Abstract

Predictors of quality of life improvement following peer mentoring in AfricanAmerican women with systemic lupus erythematosus (sle)

Author(s): Edith M Williams, J. Madison Hyer, Ramakrishnan Viswanathan, Trevor D. Faith, Jim C. Oates & Leonard Egede

Background: Systemic lupus erythematosus is a complex autoimmune disorder with heterogeneous presentation. Behavioral interventions have had mixed effects among this population, particularly among African American women, whom are disproportionately affected. The present study investigates predictors of individual responsiveness to a peer mentoring program designed to provide modeling and reinforcement by peers to African American women with systemic lupus erythematosus.

Methods and findings: Potential predictors of outcome in the analyses include sociodemographic variables, psychosocial variables, and self-reported disease symptoms. Changes in patient reported outcomes were calculated between pre- and post-intervention time points. To categorize patients into groups based on level of improvement, a cluster analysis using the Ward’s Minimum Variance method was performed. Statistical comparisons of groups for demographics and patient reported outcomes were performed using Fisher’s exact test or Wilcoxon rank-sum tests. Two disease activity variables significantly predicted individual improvement, whereas other factors assessed had no statistically significant effect. Those mentees with worse self-reported baseline symptom severity (SLAQ2) and disease activity ratings (SLAQ3) had the highest likelihood of improvement.

Conclusion: While other factors may influence individual response to the intervention, this analysis stems from a pilot study and may be underpowered to detect them. This subject warrants further study to determine the characteristics of individuals more or less likely to benefit from an intervention so that it can be tailored to their needs. The present data show that individuals with the most severe and active disease may benefit more from an intervention providing social support and targeting their self-management practices.