Supporting families of children with a feeding tube: caregivers’ and professionals’ perspectives on formal and informal support

Friendship, and wider peer relationships, contribute to young people's sense of safety and wellbeing (Blakemore, 2018; Cossar et al., 2013; Foshee et al., 2014; Roesch-Marsh & Emond, 2021). Moreover, during adolescence the significance and influence of young people's peer relationships have been found to intensify in many countries around the world (Blakemore, 2018; Coleman, 2011). Nevertheless, recognising this has failed to ensure that child protection or wider safeguarding systems and interventions take account of young people's friendships or wider peer relationships when supporting those affected by violence and abuse. On the contrary there is evidence that many social work responses disregard peers, while centring family relationships, in their efforts to safeguard young people (Bracewell et al., 2020; Firmin, 2019, 2020; Johnson, 2017; Rogowski, 2012). Such an absence is notable given the role of friendship, and wider peer relationships, in young people's exposure to risk as well as protection. Multiple studies have found that young people are more, or as likely, to disclose concerns about abuse to their peers than their parents or other adults (Allnock & Atkinson, 2019; Barter, 2018; Brennan & McElvaney, 2020; Cossar et al., 2013). More broadly, positive attitudes can be reinforced through peer relationships. Peer influence can support pro-social behaviours and beliefs, such as healthy living (e.g. healthy eating and avoiding drugs and alcohol), equality, anti-discrimination and ambition (Laursen, 2018; Veenstra et al., 2018). In recognition of this, prevention programmes aimed at reducing rates of bullying, intimate partner violence and sexual harassment in schools have commonly sought to create opportunities for ‘bystander’ interventions, peer mentoring and buddying schemes, in which supportive and protective peer cultures are utilised and nurtured (Banyard et al., 2020; Foshee et al., 2014). Peer relationships also provide wider opportunities and contexts for pro-social activities and skill-building (Ramey et al., 2018; Veenstra et al., 2018). However, as already identified, peers can also be a source of harm. These harms can be perpetrated on and offline and can include a wide range of activities such as bullying, criminal and sexual exploitation and physical and sexual abuse. Peer victimisation is reported to be global problem impacting the welfare of significant numbers of young people around the world (UNICEF, 2019, 2020). In the year ending March 2018 the crime survey for England and Wales estimated that 4.4 per cent of children aged 10 to 15 years (423,000) had been a victim of violent crime in the previous 12 months (Office for National Statistics, 2018). For young people who participated in the survey, 92 per cent knew the person who had instigated violence against them. In 86 per cent of cases, they attended school together, and for 13 per cent, the instigator was identified as a friend (including boyfriend or girlfriend). In this special issue we present papers from Australia, China, Europe, Ghana and North America, which consider the role(s) of friendships and wider peer relationships. Despite their geographical spread, this body of work features numerous shared messages about the opportunities and challenges that come with considering peers in both informal and formal protective responses to young people in need of support and/or protection. They also point to the definitional, methodological, policy and practice gaps that warrant attention, for friendships and peer relationships to be sufficiently considered within child protection and wider safeguarding systems. The papers in this special issue consider the role of both friendship, and wider peer support networks and relationships, in safeguarding young people. The terms friend and peer have distinct but interrelated meanings which have implications for research and practice (Roesch-Marsh & Emond, 2021). Most of the papers contained in this issue illustrate that the different meanings these terms hold for young people and practitioners matter. For example, in Cudjoe et al.'s (2022) paper, young people from Ghana spoke about friends as important people who you have fun with but not necessarily someone to share difficulties with, such as dealing with parental mental health. The voluntary and informal nature of friendship means that young people are often left to deal with these issues alone. As authors Warrington et al. (2023) from the United Kingdom found in their exploration of friendship and peer support following sexual abuse, the support of friends can be vital for some but the sensitivity and understanding of friends can be variable and unreliable. In contrast, Cody et al. (2022) focused on structured peer support for young survivors of sexual violence across Europe and North America, defining peer support as ‘support provided by those with similar experiences’. This formalised peer support system was viewed as an additional or alternative support provision to that of informal friendship networks and ensured that peer supporters receive appropriate training and help. The unique nature of support from friends was described variably but primarily presented as something with potential to feel less emotionally charged, pressured or judgemental. Children commonly think that once their peers get to know about their parent's mental illness, they may cease to enjoy activities together. Therefore, it is important to keep silent about their parents' mental illness when around their peers to continue enjoying relationships with them. Likewise, in studies from the United Kingdom, Daw et al. (2022) identified that young people can feel ‘helpless’ and ‘fearful’ when their friends seek support around domestic abuse, and Warrington et al. found that precarious peer cultures were not always suitable for providing support in the aftermath of sexual violence. The challenges associated with accessing support through informal friendships appeared to be mitigated, at least to some extent, in more formal peer support structures. A study across Europe and North America found that shared peer experiences of sexual violence created a context conducive with peer support groups. Having shared experiences facilitated peer support that was relatable, credible and translatable, where young people were not judged (or fearful of judgement) when turning to peers for support. Similarly, in Ghana it was recommended that young people who shared a traumatic experience could be better placed to support one another and be less likely to bullying or judge. A third type of peer relationship was explored by Zhu (2023) in China. In this scenario, young people were not supported through existing friendships or organised around a shared experience of harm/abuse, but within schools through peer mentoring systems. In this form of peer support, younger pupils are matched with older young people who can then support them with the aim of reducing school bullying. However, the author notes that these hierarchical peer relationships might themselves feature power imbalances, with an age gap introducing the potential for exploitation and bullying. Reflecting other conclusions in this special issue, they point to the importance of education and practical support for young people who are positioned as mechanisms for peer support (be that formal or informal) to ensure that these relationships do not feel burdensome to the young people providing the support and that any help they offer is protective. Clear definitions are therefore crucial. Peer support through existing friendships, shared interest or experience groups or through a shared context all present unique challenges and opportunities, and consequently, the type of relationship being studied requires careful consideration. The best thing that I did was to be there for her [friend]. Not try and pressure her into breaking up with him, because that's, kind of, being just as bad as him, but, like, to just be emotionally there for her and make sure you're there to comfort her whenever she's down. (Young person 13–16) At first glance such a request appears relatively feasible. However, the collection of arguments made across this special issue highlight a range of considerations that would need to be addressed before this request can be met. The articles in this issue suggest that a non-judgemental approach is most reliable when coming from formal peer support structures, rather than informal friendship networks. The fear of shame, or being misunderstood, was mitigated either through shared experiences within the