Peer Providers Research Articles

Mental Health Conditions Between Neurodiversity and the Medical Model

Scholarship in neuroethics and related disciplines has long reflected on the value of different conceptual models of disability and impairment. While this theoretical work is valuable, centering the voices of people with mental health conditions in neuroethics research can help us better understand how such models apply in everyday people’s lives. Drawing on qualitative data from a study on mental health peer providers’ lived experiences of recovery, this paper will demonstrate that peers borrow from both a neurodiversity framework and the medical model of disability, though their feelings toward the two models were often complex and ambivalent. These findings advance neuroethics by indicating that future research and clinical practice should take a nuanced approach to responding to the needs of people with mental health conditions and turn to peers as experts, honoring their values and recognizing both the promise and pitfalls of living with a mental health condition.

Enabling Sustainable Energy Communities in ASEAN: A Systematic Approach to P2P Energy Transactions on Matakus Island Using IoT and Blockchain

Abstract This paper addresses the need for energy diversification and sustainable development in the ASEAN region by proposing a decentralized peer-to-peer (P2P) energy trading system. PowerChain, a peer-to-peer energy trading platform, is tailored as the designated medium for implementation. PowerChain harnesses the capabilities of blockchain technology and utilizes MQTT and HTTP protocols to ensure security, transparency, and user-IoT interaction. A case study was conducted on Matakus Island, a rural area in Indonesia with high solar power generation potential and a suitable demographic for the study. Currently reliant on diesel-based power generation, the island serves as an ideal location to evaluate the feasibility and benefits of transitioning to a RE-based P2P energy trading system. Based on simulations using 2 types of load and generation from peer providers, it was found that unused energy for type 1 was 815.9 kWh/year and for type 2 was 821.05 kWh/year. So the total unused energy from 10 peer providers on Matakus Island that can be transacted on the Powerchain platform is 1,636.95 kWh/year. This energy can meet the needs of Matakus Island for 93.7 days.In the platform simulation, three experiments were carried out, namely, single type transactions, multiple type transactions, and rejection of energy requests. From these three experiments, Powerchain was able to perform well, where the seller was successfully selected based on the closest distance, and if the closest selection could not be fulfilled, the seller would come from several nearby buyers. And when a selected peer is rejected, the existing algorithm can search for and select a replacement peer.The integrated approach presented in this study demonstrates the viability of using IoT and blockchain technologies to transform the energy market structure and accelerate the transition towards cleaner and more efficient energy systems in ASEAN.

Perspectives and Experiences of Stakeholders on Self-Disclosure of Peers in Mental Health Services.

With the movement towards recovery-oriented mental health (MH) services, individuals with MH lived-experience are increasingly employed as peer providers (peers). Peers are unique in that they bring knowledge from experience and eye-level connection to service users that enhance the quality of services and humanize MH systems' culture. In Israel, hundreds of peers are employed in various roles and settings across the MH system. However, peer integration into MH services faces challenges. One issue involves the use of self-disclosure (SD) in MH services which varies with explicitness across roles and settings. This study sought to understand perspectives and experiences regarding peers' SD (use & sharing of knowledge from experience) among different stakeholders in MH health services. Six focus groups and 4 semi-structured interviews (N = 42) were conducted as a part of a larger international project (UPSIDES; ERC Horizon 2020, Moran et al., Trials 21:371, 2020). Data was transcribed verbatim and analyzed using thematic analysis. Four categories and 7 themes were identified regarding current perspectives and experiences with peers' SD in MH organizations: (i) Restrained or cautious organizational approach to SD; (ii) Attitudes of peers to SD approach; (iii) The influence of designated peer roles on SD; and (iv) Unwarranted SD of peers working in traditional roles. The findings reveal that peers' SD in MH services is a complex process. Organizationalapproaches were often controlling of non-designated peers' SD practices; participants had diverse attitudes for and against peers' SD; SD occurred according to personal preferences, specific peer role and the director's approach to peers' SD; Conflictual SD dilemmas emerged in relation to service users and staff. SD sometimes occurs unwarrantely due to ill mental health. The presence of peer-designated roles positively impacts peers' SD. We interpret thecurrent mix of views and general conduct of peer SD practice in statutory MH services as related to three aspects: 1. The presence of a traditional therapeutic SD model vs. a peer SD model - with the former currently being dominant. 2. Insufficient proficiency and skill development in peers' SD. 3. Stigmatic notions about peer SD among service users and staff. Together, these aspects interrelate and sometimes create a negative cycle create tension and confusion.A need to develop professionalism of peer SD in statutory services is highlighted alongside enhancing staff and service user acknowledgement of the value of peer SD. Developing peer-designated roles can positively impacts peer SD in MH statutory services. Training, support, and organizational interventions are required to further support for peer-oriented SD and the enhancement of a person-centered and recovery orientation of MH services.

