Opportunities For Peer Support Research Articles

Creating Family-Centred Support for Preschoolers with Developmental Disabilities in Low-Income Countries: A Rapid Review to Guide Practitioners.

Preschoolers with disabilities and their caregivers have been neglected in health and social service provision in most low-income countries and arguably also in low-resourced areas of more affluent nations. Yet as this rapid review of the published literature identifies, there are low-cost, evidence-based strategies to address their needs that can be implemented in communities by local people. Five key features of the necessary supports are examined. First, the leadership functions required to create and implement the support services. Second, the family-centred, home-based support provided to caregivers and the personnel undertaking this form of support. Third, providing opportunities for peer support to flourish and encouraging the formation of advocacy groups across families. Fourth, mobilizing the support of significant groups within the community: notably, traditional healers and leaders, health services and poverty alleviation initiatives. Fifth, devising ways in which preschool educational opportunities can be offered to children as a prelude to their inclusion in primary schools. The review serves a further purpose. It provides an example of how public health researchers and academics could achieve more rapid implementation of evidence-based knowledge into existing and new support services through dissemination to community practitioners.

Building a communication and support network among quality improvement teams in nursing homes: a longitudinal study of the SCOPE trial

BackgroundWe applied a longitudinal network analysis approach to assess the formation of knowledge sharing and collaboration networks among care aide-led quality improvement (QI) teams in Canadian nursing homes participating in the Safer Care for Older Persons (in residential) Environments (SCOPE) trial which aimed to support unregulated front-line staff to lead unit-based quality improvement (QI) teams in nursing homes. We hypothesized that SCOPE's communicative and participatory nature would provide opportunities for peer support, knowledge sharing, and collaboration building among teams.MethodsFourteen QI teams in Alberta (AB) and seventeen QI teams in British Columbia (BC) participated in the study. Communications across nursing homes occurred through a series of 4 collaborative Learning Congresses (training sessions) over a 1-year period. The senior leaders of QI teams participated in two online network surveys about the communication/collaboration between teams in their province, 1 month after the first, and 6 months later, after the fourth Learning Congress. We developed communication and collaboration network maps pertaining to three time points: before SCOPE, at 2 months, and at 9 months.ResultsOver time, teams made significantly more new connections and strengthened existing ones, within and across regions. Geographic proximity and co-membership in organizational chains were important predictors of connectivity before and during SCOPE. Teams whose members were well connected at baseline disproportionately improved connectivity over time. On the other hand, teams that did not have prior opportunities to connect appeared to use SCOPE to build new ties.ConclusionsOur findings suggest the importance of network-altering activities to the formation of collaboration networks among QI teams across nursing homes. Active strategies could be used to better connect less connected teams and facilitate collaboration among geographically proximate teams. These findings may inform the development of interventions to leverage existing networks and provide new networking opportunities to develop and sustain organizational improvements.

Digital communication tools in family therapy: A review of opportunities and challenges for English-Speaking practitioners

Digital communication tools have revolutionized the field of family therapy, offering both opportunities and challenges for English-speaking practitioners. With the proliferation of technology, therapists have access to a wide array of platforms and applications that can enhance therapeutic interventions. However, integrating these tools into practice requires careful consideration of ethical, legal, and clinical implications. Digital communication tools offer numerous advantages for family therapy practitioners. Teletherapy platforms enable therapists to reach clients in remote locations or those with mobility constraints, expanding access to care. Video conferencing allows for face-to-face interactions, facilitating rapport building and nonverbal communication cues essential for effective therapy. Additionally, digital tools such as secure messaging apps or virtual whiteboards enhance communication between sessions, fostering continuity of care and homework completion. Online support groups and forums provide clients with opportunities for peer support and community engagement, supplementing traditional therapy approaches. Despite their benefits, digital communication tools pose significant challenges for English-speaking practitioners. Ensuring confidentiality and data security is paramount, requiring adherence to stringent privacy regulations such as HIPAA (Health Insurance Portability and Accountability Act). Therapists must navigate issues of informed consent, boundary maintenance, and emergency protocols in the digital realm. Moreover, technological barriers, such as internet connectivity issues or lack of digital literacy among clients, can hinder the effectiveness of therapy sessions. Cultural considerations also play a role, as language barriers or cultural differences in technology use may impact therapeutic engagement. Digital communication tools offer English-speaking family therapy practitioners unprecedented opportunities to enhance therapeutic interventions. However, these tools come with inherent challenges that must be addressed to ensure ethical and effective practice. By carefully navigating the opportunities and challenges presented by digital communication tools, therapists can harness the power of technology to improve client outcomes and advance the field of family therapy.

