Adult Peer Research Articles

Evaluation of a Skills Enhancement Training Intervention With Remote Coaching for Young Adults Providing Peer Support.

This column reports on a study that investigated a skills enhancement and role clarification training intervention for young adult peer support specialists (YPSSs). Young adults who had received intensive mental health services—including young adults who had experience as YPSSs—were partners in developing the intervention and in completing all aspects of the study. Study participants were YPSSs who were already providing one-on-one, person-centered planning in community settings before the study. The results, based on YPSSs’ self-reports and rated video recordings of YPSSs’ practice, showed postintervention gains in participants’ skills and confidence in providing person-centered planning to the young people they worked with as well as reduced job-related anxiety and high training satisfaction.

PEEPS: A Relational Framework for Incorporating Resilience Into Community-Based Programming for Youth

Youth in communities across the world are exposed to adversity and trauma at high levels. In this article, we describe a research-informed, resilience-promoting framework that can be incorporated into a variety of touch points for youth (e.g., school, family, community, extra-curricular activities). The PEEPS Framework is relational in nature and includes the following five interconnected components: (a) positive adult relationships, (b) esteem, (c) empathy, (d) peer relationships, and (e) strengths-based approach. We outline the research that supports each component, describe how we are currently implementing the PEEPS framework in the form of a volunteer training, and offer research-based suggestions for implementation and tools that other professionals can utilize.

Socioecological correlates of social play in adult mantled howler monkeys

The study of animal play is highly complex since its potential functions vary with social and environmental circumstances. Although play is generally characteristic of immature animals, it may persist in adults in its social form, particularly when interacting with young individuals, and less often with other adult playmates. We measured the amount of social play in 62 wild adult howler monkeys, Alouatta palliata , belonging to seven different groups in Mexico and Costa Rica. Overall, adult play represented a small mean proportion of observation time across all groups, but it was present in all study groups. Generalized linear mixed models revealed that group size correlated with both adult–adult and adult–immature play, supporting the hypothesis that more individuals provide more play opportunities. While play between adults decreased with increases in the immature to adult ratio, we did not find a clear preference for adults to play with immatures, emphasizing the importance of playing with other adult peers. Conversely, adults played more with immatures as the immature to adult ratio increased, which may correspond with the role adult–immature play may have in the socialization process of young individuals. More time dedicated to foraging on fruits corresponded with more adult–adult play. This finding, aside from being associated with more energy being available to engage in play, supports the hypothesis that play is a mechanism for solving conflicts associated with contest competition by either reducing social tension and/or fighting for a limited resource. The range of factors affecting social play indicates that this behaviour in adult howler monkeys is facultative, having affiliative, socializing and competitive roles, depending on the socioecological context. • Adult play correlated positively with group size and fruit consumption. • Adult play correlated negatively with immature to adult ratio. • Adult females played more than adult males. • Adults of both sexes had no preference for playing with immatures over other adults. • Social play may have different functions but the same behavioural structure.

A Scoping Review of Interventions Delivered by Peers to Support the Resettlement Process of Refugees and Asylum Seekers

Background: Refugees and asylum seekers face many social and psychological challenges on their journey to resettlement in host countries. Interventions and programmes designed to assist in these challenges are necessary. The aim of this scoping review is to conduct a systematic search of the literature as it pertains to interventions delivered by peers to refugees and asylum seekers during the resettlement process. Methods: A PRISMA-compliant scoping review was conducted. Four databases, Scopus, Embase, Ebsco, and ScienceDirect were searched for peer-reviewed articles published in English from 2000–2021. Studies were included if they reported on interventions, outcomes or the training received by adult peers to support refugees and asylum seekers during the resettlement process. Results: Of an initial 639 journal articles retrieved, 14 met the inclusion criteria for this review. Most included studies were conducted in Western high-income countries, except for one. Studies were heterogeneous in terms of the nationalities of peers and those receiving peer interventions; the outcomes reported on; the content of interventions; and the methodologies used. Conclusions: Findings suggest that peer interventions seem to be effective in addressing many of the challenges faced by refugees and asylum seekers. Community integration, acculturation and psychological distress are some of the key benefits. When such interventions are co-produced in participatory research involving refugees, asylum seekers, and the civil society organisations that support this population, they are naturally culturally responsive and can therefore address issues relative to different ethnic needs during the resettlement process.