Relational Complexity of the Near-Age Peer Support Provider Role in Youth and Young Adult Community Mental Health Settings.

Increasingly, US community mental health settings are integrating professional near-age youth peer support providers to improve youth service engagement and outcomes. Youth peer specialists (YPS) use their lived and living experiences with a mental health diagnosis to validate, empathize, and provide individualized support, while also improving their program's overall responsiveness to young people's needs. Although promising, these roles tend to lack clarity-responsibilities vary immensely, and turnover is high. Examining near-age youth peer on-the-job experiences is needed to design effective on-the-job supports. Using community-based participatory action research methods, young adults with lived experience worked in partnership with a PhD-level qualitative researcher to design, recruit, conduct, and analyze in-depth-interviews with current and former near-age youth peer providers. Ten young adult peer mentors in Massachusetts completed interviews that revealed near-age youth peer role relational complexity. Five relational aspects were identified requiring relational practice skills and self-awareness, including relationships with (1) self, (2) clients, (3) supervisors, (4) non-peer colleagues, and (5) other near-age peer providers. Near-age peers experience relationship-related struggles with non-peer identified colleagues who do not understand nor value the near-age peer role. Findings expand on current near-age peer practice and associated on-the-job challenges. Training, supervision, and professional development activities that target these five relational areas may improve YPS on-the-job wellbeing, decrease YPS turnover, and improve youth client outcomes.

הערכת יישום פרויקט UPSIDES ("אפסיידס") בישראל: מסקנות לקידום יישום מיטבי של תמיכת עמיתים בשירותי השיקום בבריאות הנפש בישראל

Background: Over the last few decades there is an increasingly heavy burden on mental health (MH) in Israel and around the world. Peer providers are a relatively new and contributing service. Peers integrate into the rehabilitation system alongside various professionals, including occupational therapists. When optimally integrated into MH services, peers can support service users' recovery, benefit their own recovery, and promote a recovery and person-centered orientation in MH organizations. However, there are multiple implementation challenges which make peer contribution somewhat questionable. UPSIDES – an international project aims to enhance and scale up implementation of peer support in five countries across Europe, Africa, and Asia. As part of this program, a peer support intervention was developed and implemented in two mental health rehabilitation organizations in Israel. The aim of the study: To examine the implementation process of peer support within UPSIDES project in Israel. Research method: Participatory action research using a qualitative method that focuses on implementation evaluation. Twenty six interested parties participate in 4 focus groups and 6 interviews, following the UPSIDES intervention implementation. A qualitative thematic analysis was performed based on the CFIR framework, using MAXQDA 2020 software. Findings: UPSIDES provided a comprehensive response to implementation of peer support addressing most challenges previously identified. However, 4 challenges emerged: (i) being positioned in a dual role: traditional and peer-designated role in the same organization, (ii) maximizing impact on the organization, (iii) adequate staff training, and (iv) the sustainability of the intervention. Conclusions and implications for practice and policy: The remaining challenges highlight that in order to promote a recovery and person-centered orientation in MH organizations and sustainable peer roles, there is a need for professional training and guidance throughout the implementation processes across all levels of the organization. More specifically if is recommended to encourage direct exposure of teams to peer roles and newly developed governmental policies, fund and enforce designated peer roles, advance peer training and certification processes, alongside education and training for organizations.

Use of volunteers in early years interventions for parents: A scoping review of roles and the extent of evaluation research in this area.