"Too Many Jobs and Not Enough Hands": Immigrant and Refugee Community Health Workers at the Frontlines of the COVID-19 Pandemic.

Refugees and immigrants have experienced heightened health inequities related to COVID-19. As community-embedded frontline health personnel, refugee and immigrant community health workers (riCHWs) played essential roles in the provision of informational, instrumental, and emotional support during the unprecedented first year of the pandemic. Despite the importance of this workforce, riCHWs are at high risk for burnout due to low recognition and demanding workloads. This was exacerbated as riCHWs navigated a new and uncertain health delivery landscape. We sought to glean insight into riCHWs' stressors, coping strategies and resources, and self-efficacy to identify ways to support their work and wellbeing. Using a narrative inquiry approach, we conducted semi-structured, in-depth interviews with 11 riCHWs working in a midsized city in the midwestern United States. We generated three distinct yet interrelated themes: (1) Rapid and trustworthy information is key, (2) Creativity and perseverance are good … structural support is better, and (3) Integrating riCHW expertise into health promotion programming and decision-making. Although riCHWs were deeply committed to enhancing community wellbeing, quickly shifting responsibilities in tandem with structural-level health inequities diminished their self-efficacy and mental health. riCHWs relied on work-based friends/colleagues for informational and emotional support to enhance their capacity to deliver services. Findings suggest increasing opportunities for peer support and idea-exchange, professional development, and integration of riCHW expertise in health promotion decision-making are effective strategies to enhance riCHWs' professional self-efficacy and personal wellbeing.

Autistic adults’ experiences of managing wellbeing and implications for social prescribing

Autistic people demonstrate poor outcomes on objective measures of wellbeing, yet research centring lived experience provides a more nuanced picture. There is growing support for person-centred, holistic and community approaches to enhancing wellbeing for autistic people. Social prescribing may be one such approach. This qualitative study explored the concept of wellbeing for autistic adults – including barriers and self-management – and the implications of this for modifying social prescribing. It involved semi-structured interviews with 21 autistic adults in the UK. Reflexive thematic analysis of the data supports research suggesting that self-determination may underlie many aspects of wellbeing for autistic people. The COVID-19 pandemic provided new opportunities to develop wellbeing strategies but also had negative impacts. Social prescribing could promote self-determination by signposting autistic people to peer support opportunities building on intrinsic interests.

Student nurses as a future general practice nursing workforce. Implementing collaborative learning in practice: implications for placement learning and patient access. A mixed methods study

BackgroundThere is a global shortage of nurses, with particularly acute shortfall in General Practice Nursing in the United Kingdom estimated at as high as 50% vacancy rate by 2031 by some sources. There has previously been reluctance for General Practices to host student nurses on placement, but it has become imperative to increase placement capacity if practices are to be able to recruit a future workforce. Collaborative Learning in Practice is a means of organising placement learning for student nurses using a coaching model, that allows for leadership development, peer support and earlier engagement in patient care, and increases placement capacity.MethodsThis was a mixed methods study using qualitative data from focus groups to evaluate the implementation of Collaborative Learning in Practice, and routinely collected audit data on numbers of clinic appointments to investigate the potential impact an increased capacity of student nurses might have on patient access to services. The aims of this study were: to implement and evaluate Collaborative Learning in Practice in General Practice Nursing settings; to explore issues of interprofessional learning; to explore patient access to services related to increased student nurse capacity.ResultsOur qualitative data indicated the following themes as important to students and staff: Peer Support; Interprofessional Learning; and the Importance of ‘own clinics’ for students to see patients. The audit data indicated that having students leading their own clinics increased the clinic numbers available by approximately 20% compared to when students were not in placement.ConclusionsThis study shows that student nurses increased clinic capacity and improved access for patients. Students valued their placement, felt that they were more ‘part of the team’ than in other placements and consequently had a greater sense of belonging. This was multifaceted, coming in part from the welcoming practice staff, in part from the opportunities for peer support engendered by the collaborative learning in practice model, and in part from the interprofessional learning opportunities available. General Practice Nursing placements for students are important for future workforce recruitment and can help meet Quality and Outcomes Framework targets for General Practices.