The Effects of Drugs on Behavior Maintained by Social Contact: Role of Monoamines in Social Reinforcement.

Drug use is highly concordant among members of adolescent and young adult peer groups. One potential explanation for this observation is that drugs may increase the reinforcing effects of social contact, leading to greater motivation to establish and maintain contact with other members of the peer group. Several classes of drugs, particularly drugs that increase synaptic dopamine, increase the reinforcing effects of contextual stimuli, but the extent to which these drugs enhance the reinforcing effects of social contact is not known. The purpose of this study was to determine the extent to which drugs that increase synaptic dopamine, norepinephrine, and serotonin enhance the positive reinforcing effects of social contact. To this end, male and female Long-Evans rats were pretreated with acute doses of the selective dopamine reuptake inhibitor, WIN-35,428, the selective norepinephrine reuptake inhibitor, atomoxetine, the selective serotonin reuptake inhibitor, fluoxetine, the non-selective monoamine reuptake inhibitor, cocaine, and the non-selective monoamine releasers d-amphetamine and (±)-MDMA. Ten minutes later, the positive reinforcing effects of 30-s access to a same-sex social partner was examined on a progressive ratio schedule of reinforcement. To determine whether the reinforcement-altering effects of these drugs were specific to the social stimulus, the reinforcing effects of a non-social stimulus (30-s access to an athletic sock of similar size and coloring as another rat) was determined in control subjects. WIN-35,428, d-amphetamine, and cocaine, but not atomoxetine, fluoxetine, or MDMA, dose-dependently increased breakpoints maintained by a social partner under conditions in which responding maintained by a non-social stimulus was not affected. These data indicate that increases in extracellular dopamine, but not extracellular norepinephrine or serotonin, increases the positive reinforcing effects of social contact in both male and female rats. These data also provide support for the hypothesis that some drugs with high abuse liability increase the motivation to establish and maintain contact with social peers.

Familial transmission of attention allocation towards one's own and a peer's body: An eye-tracking study with male adolescents and their fathers.

Previous research provides evidence of maternally transmitted body-related attentional biases in female adolescents. In contrast, it remains unclear whether a familial transmission of body-related attentional biases also exists within father-son dyads. Therefore, the current study examined n = 42 male adolescents and their fathers with respect to direct and indirect paternal influences on body-related attention patterns and specific body-related concerns in sons. Besides completing specific body image questionnaires, participants were shown pictures of their own and a respective peer’s body, while their eye movements were tracked. The fathers additionally viewed the body pictures of their own son and an adolescent peer. Contrary to the assumed direct and indirect paternal transmission processes, the sons’ body-related attention patterns were not significantly associated with the perceived amount of paternal body-related feedback, with the fathers’ attention patterns towards their own son’s and the adolescent peer’s body, or with the fathers’ attention patterns towards their own and the adult peer’s body. Similarly, no significant associations were found between direct or indirect paternal influences and the sons’ drives for muscularity and thinness, body dissatisfaction, and muscularity-related body-checking behavior. Comparing the present findings with previous research indicating a maternal transmission of body-related attentional biases and body-related concerns in female adolescents, alternative (not gender-linked) familial transmission processes, e.g., via one’s own mother, or a comparatively higher relevance of other sociocultural influences, e.g., via peers or the media, might be assumed for male adolescents.

Community Engagement and Human-Centered Design: Lessons From HEARS in Inclusive Recruitment of Older Adults

Within hearing care, significant disparities persist despite the highly prevalent nature of age-related hearing loss and relatively few trials include representation of racial/ethnic minorities. HEARS is an affordable, accessible hearing care intervention delivered by older adult peer mentors. The HEARS randomized controlled trial (NCT03442296) is a community-engaged RCT with an embedded human-centered design practitioner. Recruitment efforts occurred over 18 months in partnership with 13 affordable housing and social centers. The cohort (n=151) includes 43% (n=65) who self-identify as African American and 63.6% (n=96) with <$25,000 annual household income. The cohort represents the largest to-date of African American and low-income older adults with hearing loss. Recruitment efforts entailed 470.5 staff hours and $4,917.26 in supplies, equating to 1.4 hours and $14.13 per 1 individual screened and 3.1 hours and $32.56 for 1 participant randomized. Community-engaged research, partnered with human-centered design, may offer critical approaches to increasing representation within behavioral intervention trials.

