term conditions come together for 6 weeks and share experiences.

    It would be great if Israel took on this program. In Europe we have just set up a network of master trainers and recently carried out a training for master trainers that were from Denmark, Switzerland, Austria and Germany which was organised by Careum.

  • 2014-07-15 at 12:10

    I think, it’s a challenge for peers–with no or not much experience in leading groups–to moderate the Stanford program. But it’s a joy to see them succeed and getting more and more confident in administering it. It is also a joy to see how they add to it with their personalities: While it is a standardized program, the workshops are quite unique with their different leaders and participants, of course.

  • 2014-07-16 at 07:20

    The Stanford program has been great for the development and work for patient empowerment in Norway, too. And I beleive Jim is right, the program gives necessary guidance to inexperienced peer leaders. In Norway the program has been very popular, but with the revised version our peer organisations felt they/we are now ready to design our own program, better adtapted to the Norwegian model. I think our country is lucky in having strong peer organisations, making it possible to draw on patient experiences to design av good program. The same organisations also provide peer leaders and help organise the leader training. Good luck in Israel!

    • 2014-07-16 at 07:37

      Dear Jim, Margot and Marianne,
      thanks for your comments and providing insights into experiences with the Stanford model. Strong capacities within countries and patient/peer organizations indeed seem to be a key element for implementiation.

      It would be great to learn more about your experiences in Norway, Marianne, in particular what you have done differently in peer education and where you made changes. I suppose this could be highly interesting for Israel and other countries, too…

      All the best, Joerg

      • 2014-07-16 at 09:01

        Dear all,
        I think Jorg is rigth, the key is respect for the competence and insight of the peer organisations. The Norway story has developed over the last 10-15 years, but I will try to give the story in a few points:

        1. The Stanford model is designed for older people, and our peer communitie (63 organisations) is a lot more diverse.

        2. The Stanford model has strict instructions for the leaders, our peers have enough competence and experience to act more on their own.

        3. Our peers have chosen to develop the course via internet, This may be unexpected, but through the mecanisms of plans, communication with leader and compulsory peer support among participants this actually works. The course will be adapted to face-to-face courses, which I suspect will continue to be the most common version, but lessons and dynamics and – surpisingly – the ‘change agent’ inherent in the course works just as well in distance learning.

        4. The lessons: We keep 8 lessons, the 4 first focusing on change and ‘mastery’ of own situation, tools for change and the difficult feelings related to change, the last 4 on how to secure the changes and communicate them to friends, family, community, health personell etc.

        5. At least one of the leaders must be peer, the less health expert advice, and focus on diagnosis, the better the course works.

        Hope this was helpful, a lot of thought and experience has gone into our work with this program.

        Have a nice day,

        • 2014-07-16 at 11:29

          Dear Marianne,
          thanks so much for the additional insight. Seems like in Norway the Stanford approach was/is a great stepping stone towards enhancing peer education and counselling in health and social care.

          Here in Switzerland, the CDSMP has started only two years ago. In some ways with similar experiences. Tandems (peer plus professionals) are common.

          Thanks also for the details on the online approach. This has been and still is a topic in various discussions amongst European partner organizations ( trying to figure out the best way to work with an online approach.

          I am looking forward to reading / hearing more from Norway, let’s stay connected. And I am sure members of the European Network on Patient Empowerment ENOPE are interested as well.


          • 2014-07-16 at 11:33

            Dear Joerg,
            I am glad to share the insights we have gained. The online course will be ready for pilot testing next spring, and I very much want to be able to present it to interested parties at that time. I also appreciate an arena for this kind of discussion and would be delighted to stay connected.

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