Peer Support to Enhance the Shanghai Integration Model

Partnership objectives

To improve diabetes management, patterns of care and individual well-being among patients served by  Community Health Centers in Shanghai, China.

What are the health needs and challenges? 

The International Diabetes Federation estimates the adult prevalence of diabetes in China is 9.8%, compared with a worldwide estimate of 8.8%.  A 2013 report in the Journal of the American Medical Association found adult prevalence of diabetes in China of 11.6%, about 113.9 million adults.

Effective management of diabetes and other chronic diseases requires high-quality primary care and specialty care, as neeed; support for daily, self-management of the disease, and attention to psychosocial and mental health conditions that may complicate disease management.  Integration of these various important elements of effective diabetes care and management is challenging.  

Description of partnership activities and how they address needs and challenges 

The Merck Foundation has committed US$781,000 over three years (2016-2018) to support the UNC School of Public Health, in collaboration with its implementing partners, in developing, implementing and evaluating a peer support (e.g., community health worker) program in 10 Community Health Centers in Shanghai to help improve diabetes self-management, treatment adherence, and quality of life among people living with diabetes. 

The peer support program will be combined with the ongoing Shanghai Integration Model (SIM) that integrates the care provided by specialty/tertiary hospitals and primary/community health centers to help improve patterns of care and clinical outcomes. 

Summary of impact and forward looking information

UNC School of Public Health and its partners will develop and implement a rigorous program evaluation.  Outcomes will be evaluated at each of these levels in 10 Community Health Centers: 

  • Patterns of care, including attendance at regular care, follow through with referral to specialty care, and perceptions of patients as well as primary and specialty care providers about continuing needs for integration of care. 
  • Components of care, including medication adherence as well as key aspects of disease self-management, such as healthy diet, physical activity etc. 

Ultimately, the partnership aims to extend the combined SIM and peer support to Community Health Centers throughout Shanghai and share the results of this program throughout China in partnership with the Chinese Diabetes Society.

Measurement of progress towards objectives: 

The partnership was initiated in late 2016.  Preliminary evaluation results are anticipated in late 2019.


*MSD is known as Merck in the U.S. and Canada.

Partnership information

Company(ies) MSD

Partner(s) Merck Foundation, Shanghai Center for Disease Control and Prevention, Shanghai Diabetes Institute, Shanghai Health Bureau, Shanghai Jiao Tong University, Shanghai Sixth People’s Hospital, University of North Carolina School of Public Health “Peers for Progress”

Type of Partner(s) Academia / Hospitals, Government, Other Business

Therapeutic Focus Non-Communicable Diseases

Disease(s) Diabetes

Program Type(s) Health System Infrastructure - Outreach & Medical Services


Research Country(ies) China

Start Date 2016

Anticipated completion date 2018