Certified Older Adult Peer Support Specialists' Use of Technology to Support Older Adults in the Community

Middle-aged and older adults with mental health conditions have a high likelihood of experiencing comorbid physical health conditions, premature nursing home admissions, and early death compared with the general population of middle-aged and older adults. An emerging workforce of certified older adult peer support specialists aged 50 years or above is one of the fastest growing mental health workforces and may be a suitable community-based workforce to simultaneously support the mental health, physical health, and aging needs of middle-aged and older adults with a serious mental illness. Older adult peer support specialists are people with a lived experience of aging into middle age and older adulthood with a mental health condition. This presentation will present three single-arm pilot studies examining how certified older adult peer support specialists’ incorporate technology, including text messaging, ecological momentary assessments, and smartphone applications into practice and clinical outcomes among older adults with serious mental illness.

When friendships surpass parental relationships as predictors of long-term outcomes: Adolescent relationship qualities and adult psychosocial functioning.

Perceptions of adolescent-parent and adolescent-peer relationship qualities, and adolescents' attachment states of mind were examined as predictors of adult social and romantic relationship quality, depressive symptoms, and work performance. Adolescents (86male, 98 female; 58% White, 29% African American, 8% mixed race/ethnicity, 5% other groups) were followed from age 13 to 24 via observational, self-, parent-, and close friend-reports. Adolescent close friendship quality was a significantly better predictor of adult peer and romantic outcomes, work performance, and depressive symptoms than parental reports of the parent-teen relationship; attachment security was also a strong predictor of numerous outcomes. Results are interpreted as reflecting the difficulty for parents judging parent-teen relationship quality and as reflecting the growing importance of close friendships during this period.

Social consequences and contexts of adverse childhood experiences

Adverse childhood experiences' (ACEs) negative consequences on health, education, and life opportunities are often explained through the neurodevelopmental changes in a person's stress reactivity and coping, which contribute to the adoption of health-damaging and antisocial behaviors. However, such focus on the biological dimension eclipses the equally important social dimension of adversity, in particular, how adversities at home can influence association with peers who exhibit and can exacerbate negative behaviors like early and binge drinking, illegal drug use, and gang involvement. More than the consequences for peer formation, this study also investigates the contexts in which ACEs are most predictive. Using a longitudinal study of US youths who were adolescents in 2007 and young adults in 2017, I find that experiencing adversity predicted involvement in peers exhibiting negative behaviors. However, the consequences of ACEs are not similar for everyone and for every outcome: (1) In disadvantaged families where ACEs were most likely, experiencing adversity influenced having peers in gangs but not the other outcomes. (2) In the most advantaged families where ACEs were least likely, having an ACE only predicted adult peers' regular drug use. (3) In families who were in the middle, experiencing adversity predicted early and binge drinking among peers. Taken together, they suggest that complex social processes and environments operate in the negative effects of ACEs, and the present research suggests a method to investigate how ACEs' impact may differ according to one's social context.

Perceived benefits from non-formal digital training sessions in later life: views of older adult learners, peer tutors, and teachers

ABSTRACT Rapid development of digital technologies affects the lives of all people and often leads to people being in unequal positions regarding digital skills training opportunities. Older adults’ motivations for learning digital skills vary, but they are generally connected with expectations of upcoming benefits. This study investigates the self-perceived benefits of older adults, information and communications technology (ICT) teachers and peer tutors who have participated in digital training sessions in older-adult organisations or adult education centres. The data included 226 respondents (136 women, 90 men; older adults 53–90 years old, mean age 71 years, SD 6.74; ICT teachers 30–68 years old) from Finland. According to the results, participation in digital training events supported development of digital literacy and wellbeing of the participants. Most older adult peer tutors described an increase in their wellbeing. The findings of the study indicate that participation in digital training sessions in later life is beneficial, as it supports the growth of independence and positive interdependence in new types of learning communities that strengthen older adults’ learning and wellbeing.