formal peer relationships in question, or through formal training and advice or professional support structures that equipped peers to be understanding and supportive. When the survivor [peer mentor] goes out and meets them, and they're able to see that their story is similar to theirs, and that they have been able to triumph in their own ways, it really creates the sense of hope for them. (Professional respondent 1, Organisation A) Cody et al. stress, however, that supporting and training these peer mentors requires time and resources and is not a cheap alternative to professional support. While acknowledging the unique value of formal peer support, articles in this issue also show that some young people seem to highly value the informality that came with support from friends. Moreover, various authors noted that support from friends was important due to their temporal proximity to young people during adolescence. Young people are with friends during the day at school, and in various out-of-school settings, creating numerous opportunities for support (Zhu, 2023). Such support included being a point of disclosure, providing comfort or emotional support, or acting as a conduit to professional support (Warrington et al.). However, for young people to provide this type and level of support, they require practical advice from adults; and to an extent, this again introduced a level of formality. Taken collectively, the contributions in this special issue suggest a balance needs to be struck and that both formal and informal pathways of support (likely across a continuum) are required. However, none of the contributions were able to clearly articulate what such a continuum might entail, as each focused on a single element. Nevertheless, this provides an important starting point to consider how this continuum might be conceptualised and provides a basis to understand how a young person's peer support needs might best be met. Recommendations to introduce elements of formality into friendship-support mechanisms largely stems from the identified challenges of integrating peer relationships into child protection and wider safeguarding practices. Young people reported concerns about how to maintain friendships while they were also experiencing safeguarding issues (Daw et al.). Seeking support from friends could result in bullying or isolation, when young people failed to understand how to support each other or judged friends negatively due to what they had experienced (Cudjoe et al., 2022). Friendships during adolescence are also dynamic, changing frequently, and with this comes a level of precarity. Reaching out to people who may not remain your friends over an extended period of time could be perceived as a risky endeavour. Consequently, young people surveyed in Australia stated that they were most likely to disclose abuse to their mother (about concerning behaviour of an adult, 68.7 per cent; or a peer, 63.1 per cent) followed by a friend (64.4 per cent; 57.9 per cent) (Russell & Higgins, 2023). Thus, family relationships remain very important and we should not assume that peers are always the first choice, or indeed best placed, to respond to young people who require support. Finally, there is a risk that some young people will feel (or be) burdened when supporting their friends or peers. Authors noted a need to mitigate any ‘responsibilisation’ that might be an unintended consequence of providing young people with the skills and formal space to support each other with experiences of abuse (Daw et al., 2022). For example, when young people were asked about the possibility of being approached by friends who were experiencing domestic abuse, they reported being concerned that they would feel fearful and helpless. All young people require a certain level of practical advice about the nature of abuse (in all its forms), how it impacts young people and what they can do if a friend approaches them for help. Such advice should not suggest that it is the young person's responsibility to prevent or disrupt harm; but instead ensure they are equipped to respond effectively if situations arise where their friends need support, including where they could go to seek more formal assistance. All the above challenges appeared particularly pronounced in situations of informal peer support, particularly support within existing friendships. Formal peer support structures, particularly for young people who had experienced issues such as sexual abuse, were designed to ensure young people were assisted to support each other and involved young people who all had similar experiences of abuse and therefore reduced the risk of being judged or misunderstood. The stories told in this special issue suggest not only that young people's friendships and peer relationships could play a role in safeguarding responses – but that they already do through both informal and formal routes. Nonetheless, far more work is required to understand the dynamics of this support and the best ways to maximise its potential and minimise its risks. There are methodological challenges and shortfalls with work completed to date. For the most part, researchers rely on gatekeeping organisations to speak to young people about their experiences of peer or friendship-based support and access to such organisations varies. In most countries featured in this special issue, the roles of peers have not been fully considered in practice or policy development, as the forms of peer support identified sit beyond formal response systems. Arguably, greater recognition by, and integration into, wider organisational responses to violence and abuse would provide the practical mechanisms required to safely maximise the potential for peer support. While the papers in this special issue draw upon experiences from a number of countries there remain gaps that warrant attention. First, it appears that gender may impact on the accessibility and availability of support from peers and friends. For example, girls and young women surveyed in Australia were more likely to seek support from peers than boys and young men (Russell & Higgins, 2023). Do we understand these gender differences, and are they reflected for various forms of harm and in different countries? More broadly, an intersectional account of friendship and peer support in safeguarding is required. How do the opportunities and concerns raised in this editorial vary in terms of ethnicity, sexuality, ability and so on? Moreover, what avenues of support do online peer relationships, through for example social media platforms, provide for support and how and in what ways do these online peer dynamics reflect or differ from those factors outlined in the current papers and for whom? The papers in this special issue provide a foundation for raising these important questions, although further research is required to answer them and of course this requires research funding bodies to recognise this as a central aspect of safeguarding for young people. We would like to thank all the authors who contributed to this special issue. We believe it brings together a wealth of knowledge but also raises challenging questions for both practice and policy development on how we can best support young people who are at risk of or are currently experiencing harm. In terms of this special issue two key considerations are established—and we hope that these are taken into account in the design of future research. First, that definitions matter. Work is required to explore support via various peer relationships; pre-existing friendships, specialist peer support groups and temporally or physically proximal support structures (in schools for example); and clarity is needed as to what type of peer relationships are under study on each occasion. Secondly, developing a continuum of formal and informal support to characterise the ways that peer relationships/friendships can be integrated into safeguarding practice/policy might also provide a route for clarifying the types of interventions under study and their implications for service development. Formal peer support structures, that exist outside of young people's established friendships, offer specific benefits and require specific scaffolding; these requirements are different for informal support via pre-existing friendship. Questions might also be asked about what happens in the middle, where friendships form within formalised circles of support; friendships that may persist beyond a peer support intervention. Like my best friend … He's always there day and night. I can ring him at three o'clock in the morning and he'll answer the phone … He's very understanding, and he seems to say the right stuff. (Interview 6, male, 21 years)