Experiences of implementation of the group-based adaptation training intervention for patients with chronic somatic illnesses or disabilities among multi-professional teams in specialized healthcare

Objective To describe the experiences of multi-professional teams of implementation of group-based adaptation training intervention for patients with chronic somatic illnesses or disabilities in specialized healthcare. Materials and methods Multi-professional teams (n = 7) implementing adaptation training courses for chronically ill patients in specialised healthcare were interviewed between 09/2020 and 12/2021. The themes for thematic group interviews were based on the standard protocol implementation of adaptation training in specialised healthcare, including planning, implementation and evaluation of the adaptation training courses. The interviews were audio-recorded and transcribed. The data were analysed using inductive content analysis. Results The experiences of multi-professional teams involved using pedagogical methods, providing guidance and counselling to support the rehabilitation process, ensuring opportunities for peer support, and supporting the course participants’ involvement and activities in everyday life. Conclusions Healthcare professionals should use pedagogical methods in reflective guidance and counselling to promote client-oriented approach in supporting adaptation. Their competence in pedagogy needs to be build and maintained by continuous education. Multi-professional teams need to ensure sufficient and versatile conditions for peer support and involvement of family members by creating open and trusting atmosphere, unhurried encounters, discussions, different and varying ways of working. Adaptation training can strengthen the self-efficacy of participants and help them shift their attention from illness and disability to thoughts of the future. Adaptation training can support active and meaningful daily life in a changed life situation.

“I would want to see young people working in here, that’s what I want to see…” how peer support opportunities in youth offending services can support a Child First, trauma-informed, and reparative model of practice for youth justice

PurposeThis paper aims to explore how peer support can support a combined Child First, trauma-informed and restorative approach for youth justice. While other scholars have identified clashes between these approaches, particularly between Child First and restorative approaches, a focus on reparative practice with peers has been under-explored as a more child-centred model for reparation-focused work.Design/methodology/approachWe draw on qualitative data from interviews and surveys undertaken with young people and parents/caregivers in a London youth offending service (YOS). The data was part of a broader mixed-methods study in the YOS that used observational methods alongside surveys and interviews to evaluate the effectiveness of its model of practice. Peer support emerged as a theme.FindingsParticipants expressed the desire to see young people working and volunteering in the YOS and felt this would help make it a safe and non-threatening space. Young people who had completed their time with the YOS saw themselves as role models with the insight and skills to support others. These young people expressed a strong desire to work in the YOS and, in some cases, to develop long-term careers supporting young people.Originality/valueOur research challenges the notion that young people who have been involved in crime struggle to empathise, providing rich examples of their empathic understanding for peers. Peer support opportunities could offer a reconceptualisation of restorative practice that is Child First and trauma-informed. Such opportunities would benefit both the young people being supported and those offering support, building a co-produced approach that is directly informed by the expressed needs and desires of the young people.