Early years interventions, particularly those supporting parents in the first 1001 days of their infants life, support healthy development of infants and prevent adverse experiences that can have long term negative impacts. Volunteers are often used to deliver such interventions. This scoping review aimed to explore the roles and characteristics of volunteers across early years interventions and map the evaluation in this field to identify gaps in the literature. A scoping review was conducted according to the Arksey and O'Malley Framework. Academic databases and grey literature sources were searched to identify literature evaluating volunteer-based interventions for parents in the first 1001 days of their infant's life (conception to aged two). Research conducted in the UK or comparable high-income countries since the year 2000 were identified and data relating to the volunteer role, intervention design and evaluation methods were mapped. Sixty-six articles were eligible for inclusion in the review. Volunteers were commonly involved in interventions to provide peer support for a range of parenting related matters, support breastfeeding and the mental and emotional wellbeing of parents. Volunteer roles were categorised based on their background (peers or non-peer volunteers), their responsibilities (provider of peer support, educator or providers of practical support) and the delivery style of their role (in person one to one support, group leader or remote support). Research most often involved exploring the experiences of those involved in receiving or delivering the interventions and measuring outcomes in relation to breastfeeding and parent mental wellbeing. Volunteers play a large role in the provision of early years interventions. Their varied contribution is presented through a typology that will allow comparisons of roles in future research. Further research exploring the impact on the volunteers and the organisation will support decision making around choosing a volunteer led model within early years services.

Perceptions of youth-friendly sexual and reproductive health services in selected Higher and Tertiary Education Institutions of Zambia: A qualitative study on the perspectives of young people and healthcare providers.

The recognition of the need for Adolescent and Youth-Friendly Health Services (AYFHS) is growing. It is important to ensure the provision of high-quality sexual and reproductive health (SRH) services that cater to the unique needs of adolescents and young people (AYP). Adolescents and young people spend a significant amount of time in Higher and Tertiary Education Institutions (HTEIs) where adolescent friendly services are needed. However, there is limited evidence on the availability of sexual and reproductive health services for young people in HTEIs in Zambia. Using the Human Rights Based Approach to healthcare availability, accessibility, acceptability, and quality of care (AAAQ) framework, this study explores young people's perceptions of youth-friendly sexual and reproductive health services in selected HTEIs in Zambia. Between March and June 2021, a qualitative case study was conducted in 12 selected HTEIs located in Lusaka, Central, and Copperbelt provinces of Zambia. The study employed In-depth Interviews (IDIs) and Focus Group Discussions (FGDs) with AYPs, as well as Key-informant Interviews (KIIs) with healthcare providers. The healthcare providers at health facility, district and provincial levels were interviewed to provide insights about the services provided in the HTEIs. A total of 112 interviews were conducted. Data analysis was performed using thematic analysis in NVivo version 11. In the study, young people reported the availability of primary health services like malaria, HIV, and pregnancy testing, as well as screening for STIs. However, their awareness of SRH services was limited. Contraception, STI testing and treatment, and HIV and pregnancy screening and testing were the most accessed services. Equipment and commodity shortages were common, hindering care provision. Young people found healthcare services in educational institutions inaccessible, with limited comprehensive care and understanding from providers. Services lacked tailoring for key populations and privacy/confidentiality. Health care providers also reported inadequate youth-friendly spaces, equipment, medication and trained workers which compromised the quality of care. Peer educators and provider training were seen as essential for improving accessibility and acceptability of services. The findings indicate significant barriers to the accessibility, availability, and acceptability of SRH services for AYP in HTEIs in Zambia. There is a pressing need to enhance AYSRH programming by increasing awareness of services and ensuring their availability and accessibility for young people. Sufficient funding for AYFHS can address challenges related to service quality, including inconsistent availability of medical equipment and supplies. Building the capacity of service providers can potentially enhance the uptake of services by AYP. It is crucial to target services to address the specific vulnerabilities of students with disabilities and key populations, aligning with the goal of achieving universal health coverage and leaving no one behind.