ObjectiveTo examine and synthesise qualitative evidence of women's, peer supporters’ and healthcare professionals’ views and experiences of breastfeeding peer support. DesignThe Joanna Briggs Institute (JBI) approach to systematic reviews of qualitative studies was followed. Seven databases: CINAHL, MEDLINE, EMBASE, PsycINFO, Scopus, Maternal & Infant Care, and Web of Science were searched. Included papers were critically appraised using the JBI Critical Appraisal Checklist for Qualitative Research. JBI's meta-aggregation approach was used to synthesise findings. JBI's ConQual process was followed to assess confidence of evidence. Participants and settingPrimiparous and multiparous women, lay breastfeeding peer supporters, and healthcare professionals based in high, middle, and low income countries. FindingsTwenty-three papers presenting findings from 22 studies were included. The synthesised findings included: (1) Positive characteristics, approaches and benefits of peer support(ers); (2) Relationships between healthcare professionals and peer supporters; (3) Improving women's access to peer support services; (4) Barriers and enablers to provide peer support. Key conclusions and implications for practiceBreastfeeding peer support increased women's self-esteem and confidence in breastfeeding while reducing social isolation. Peer supporters valued the experience, which gave them a sense of purpose and confidence, and felt good about helping the women they supported. Women appreciated peer supporters who were caring, spent time with them, shared experiences, provided realistic information, practical and emotional support. Although there were tensions between some healthcare professionals and peer supporters, many valued the mutual support offered. Embedding peer supporters in healthcare systems for them to work alongside healthcare professionals, combined with good communications and building trusty relationships could be a useful strategy to reduce tensions between them.