A qualitative analysis of how frontline homeless service workers in Texas experience burnout during the COVID-19 pandemic

ABSTRACT Frontline homeless service provision is both rewarding and challenging work. Some have raised concerns about elevated burnout risk, traumatic stress, compassion fatigue, and high levels of staff turnover in the sector. Previous research has shown that the COVID-19 pandemic exacerbated existing challenges and added new ones, such as adapting to changing public health guidance, which created particularly stressful conditions for workers and agencies. The aim of this study was to explore to what extent homeless service workers have experienced burnout during the pandemic and the primary work-based contextual factors they believe contribute to burnout. Qualitative interviews were conducted with 21 frontline homeless service workers in Texas. While all participants described some burnout during the pandemic, the severity varied. Participants’ burnout experiences aligned with the three dimensions of burnout: energy depletion, mental distancing from work, and reduced professional efficacy. Workers also pointed to multiple organization-level factors as causes of burnout during the pandemic. These included poor communication, top-down decision making, lack of organization support, reduced peer support from co-workers, and inadequate supervision. Recognizing how organizational factors can impact worker well-being, recommendations for strengthening leadership, improving supervision strategies, and creating opportunities for peer support between co-workers are offered.

Global Statements to Produce and Implement Evidence in the Post-COVID-19 Era Provide a Path Forward for Rehabilitation - A Joint Initiative of Cochrane Rehabilitation and the Leading Journals in the Field.

Global Statements to Produce and Implement Evidence in the Post-COVID-19 Era Provide a Path Forward for Rehabilitation - A Joint Initiative of Cochrane Rehabilitation and the Leading Journals in the Field.

CHALLENGES AND SUPPORTS FOR VETERAN CAREGIVERS DURING THE COVID-19 PANDEMIC: A MIXED-METHODS STUDY

Abstract Informal caregivers face challenges in supporting older or medically-complex Veterans, which could be exacerbated by the COVID-19 pandemic. Our mixed methods observational study explored Veteran caregivers’ supports, challenges, and self-identified impacts during the pandemic. Caregivers whose veterans needed help with at least one activity of daily living for the last year and received care at one of five Veterans Health Administration (VA) study sites were eligible. Survey participants (n=46) were 96% female, 32-83 years old (median 59); most (83%) cared for a spouse. A majority (67%, n=31) reported increased stress since the start of the pandemic. Top sources of increased stress included worry about COVID-19 infection, increased caregiving responsibility, delayed access to care, concerns about vaccine safety, and employment or financial concerns. Caregiver interviews (n=26) qualitatively analyzed using a rapid, templated approach identified the following themes: (1) the benefits and challenges of VA COVID precautions to Veteran care access (e.g. telehealth, getting care for new problems), (2) supports afforded by and limits of the expansion of the VA Caregiver Support Program, (3) declines in Veteran physical and cognitive functioning, (4) increased caregiver role in Veterans’ support and care, (5) changes in work and living situations to address increased caregiving needs and/or reduce risk of exposure, and (6) loss of and then return to more usual routines and social outlets amid ongoing COVID-related uncertainties. Recommendations include targeted, personalized outreach to engage caregivers in existing supports, removing barriers and streamlining processes for obtaining services, and creating durable caregiver-to-caregiver, peer support opportunities.

The Adverse Effects of Burnout and Compassion Fatigue Among Mental Health Practitioners: Self-care Strategies for Prevention and Mitigation

Over the years, a body of empiricism and conceptual frameworks has burgeoned related to the emotional toll often exacted on mental health practitioners engaged in the helping field—an emotional toll often denoted as burnout and compassion fatigue. This article delineates the concepts of burnout and compassion fatigue and their adverse, often catastrophic, effects on mental health practitioners’ personal and professional functioning when left unaddressed. The article also highlights the more recent research relating to the changes and challenges brought about by the SARS-CoV-2 (COVID-19) pandemic and its exacerbation of burnout and compassion fatigue among mental health practitioners. Finally, the article highlights practical, empirically validated, and efficacious self-care strategies for individual practitioners and organisations to utilise in preventing and mitigating the adverse effects of burnout and compassion fatigue. The latter are: walking or other forms of exercise; engaging regularly in mindfulness and meditation practices; seeking support from family and friends; engaging in pleasurable activities, such as taking a holiday and socialising; and personal psychotherapy. The top five best practice strategies for office/practice managers are: instituting reasonable working hours and caseloads for mental health practitioners; optimising working spaces and consulting rooms; providing adequate break times throughout the working day; providing ample opportunities for peer support, clinical supervision, and other debriefing initiatives; and facilitating occasional team-building and wellbeing days.