Older Adult Peer Support Specialists' Age-Related Contributions to an Integrated Medical and Psychiatric Self-Management Intervention: Qualitative Study of Text Message Exchanges.

BackgroundMiddle-aged and older adults with mental health conditions have a high likelihood of experiencing comorbid physical health conditions, premature nursing home admissions, and early death compared with the general population of adults aged 50 years or above. An emerging workforce of peer support specialists aged 50 years or above or “older adult peer support specialists” is increasingly using technology to deliver peer support services to address both the mental health and physical health needs of middle-aged and older adults with a diagnosis of a serious mental illness.ObjectiveThis exploratory qualitative study examined older adult peer support specialists’ text message exchanges with middle-aged and older adults with a diagnosis of a serious mental illness and their nonmanualized age-related contributions to a standardized integrated medical and psychiatric self-management intervention.MethodsOlder adult peer support specialists exchanged text messages with middle-aged and older adults with a diagnosis of a serious mental illness as part of a 12-week standardized integrated medical and psychiatric self-management smartphone intervention. Text message exchanges between older adult peer support specialists (n=3) and people with serious mental illnesses (n=8) were examined (mean age 68.8 years, SD 4.9 years). A total of 356 text messages were sent between older adult peer support specialists and service users with a diagnosis of a serious mental illness. Older adult peer support specialists sent text messages to older participants’ smartphones between 8 AM and 10 PM on weekdays and weekends.ResultsFive themes emerged from text message exchanges related to older adult peer support specialists’ age-related contributions to integrated self-management, including (1) using technology to simultaneously manage mental health and physical health issues; (2) realizing new coping skills in late life; (3) sharing roles as parents and grandparents; (4) wisdom; and (5) sharing lived experience of difficulties with normal age-related changes (emerging).ConclusionsOlder adult peer support specialists’ lived experience of aging successfully with a mental health challenge may offer an age-related form of peer support that may have implications for promoting successful aging in older adults with a serious mental illness.

Enhancing Wellbeing for Older Adults With Serious Mental Illnesses: Co-Producing a Positive Psychology Course With Certified Older Adult Peer Specialists.

Compared to peers in the general population, persons aging with serious mental illnesses (SMIs) face physical health disparities, increased isolation, and decreased subjective experiences of quality of life and wellbeing. To date, limited intervention research focuses on addressing specific needs of persons aging with SMIs and no interventions targeted for that population are informed by the theory and science of positive psychology. With the aim of co-producing a positive-psychology-based program to enhance wellbeing for older adults with SMIs, the author held a series of focus groups and individual interviews with six certified older adult peer specialists. Analysis of the data developed in-depth insights into helpful processes, values, and priorities of individuals aging with SMIs, as well as the creation of a wellbeing-enhancing course curriculum.

Peer conversation about substance (mis)use.

What happens when a friend starts talking about her own substance use and misuse? This article provides the first investigation of how substance use is spontaneously topicalized in naturally occurring conversation. It presents a detailed analysis of a rare video-recorded interaction showing American English-speaking university students talking about their own substance (mis)use in a residential setting. During this conversation, several substance (mis)use informings are disclosed about one participant, and this study elucidates what occasions each disclosure, and how participants respond to each disclosure. This research shows how participants use casual conversation to offer important substance (mis)use information to their friends and cohabitants, tacitly recruiting their surveillance. Analysis also uncovers how an emerging adult peer group enacts informal social control, locally (re-)constituting taken-for-granted social norms and the participants' social relationships, to on the one hand promote alcohol use while, on the other hand endeavouring to prevent one member from engaging in continued pain medication misuse. This article thus illuminates ordinary peer conversation as an important site for continued sociological research on substance (mis)use and prevention.