BackgroundA growing number of people are living with comorbid dementia and cancer (CDC), and they are particularly likely to require support from family caregivers. Carers of people with CDC play a vital supportive role but have reported unmet support needs, including a lack of CDC-specific information resources and peer support. A targeted online peer support forum may provide an accessible way to help address unmet needs of carers of people with CDC.ObjectiveThis study aimed to explore the types and frequency of social support provided on an online peer support forum for caregivers of people with CDC, hosted by a dementia charity in the United Kingdom.MethodsWe conducted a mixed methods study using descriptive statistics and qualitative content analysis. All posts (N=893) on the forum since its launch in November 2018 to April 2024 were exported into Microsoft Excel for analysis. Descriptive statistics were used to examine forum use and user characteristics. Deductive content analysis was conducted to explore the types and frequency of social support provided on the forum. Posts were analyzed according to an adapted version of Cutrona and Suhr’s Social Support Behavior Code, consisting of 5 main categories of support: informational, emotional, esteem, network, and tangible. Coding was completed independently by 2 coders, and any coding disagreements were resolved by reaching a consensus through discussion.ResultsA total of 258 usernames posted on the forum since its inception. There were 893 posts; 583 (65.3%) were coded as providing social support. All 5 Social Support Behavior Code categories were present in the forum posts. Informational support was the most common type of social support provided on the forum, which mostly involved providing suggestions for caregiving and coping strategies and sharing personal experiences that provide CDC-specific knowledge or insight. This was followed by emotional support, which consisted mostly of expressing shared understanding and empathy for caregivers in their unique situation of CDC and providing expressions of care for the recipient’s well-being. Esteem, network, and tangible support were less common, though they included providing validation and relief of blame to other caregivers, typically in decision-making regarding cancer treatment; reminding caregivers that others were available on the forum for support; and expressing willingness to answer questions about their CDC caregiving experience.ConclusionsThis study demonstrates the use and value of a CDC-specific online forum as a source of social support for carers of people with CDC, facilitating users’ access to CDC-specific information and peer support. The relatively new forum shows promise as a free and accessible resource that can contribute to addressing carers’ informational and peer support needs.