Impact of Virtual Yoga on Management of Sleep and Anxiety in Persons with Vision Impairment

The goal of this research was to assess the effects of virtual yoga on sleep and anxiety in persons with vision impairment. This study was a quasi-experimental single group design. Thirteen participants engaged in a six-week Hatha yoga experience with weekly sessions presented on a zoom platform with the recorded sessions provided to the participants after each session. Participants completed self-report assessments for sleep quality and anxiety, pre and post intervention. Wilcoxon Signed Ranks tests revealed significant improvements in both outcomes. Participants reported other positive outcomes from this experience, including opportunities for peer support, socialization, and the ability to exercise within the safety of their home environment.

Posterior Tibial Nerve Stimulation in Children with Lower Urinary Tract Dysfunction: A Mixed-Methods Analysis of Experiences, Quality of Life and Treatment Effect.

Background: Posterior tibial nerve stimulation (PTNS) is one of the treatment modalities for children with therapy-refractory lower urinary tract dysfunction (LUTD). This study used a mixed-methods analysis to gain insight into the experiences of children treated with PTNS and their parents, the effect of treatment on quality of life (QOL) and the effect of PTNS on urinary symptoms. Methods: Quantitative outcomes were assessed through a single-centre retrospective chart analysis of all children treated with PTNS in a group setting between 2016–2021. Voiding parameters and QOL scores before and after treatment were compared. Qualitative outcomes were assessed by an explorative study involving semi-structured interviews transcribed verbatim and inductively analysed using the constant-comparative method. Results: The data of 101 children treated with PTNS were analysed. Overall improvement of LUTD was seen in 42% and complete resolution in 10%. Average and maximum voided volumes significantly increased. QOL improved in both parents and children independent of the actual effect on urinary symptoms. Interviews revealed PTNS to be well-tolerated. Facilitating PTNS in a group setting led to feelings of recognition in both children and parents. Conclusions: PTNS is a good treatment in children with therapy-refractory LUTD and provides valuable opportunities for peer support if given in a group setting.

Psychosocial screening in a pediatric diabetes clinic: Adolescents' and mothers' perspectives.

Adolescents with type 1 diabetes (T1D) frequently experience psychosocial concerns, and mental health screening is becoming increasingly common in routine diabetes care. However, little is known about what adolescents or their caregivers think about the role of mental health screening and intervention within the context of comprehensive diabetes care, or how their diabetes care providers should be involved in navigating mental health concerns. This study used qualitative methods to obtain the perspectives of adolescents with T1D and their caregivers regarding these issues. Participants were 13 adolescents with T1D (ages 12-19 years; M = 15.1 years; 53.8% female; 61.5% Hispanic/Latinx White) and 13 mothers, recruited from an outpatient pediatric endocrinology clinic in South Florida, who participated in semi-structured interviews via video teleconference. Thematic content analysis was used to evaluate participants' responses. Adolescents and their mothers reported positive experiences with the clinic's psychosocial screening procedures and appreciated meeting with the psychology team during visits. They wanted the clinic to offer more opportunities for peer support. Mothers highlighted barriers to seeking mental health care outside of the clinic and the importance of mental health professionals understanding diabetes. Mothers also wanted the clinic to offer more on-site therapeutic services. Study participants valued psychosocial screening and supported addressing mental health as a routine part of diabetes comprehensive care.

"A Place to Be Heard and to Hear": the Humanities Collaboratory as a Model for Cross-College Cooperation and Relationship-Building in Undergraduate Research.