Seeking Virtual Support: Social Media in the Advanced Cancer Experience Among Adolescents and Young Adults (AYAs) (SCI941)

1.Describe the types and roles of digital media adolescents and young adults reporting to be most helpful in coping with their advanced cancer diagnosis.2.Propose potential interventions for leveraging digital technologies for optimizing psychosocial support of adolescents and young adults with cancer. A cancer diagnosis, especially advanced cancer, interferes with adolescent/young adult (AYA) peer relationships. AYAs increasingly use digital technologies (i.e. social media, videogames) as a social instrument; little is known about the role of digital technologies in the AYA cancer experience. To describe the AYA experience with advanced cancer, including sources of psychosocial support. Semi-structured interviews were conducted with 32 English-speaking AYAs (14-25 years) with advanced cancer (relapsed/refractory disease, estimated survival <50%). Interviews were audio-recorded, de-identified, and transcribed verbatim. Questions focused on communication and sources of psychosocial support. Three coders (CW, AS, KB) applied directed content analysis using Dedoose software. Discrepancies were reconciled by consensus meetings. When asked about sources of support, social media, multi-player online games, and texting were identified as modalities for seeking and maintaining peer support. Three themes emerged regarding the role of digital technologies: distraction, maintaining relationships with peers during treatment away from home, and (especially among young adults) identifying similar-aged AYAs with cancer to build informal support groups. One adolescent shared: “…I talk with people on my game, and they know my situation. I kind of just play games with them and talk to them about where I am stuck.” Another adolescent shared: “I was able to keep in contact with all my friends from high school [through social media]…. And a lot of video games, because that’s where I talk to my cousins and other friends.” Negative consequences were acknowledged, such as the reminder of missing out on “normal” age-appropriate activities, but to a lesser extent. AYAs with advanced cancer cite digital technologies as a mechanism for maintaining peer relationships and seeking psychosocial support.

“ADULTING” WITH IBD: A NOVEL, VIRTUAL INFLAMMATORY BOWEL DISEASE TRANSITION PROGRAM FOR TEENS AND CAREGIVERS

Abstract Introduction: Rates of newly diagnosed inflammatory bowel disease (IBD) in pediatric patients increased by 133% from 2007–2016. With the rise comes an increase in patients ultimately transitioning from pediatric to adult GI care. While pediatric care is family-centered and multi-disciplinary adult care is patient-centered with expectation for autonomy. However, less than 15% of patients are fully responsible for their IBD care by late adolescents. The transition period is marked by adverse health outcomes including decreased compliance and increased disease activity and hospitalization. Our data recognized up to 74% of IBD youth reported not having discussed transition at home or with their GI providers, and a desire to receive information in person. Without guidance from the GI team patients may not have adequate time to plan for successful transition. Methods: A one-day 3.5-hour transition preparedness workshop was developed to address the demonstrated need in a pediatric GI clinic. Recruitment letters were distributed to 134 IBD youth ages 15–19. Eighteen consenting participants completed measures prior to and following the workshop (at 3 and 12 months). Assessment tools included previously validated self- and parent-reports: Patient Health Questionnaire-8, General Anxiety Disorder-7), Transition Readiness Assessment Questionnaire, IBD Self Efficacy Scale; and Helping for Health Inventory. Results: While the workshop was designed for in person the pandemic required shift to virtual had strengths and potential drawbacks. Youth across 300 miles were able to attend, as well as IBD young adult peers sharing their personal transition experiences. It is hypothesized pre-workshop data will demonstrate low levels of transition readiness and IBD self-efficacy, with increases in 3- and 12-month post-workshop data. Transition readiness is also presumed to correlate with measures of IBD self-efficacy and miscarried helping by parents. We will present program effectiveness data with factors known to both facilitate and obstruct successful transition from pediatric to adult IBD care. Conclusion: There remains a paucity of literature evaluating the efficacy of IBD transition programs. This research informs such programs by evaluating the efficacy of a one-day virtual workshop on skill development and knowledge. Assessment data and follow up after transition to adult care will provide important information to guide development of evidence-based transition planning for IBD patients.

A Theory-Based Self-Management Training Program for Older Adult Peer Leaders with Diabetes: A Feasibility Assessment.