BackgroundPeer support is valued by its users. Nevertheless, there is initial low take‐up of formal peer support programmes among patients with chronic kidney disease (CKD), with fewer patients participating than expressing an interest. There is little evidence on reasons for low participation levels. Few studies have examined the perspectives of carers.ObjectiveTo explore with CKD patients and carers their needs, wants and expectations from formal peer support and examine how barriers to participation may be overcome.MethodsQualitative interviews with a sample of 26 CKD stage five patients and carers. Principles of Grounded Theory were applied to data coding and analysis.SettingSix NHS Hospital Trusts.ResultsWhilst informal peer support might occur naturally and is welcomed, a range of emotional and practical barriers inhibit take‐up of more formalized support. Receptivity varies across time and the disease trajectory and is associated with emotional readiness; patients and carers needing to overcome complex psychological hurdles such as acknowledging support needs. Practical barriers include limited understanding of peer support. An attractive peer relationship is felt to involve reciprocity based on sharing experiences and both giving and receiving support. Establishing rapport is linked with development of reciprocity.ConclusionsThere is potential to facilitate active uptake of formal peer support by addressing the identified barriers. Our study suggests several facilitation methods, brought together in a conceptual model, including clinician promotion of peer support as an intervention suitable for anyone with CKD and their carers, and opportunity for choice of peer supporter.

BackgroundThere is an ample body of literature examining the experiences and outcomes of peer support services for mental health recovery in western countries. However, formal peer support is only recently adapted and piloted to alleviate depression among older people, and little is known about how the peer-to-peer model might be lived out in the older Chinese population. This qualitative study investigated peer supporters’ (PS) perspectives of their roles and experiences of rendering formal peer support to community-dwelling older adults at risk of or living with depression in Hong Kong.MethodsThe study adopted a qualitative design. Five semi-structured focus groups were conducted with 27 trained peer supporters between ages 54–74 (21 females and 6 males) who had provided peer-to-peer support to older adults at risk of or living with depression in the community for at least 12 months. Thematic analysis was employed to derive content and meanings from the focus group transcripts.ResultsParticipants’ mean age was 61.9 years; two-thirds of them were retired and the rest still engaged in part-time or full-time employment. Four themes were identified in relations to the roles and experiences in rendering the peer support services: (1) peerness in health and age-related lived experiences; (2) companionship, social and emotional ties beyond formal support; (3) meaningful roles to facilitate older people’s functional ability; and (4) hopes and actions against the undesirable outcomes of aging. Being a PS might provide meaningful roles for persons in transition to or living in late adulthood, and enable community-dwelling older adults with depression to maintain functional ability. On the other hand, defining the concept of ‘peer’ beyond the shared experience of mental distress, ensuring a healthy boundary between the peers and the service users, maintaining a careful balance between time-limited formal support and stable social ties, and providing self-management training and on-going support appear crucial.ConclusionsThis study of PS’ perspectives and experiences offer insights into the age-specific dimension of the peer relationship. Despite the promising effects it might offer, careful implementation of peer support among older adults is warranted to safeguard against the ensuing loss of meaningful social ties and the potential emotional distress.

Experiences and outcomes of prevention and early intervention programs for young people of parents with a mental illness

Background:In an effort to shield them from distress, pre-hospital ambulance staff may avoid discussing traumatic workplace experiences with friends and family. As a source of informal support, however, workplace camaraderie is considered important for managing occupational stress. For supernumerary university paramedic students there is limited research concerning how such experiences are managed, and whether they may benefit from similar informal support. This is a concerning deficit when contextualised by reports of higher stress levels among students undertaking work-based learning, and among paramedics / paramedic students in general. These original findings allude to how university paramedic students who are supernumerary within the pre-hospital workplace utilise informal support mechanisms.Methods:A qualitative, interpretive approach was adopted. University paramedic students were recruited via purposive sampling. Audio-recorded face-to-face semi-structured interviews were performed and transcribed verbatim. Analysis involved initial descriptive coding and then inferential pattern coding. The identification of themes and discussion topics was facilitated by a review of the literature.Results:Twelve participants were recruited aged from 19 to 27 years, and 58% (n = 7) were female. While most participants cited that they were able to enjoy the informal stress-relieving camaraderie of ambulance staff, there were perceptions that supernumerary status may leave them potentially isolated within the workplace. Participants may also compartmentalise their experiences away from friends and family in a manner similar to that found among ambulance staff. Informal student peer support networks were praised as a source of information and for emotional support. Self-organised online chat groups were ubiquitous as a means of keeping in touch with student peers.Conclusions:While undertaking pre-hospital practice placements, supernumerary university paramedic students may not have complete access to the informal support of ambulance staff, and they may feel unable to discuss stressful feelings with friends or loved ones. However, within this study, self-moderated online chat groups were used almost universally as a readily accessible means of peer support. Paramedic educators ideally need an awareness of how such groups are used to ensure that they represent a supportive and inclusive space for students. Further research into how university paramedic students utilise online chat groups for peer support may further reveal a potentially valuable informal support structure.