This article reports findings from a study of laboratory-styled humanities undergraduate research (UR) programming designed to increase access to this high-impact practice, better reaching historically excluded students and less visible institutions. The Humanities Collaboratory (HLAB) is a ten-week summer research program that emerged from the partnership of a research university and the area community college system. Aimed at actively addressing educational inequity, and the more specific lack of access humanities students have to impactful UR opportunities, HLAB offers an intensive humanities research experience to first-generation students, low-income students, and Students of Color currently enrolled in two-year colleges, HBCUs, MSIs, and HSIs. Since the program’s creation in 2018, qualitative data collected from 50 participating students over three years of self-evaluations illustrates why HLAB presents a significant learning opportunity for students and highlights the critical importance of relationship-building in UR. Analyzing students’ responses through the heuristic of communities of practice provides insight into a community-focused UR pedagogy that emphasizes relationality among students, mentors, and institutions. Students detail the importance of collaborative skill-building, opportunities for peer support, networking connections, and possibilities for more holistic personal growth in UR experiences. Our findings describing the benefits of relational UR signal the need for cooperative programming designs that increase access to undergraduate research for humanities students across institutions of higher education.

P169 The impact of online art therapy groups for paediatric rheumatology patients

Abstract Background/Aims In January 2020 art therapy was offered to rheumatology patients at the Great North Children’s Hospital supported by the Teapot Trust, as open groups and 1:1 ward-based interventions. However, this service was suspended due to Covid 19 restrictions. In response to these restrictions and to the needs of the patients we offered weekly online art therapy groups. Methods The rheumatology team referred patients directly to the art therapist and groups were allocated. The aim was to provide a safe space for the exploration of difficult thoughts and feelings and to give opportunities for peer support and interaction. Group members defined their own goals, including: ‘to feel less worried about medical procedures’ or ‘to feel less lonely’. Parents also identified goals, including: ‘to provide something different for their child to associate with rheumatology treatment.’ Themes brought to sessions included medical anxiety, isolation, coping with loss, feeling different, resilience, control, independence and identity. Progress in therapy was measured using Goal Based Outcomes and online surveys, allowing children to report on their own progress. Results After six sessions all group participants reported progress towards meeting their individual goals. Clinical staff shared: “the last 18 months has been challenging for our patients and the need for additional therapy cannot be underestimated”, “we have had to adapt to provide art therapy and the ease of referral has made my job easier”, “our patients have valued and enjoyed their sessions, they can connect with each other so don’t feel so isolated with their diagnosis or treatment.” Parent feedback included: my daughter “was not in a very good place, she was very down and also grieving, these sessions have been invaluable to her, she has gained a lot of confidence in talking about her feelings and expressing them through art has been a great help.” My child “has been able to speak to other children like herself. To make friends and to open up a bit more.” “I have been surprised by how much of what they put down on paper was about the hospital. These are things that they don’t talk about and it has been an eye opener for me.” Patient's feedback included: it was important “to discuss my feelings in a safe environment without anyone thinking they were silly”, “Thank you for helping me express my feelings and have confidence to speak out”. Conclusion Offering art therapy online creates a forum for sharing experiences and developing a community. It has shown a positive impact on the wellbeing of the patients and their carers. In response to the positive feedback, the service will continue on a rolling basis. Disclosure M.H. Keane: None.

Regulating emotional responses to aphasia to re-engage in life: a qualitative interview study.

BackgroundPeople with post‐stroke aphasia (PWA) are more likely to experience serious mood disorders compared with those without. Emotional regulation may be important for influencing life participation after stroke. Understanding emotional regulation in the context of aphasia is important for promoting personally defined recovery, psychological well‐being and life participation.AimsTo explore how individuals experience and regulate negative emotional responses to aphasia as part of re‐engaging with life.Methods & ProceduresIn‐depth semi‐structured qualitative interviews with 14 PWA were conducted. The focus and design were developed with public and patient involvement contributors. Reflexive thematic analysis was applied.Outcomes & ResultsAnalysis generated three themes, which captured inherent diversity across participants in terms of emotional experiences, responses and regulation strategies: (1) emotional upheaval at all stages of recovery; (2) regulating emotional upheaval; and (3) discerning possibilities for life participation. Emotional regulation occurred both within and without the context of formal support services.Conclusions & ImplicationsIndividuals may be differently (en)abled in responding positively, with implications for aphasia psychological support and self‐management interventions. The findings may inform future interventions to optimize well‐being and personally meaningful outcomes for PWA.WHAT THIS PAPER ADDSWhat is already known on the subject PWA experience significant psychosocial upheaval and are at risk of mood disorders. Emotional regulation may be important for influencing one's emotional state, social participation and relationships after stroke. There is a need to better understand the ways in which PWA experience and regulate their emotions to develop better support for personally defined recovery. What this paper adds to existing knowledge PWA may experience significant and pervasive mood disorders in the long term after stroke. This may be compounded by worries for their children's well‐being. Some, but not all, regulate emotions by drawing on positivity, determination, gratitude or stoicism. Having (supportive) opportunities to experience the impact of aphasia is important for discerning helpful strategies and participation opportunities. What are the potential or actual clinical implications of this work? Confronting altered abilities requires supportive, responsive opportunities sensitive to emotional responses. Opportunities for peer support and/or meaningful emotional support and compassion from family and friends are important therapeutic targets. Therapeutic input should pay attention to any familial and parenting concerns that may be compounding low mood. Although emotional regulation and recovery may occur without formal support, mental health services must be organized in such a way that PWA can access as needed.