ObjectiveTo improve the quality of peer leader training, this study developed a theory-based self-management training program for older adult peer leaders with diabetes and assessed its feasibility.BackgroundCurrent self-management programs are designed mainly to be implemented by healthcare professionals, but healthcare staff may not fully perceive the needs and obstacles of older adults in disease management due to a lack of similar illness experience. To target this problem, peer leaders with successful self-management experiences, similar cultural backgrounds and languages, and related illness experiences are trained to guide and mentor peer patients in self-management programs.Study Design and MethodsThis study was conducted in two stages. In stage 1, a peer leader training program was developed based on experiential learning theory as the framework and self-regulation theory as the activity design strategy. In stage 2, program feasibility was assessed via participants’ feedback toward the training program by three indicators: attendance, future willingness to lead the peer-led self-management program, and leadership skills evaluated by a peer leader training assessment tool.ResultsIn this study, peer leaders demonstrated good leadership skills by expressing active willingness to lead self-management programs in the community. Peer leaders’ feedback indicated that the program’s training content was helpful in preparing peer leaders to guide older adults in learning self-management skills and in improving the abilities and confidence of peer leaders in mentoring self-management.ConclusionFindings in this study showed that peer leader training can impact the effectiveness and success of self-management in older adults with diabetes. Even in a small-scale study, the impact was evident, which demonstrated the feasibility of the program. More large-scale studies on the effectiveness of various peer leader training programs in diverse disciplines are recommended.Clinical Trials RegistryClinicalTrials.gov Identifier: NCT04298424 (the Peer-Led Self-Management Program).

Achieving Health Equity for Older Adults Through State-of-the-Art Innovations

As health indicators such as life expectancy have improved for many older adults, some older adults experience a disproportionate amount of preventable disease, death, and disability. The causes of health disparities among older adults are multidimensional in that disparities are due to multiple, interacting factors such as socioeconomic status, disability status, geographic location, and race/ethnicity. Achieving health equity in late-life requires innovative strategies to address interconnected environmental, sociocultural, behavioral and biological factors that impede opportunities to achieve optimal health and quality of life. This symposium will present state-of-the-art innovations and strategies employed among socially disadvantaged racial, ethnic, and other population groups, and communities. We will discuss innovations in the workforce enhancements with older adult peer support specialists and community health workers, community engagement techniques in program design, and digital solutions aimed at addressing multiple dimensions of health in older adults.

Older Adult Peer Specialists’ Role in Reducing Loneliness Among People With Mental Health Conditions

PeerTECH is a peer-delivered and technology-support integrated medical and psychiatric self-management intervention developed by peers. A pre/post trial by our group has shown PeerTECH is associated with statistically significant improvements in self-efficacy for managing chronic disease and psychiatric self-management skills. This presentation will discuss the feasibility and potential effectiveness of using ecological momentary assessments (EMA) with older adults with mental health conditions to allow us to recognize early signs of loneliness and intervene as early as possible in real-world settings. EMA involves repeated sampling of an individual’s behaviors and experiences in real time, real-world environments on the smartphone application. Then, we will discuss the main and interactive effects of loneliness and factors linked to mortality. In conclusion, we will discuss potential effectiveness of PeerTECH with older adults with SMI.

Barriers and Facilitators for Older Adults with Serious Mental Illness to Utilizing Medicaid Smartphone Services

As increasingly more older adults in the general population utilize smartphones to access health services, the digital divide between older adults with serious mental illness (SMI) and the general older adult population continues to widen. The purpose of this study was to examine older adult peer support specialists’ and older people with SMI’s perspectives of barriers and facilitators to utilizing Medicaid Safelink smartphone services. Data from two focus groups and five semi-structured interviews from older adult peer support specialists (N=10) and older adults with SMI (N=15) were analyzed using the Consolidated Framework for Implementation Science Research. A mixed methods convergent design integrated quantitative with qualitative data. Older adults with SMI (N= 15) had a mean age of 55 years and were mainly women (70%) and White (100%). Certified peer specialists (N= 10) had a mean age of 52 years (age range 45-67) and were mainly female (75%), 66% identified as White, and 33% identified as African American. Four themes that were identified across different aspects of barriers included technology knowledge, technology adoption, design features (i.e., smartphone size, option to increase font sizes, multi-modal capacity, navigational architecture, 508 compliance), and Safelink policies and procedures. Facilitators included free and continuous services, access to technical support, and smartphone capabilities to enable healthcare communications and facilitate the delivery of services. Improving upon the themes identified as barriers to utilizing Safelink may promote a continuum of care for older adults with SMI, closing the gap of services that occurs between in-person therapy and other interventions.