Prostate cancer significantly impacts the lives of those diagnosed, causing emotional and psychological distress, including fear, uncertainty, and anxiety. While formal peer support has been suggested as a beneficial way for men to share their experiences, little is known about the perspectives of those who choose not to participate in such activities. This study aims to explore how those men with prostate cancer who have not engaged in formal peer support perceive and describe peer support before and after participating in a supervised exercise group. This study is part of an exercise intervention research project involving men diagnosed with prostate cancer. The data consists of the individual interviews of 15 men in an intervention group who participated in supervised gym sessions with peers. The intervention did not include formal, institutionally organised peer support. Semistructured interviews were conducted three times: before, immediately after and 3 months after the group exercises. The interviews were analysed using frame analysis. The participants described peer support through five distinct frames: taking distance and highlighting individuality, existing social networks, daily activities, extended peer support, and fellowship and voluntary sharing. Before exercising in the group, the participants had often distanced themselves from formal peer support, emphasised their ability to cope independently and relied on existing social networks. After the group exercises, they still viewed formal peer support negatively but nonetheless perceived the exercise group as a low‐threshold meeting place where informal peer support occurred naturally through shared activities. The study suggests that while formal peer support may not appeal to all men with prostate cancer, alternative models that incorporate shared activities and informal interactions can provide meaningful support. These findings highlight the importance of tailoring peer support options to accommodate diverse needs and preferences, potentially improving the well‐being of men with prostate cancer.

Peer support is a widely used intervention that offers information and emotional support to parents during their infant’s admission to the neonatal unit and/or post-discharge. Despite its widespread use, there are no comprehensive insights into the nature and types of neonatal-related peer support, or the training and support offered to peer supporters. We aimed to bridge these knowledge gaps via an international study into neonatal peer support provision. A mixed-methods study comprising an online survey was issued to peer support services/organisations, and follow-up interviews held with a purposive sample of survey respondents. Survey/interview questions explored the funding, types of peer support and the recruitment, training and support for peer supporters. Descriptive and thematic analysis was undertaken. Thirty-one managers/coordinators/trainers and 77 peer supporters completed the survey from 48 peer support organisations/services in 16 different countries; with 26 interviews undertaken with 27 survey respondents. We integrated survey and interview findings into five themes: ‘background and infrastructure of peer support services', ‘timing, location and nature of peer support’, ‘recruitment and suitability of peer supporters’, ‘training provision’ and ‘professional and emotional support’. Findings highlight variations in the types of peer support provided, training and development opportunities, supervisory and mentoring arrangements and the methods of recruitment and support for peer supporters; with these differences largely related to the size, funding, multidisciplinary involvement, and level of integration of peer support within healthcare pathways and contexts. Despite challenges, promising strategies were reported across the different services to inform macro (e.g. to facilitate management and leadership support), meso (e.g. to help embed peer support in practice) and micro (e.g. to improve training, supervision and support of peer supporters) recommendations to underpin the operationalisation and delivery of PS provision.

This paper offers an analysis of informal digital peer support among LGBTQ+ young people in Australia, based on survey data from 660 young people (aged 16-25). Research on LGBTQ+ young people’s mental health support commonly focuses on their professional support needs and connection to services, but there is also a need to understand informal peer support through everyday social media use. There are known benefits of having access to multiple forms of care and support, including the immediacy of friendship and peer-based support. This paper focuses on how LGBTQ+ young people participate in informal digital support practices for mental health and the values they attribute to this. This includes support that is not only sought and found but that which is offered and reciprocated through care networks. We highlight the need to consider where informal support comes from, who is involved, and what it offers to LGBTQ+ young people. Participants commonly experienced social media as environments that offered connection to supportive people, content, and spaces – providing mental health benefits. The community, connection, and solidarity of online platform spaces can benefit young people’s mental health and wellbeing, thereby complementing formal healthcare programmes, policy and systems of care.