The MI-PHOTOS Project: Understanding the Health and Wellbeing of Rural Historically Marginalized Mothers Through Photovoice.

Despite the persistent health inequities faced by rural women in the United States, few researchers have partnered with women in rural communities to co-create sustainable change. To fill this gap, Mothers Improving Pregnancy and Postpartum Health Outcomes Through stOry Sharing (MI-PHOTOS) employed a community-based participatory research (CBPR) approach by partnering with mothers, community leaders, and community-based organizations in Robeson County, North Carolina, a rural, racially diverse county. The project's aims were (a) to promote maternal health by listening to mothers' stories of having and raising children in their community and (b) to develop a shared understanding of these mothers' strengths and challenges. MI-PHOTOS utilized photovoice, an exploratory and qualitative CBPR methodology. Grounded theory guided data analysis. During photovoice discussions, conversation focused on maternal experiences and evoked strengths, facilitators, and barriers impacting maternal health. Themes focused on (a) MI-PHOTOS serving as a social support group for the community and family stressors that mothers faced and (b) the necessity of professional support programs. Three overarching findings emerged during this process: (a) MI-PHOTOS as an informal support group, (b) mental health stigmatization, and (c) the need to bridge home visiting programs with peer and confidential therapeutic services. Future work should incorporate mothers' and communities' strengths into program development by drawing on existing home visiting programs, identifying opportunities for peer-support, and creating referral networks for individual, confidential therapeutic services. Through continued community partnership, we can generate fuller understandings of mothers' experiences of having and raising children and ultimately promote health equity among rural mothers.

What Promotes healing among the wrongfully convicted? Results from a qualitative study of exonerated persons in California

Background: Exonerees are individuals who have been wrongfully convicted of a crime. Later found innocent and released from prison, exonerees often spend decades incarcerated. While limited, research suggests that the unique trauma of wrongful conviction has profound adverse mental health implications which challenge reintegration, well-being and healing. In this study we examined exoneree perceptions of their mental health and coping mechanisms used to support healing. Methods: We conducted a qualitative study utilizing a phenomenological approach to examine shared coping and healing mechanisms among exonerees. Twelve California exonerees participated in semi-structured interviews describing their experiences with coping and healing due to wrongful conviction. Interviews were audio recorded and transcribed, transcripts were coded with a hybrid coding scheme utilizing a thematic analysis. Results: Overall findings underscore the lifelong trauma and subsequent adverse mental well-being among wrongfully convicted exonerees, framed in association with depression, anxiety, post-traumatic stress disorder (PTSD) and hypervigilance. Three areas emerged as valuable coping mechanisms for exonerees that support a pathway toward healing: 1) Peer support and building community with other exonerees through organized meetings (convenings and healing circles); 2) Community education to build community awareness through storytelling; and 3) Advocacy engagement in the wrongful conviction movement and criminal justice reform. Conclusions: Complementing comprehensive mental health services with opportunities for peer support, advocacy, and community education through storytelling may help exonerees regain lives lost to their wrongful convictions.