Feasibility and acceptability of a peer provider delivered substance use screening and brief intervention program for youth in Kenya

BackgroundYouth in sub-Saharan Africa are at high risk of substance use yet lack access to substance use interventions. The goal of this project was to evaluate the feasibility and acceptability of a peer-delivered, single-session substance use screening and brief intervention program for youth in Kenya.MethodsThis was a convergent parallel mixed methods study utilizing both quantitative and qualitative approaches. Two trained peer providers administered the screening and brief intervention program to 100 youth aged 15–24 years. To evaluate the implementation of the intervention, we collected quantitative and qualitative data. Feasibility and acceptability were quantitatively assessed using the Dissemination and Implementation Measures. Fidelity was assessed by rating all 100 audio-recorded sessions using a checklist. To obtain qualitative feedback on the intervention, we conducted five focus group discussions with 25 youths and six semi-structured interviews with two peer providers and four clinic leaders. The semi-structured interviews were guided by the Consolidated Framework for Implementation Research. Quantitative data was analyzed via descriptive statistics using STATA. Qualitative data was analyzed using thematic analysis with NVIVO.ResultsThe lifetime prevalence of any substance use was 50%. The mean level of acceptability of the intervention from the perspective of the youth was 3.53 (SD 0.15), meaning that the youth found the intervention to be acceptable “a lot” of the time. Mean levels of implementation outcomes (acceptability, adoption, Acceptability, Appropriateness, Feasibility, Reach/access, Organizational climate, General leadership skills, and Sustainability) as rated by peer providers and clinic staff ranged between 2.61 (“a moderate amount”) and 4.0 (“a lot”). In qualitative data, youth reported that the intervention was helpful and useful in enabling them to stop or reduce substance use. The peer providers felt that the intervention was easy to implement, while the clinic leaders felt that available resources were adequate, and that the intervention aligned well with the goals of the clinic.ConclusionOur findings suggest that the peer-delivered screening and brief intervention program was perceived as acceptable to the youth and feasible to implement.Trial registrationNCT04998045 Registration date: 10/08/2021.

Peer PrEP referral + HIV self-test delivery for PrEP initiation among young Kenyan women: study protocol for a hybrid cluster-randomized controlled trial

BackgroundOral HIV pre-exposure prophylaxis (PrEP) for HIV prevention is highly effective, but uptake remains low in Africa, especially among young women who are a priority population for HIV prevention services. HIV self-testing (HIVST) has been proven to increase HIV testing in diverse populations but has been underutilized to support linkage to HIV prevention services. Most young women who initiate PrEP in Africa do so through informal peer referral. We wanted to test a model of formalized peer referral enhanced with HIVST delivery among young Kenyan women.MethodsThe Peer PrEP Trial is a two-arm hybrid effectiveness-implementation cluster-randomized controlled trial being conducted in central Kenya. Eligible participants (i.e., peer providers, n = 80) are women (≥ 16–24 years) refilling or initiating PrEP at public healthcare clinics who can identify at least four peers who could benefit from PrEP and not enrolled in another HIV study. Peer providers will be 1:1 randomized to (1) formal peer PrEP referral + HIVST delivery, where they will be encouraged to refer four peers (i.e., peer clients, ≥ 16–24 years) using educational materials and HIVST kits (two per peer client), or (2) informal peer PrEP referral, where they are encouraged to refer four peer clients using informal word-of-mouth referral. In both arms, peer providers will deliver a standard PrEP referral card with information on nearby public clinics delivering PrEP services. Peer providers will complete surveys at baseline and 3 months; peer clients will complete surveys at 3 months. Our primary outcome is PrEP initiation among peer clients, as reported by peer providers at 3 months. Secondary outcomes include PrEP continuation (any refilling), HIV testing (past 3 months), sexual behaviors (past month), and PrEP adherence (past month) among peer clients, as reported by both peer providers and clients at 3 months. Implementation outcomes will include participants’ perceived acceptability, appropriateness, and feasibility of the intervention as well assessments of the intervention’s fidelity and cost.DiscussionEvidence from this trial will help us understand how HIVST could support health systems by facilitating linkage to PrEP services among young women who could benefit in Kenya and similar settings.Trial registrationClinicalTrials.gov NCT04982250. Registered on July 29, 2021.