BackgroundThe transition to parenthood is a potentially vulnerable time for mothers’ mental health and approximately 9–21% of women experience depression and/or anxiety at this time. Many more experience sub-clinical symptoms of depression and anxiety, as well as stress, low self-esteem and a loss of confidence. Women’s emotional wellbeing is more at risk if they have little social support, a low income, are single parents or have a poor relationship with their partner. Peer support can comprise emotional, affirmational, informational and practical support; evidence of its impact on emotional wellbeing during pregnancy and afterwards is mixed.MethodsThis was a descriptive qualitative study, informed by phenomenological social psychology, exploring women’s experiences of the impact of organised peer support on their emotional wellbeing during pregnancy and in early parenthood. Semi-structured qualitative interviews were undertaken with women who had received peer support provided by ten projects in different parts of England, including both projects offering ‘mental health’ peer support and others offering more broadly-based peer support. The majority of participants were disadvantaged Black and ethnic minority women, including recent migrants. Interviews were audio-recorded and transcripts were analysed using inductive thematic analysis.Results47 mothers were interviewed. Two key themes emerged: (1) ‘mothers’ self-identified emotional needs’, containing the subthemes ‘emotional distress’, ‘stressful circumstances’, ‘lack of social support’, and ‘unwilling to be open with professionals’; and (2) ‘how peer support affects mothers’, containing the subthemes ‘social connection’, ‘being heard’, ‘building confidence’, ‘empowerment’, ‘feeling valued’, ‘reducing stress through practical support’ and ‘the significance of “mental health” peer experiences’. Women described how peer support contributed to reducing their low mood and anxiety by overcoming feelings of isolation, disempowerment and stress, and increasing feelings of self-esteem, self-efficacy and parenting competence.ConclusionOne-to-one peer support during pregnancy and after birth can have a number of interrelated positive impacts on the emotional wellbeing of mothers. Peer support is a promising and valued intervention, and may have particular salience for ethnic minority women, those who are recent migrants and women experiencing multiple disadvantages.

Methodology and baseline characteristics of a randomized controlled trial testing a health care professional and peer-support program for patients with chronic obstructive pulmonary disease: The BREATHE2 study

Perspectives of oncology nurses on peer support for patients with cancer.

Peer support: more than tea and sympathy

BackgroundPeople with chronic conditions experience functional impairment, lower quality of life, and greater economic hardship and poverty. Social isolation and loneliness are common for people with chronic conditions, with multiple co-occurring chronic conditions predicting an increased risk of loneliness. Peer support is a socially driven intervention involving people with lived experience of a condition helping others to manage the same condition, potentially offering a sense of connectedness and purpose, and experiential knowledge to manage disease. However, it is unclear what outcomes are important to patients across the spectrum of chronic conditions, what works and for whom. The aims of this review were to (1) collate peer support intervention components, (2) collate the outcome domains used to evaluate peer support, (3) synthesise evidence of effectiveness, and (4) identify the mechanisms of effect, for people with chronic conditions.MethodsA systematic review of reviews was conducted. Reviews were included if they reported on formal peer support between adults or children with one or more chronic condition. Data were analysed using narrative synthesis.ResultsThe search identified 6222 unique publications. Thirty-one publications were eligible for inclusion. Components of peer support were organised into nine categories: social support, psychological support, practical support, empowerment, condition monitoring and treatment adherence, informational support, behavioural change, encouragement and motivation, and physical training. Fifty-five outcome domains were identified. Quality of life, and self-efficacy were the most measured outcome domains identified. Most reviews reported positive but non-significant effects.ConclusionsThe effectiveness of peer support is unclear and there are inconsistencies in how peers are defined, a lack of clarity in research design and intervention reporting, and widely variable outcome measurement. This review presents a range of components of peer support interventions that may be of interest to clinicians developing new support programmes. However, it is unclear precisely what components to use and with whom. Therefore, implementation of support in different clinical settings may benefit from participatory action research so that services may reflect local need.