The Role of Peer Providers to Scale Up Psychological Treatments for Perinatal Populations Worldwide.

Psychological treatments remain largely inaccessible to perinatal populations despite their robust effectiveness. This gap ispartly due to the limited numberof available treatment providers. In this review, we critically evaluate recent literature on task-sharing to peer providers and propose future directions. There is a growing evidence base demonstrating that peer providers can effectively deliver psychological treatments for perinatal populations, as well as engage in processes critical to quality assurance, such as measurement-based peer supervision. Findings have also highlighted some benefits of peers over licensed healthcare providers, such as enhanced collaborative relationships, reduced stigma, provision of social comparisons, and increased accessibility. Peer providers may be one solution to improve access to psychological treatments for perinatal populations. However, there is a need to address clinical, professional, and health-system level barriers to effectively leverage this cadre of treatment providers.

Better Together: acceptability, feasibility and preliminary impact of chronic illness peer support groups for South African adolescents and young adults.

Peer support can help navigate the isolation and psychological strain frequently experienced by youth living with chronic illness. Yet, data are lacking on the impact of providing support for youth living with mixed chronic conditions. We assessed the acceptability, feasibility and preliminary mental health impacts of a clinic-based peer support group for South African youth living with chronic illnesses, including HIV. This mixed-methods pilot study (September 2021-June 2022) enrolled 58 young patients, ages 13-24, at an urban hospital in Cape Town, South Africa. In-depth interviews elicited the perspectives of 20 young people in relation to their participation in the Better Together programme, a recurring clinic-based peer support group for patients with mixed chronic illnesses. Self-reported resilience, attitudes towards illness, stigma and mental health were captured via established measures. T-tests and multivariate analysis of variance compared psychosocial outcomes for 20 group participants and 38 control patients, controlling for socio-demographic characteristics at enrolment. Logistic regression analyses estimated the predicted probability of a positive depression or anxiety screening given peer group participation. All interviewees valued being able to compare treatment regimens and disease management habits with peers living with different conditions. Adolescents living with HIV stated that understanding the hardships faced by those with other conditions helped them accept their own illness and lessened feelings of isolation. Compared to patients who did not participate in Better Together, those who attended ≥5 groups had statistically significantly higher individual-level resilience, a more positive attitude towards their illness(es), lower internalised stigma and a more positive self-concept. The probability of being screened positive for depression was 23.4 percentage points lower (95% CI: 1.5, 45.3) for Better Together participants compared to controls; the probability of a positive anxiety screening was 45.8 percentage points lower (95% CI: 18.1, 73.6). Recurring, clinic-based peer support groups that integrate youth living with HIV and other chronic diseases are novel. Group sustainability will depend on the commitment of experienced peer leaders and providers, routine scheduling and transportation support. A fully powered randomised trial is needed to test the optimal implementation and causal mental health effects of the Better Together model.

Service exchange activities in the sharing economy: Professional versus amateur peer providers

Motivated by the need to enhance customer relationship management in the sharing economy, this paper identifies and explains heterogeneity in the service activities of different peer providers. Drawing on social exchange theory and using data gathered from 3027 properties on a Chinese online home-sharing platform, we compare different peer providers' use of economic and social exchange activities and explore the differential impacts of these exchange activities on customers' response behaviors. The results demonstrate that professional hosts place more emphasis on economic exchange activities (i.e., pricing and service response), while amateur hosts focus on social exchange activities (i.e., social interaction and customer-perceived social belonging) more strongly. Both economic exchange and social exchange activities have significant effects on customers' purchasing behaviors, but only social exchange activities have significant effects on customers' cleaning behaviors. Furthermore, collaborative rule depth has significant moderating effects on relationships between these exchange activities and customers' response behaviors. This paper contributes theoretically to discussions of peer-provider heterogeneity, service exchange activities, and governance in the sharing economy. We discuss the implications of our findings for sharing economy platforms and peer providers—for example, specifying when rule customization might be used most effectively.

Co-production in syringe service programs: Implementation in a changing organisational field

Co-production in the human services is a way of working that includes the expertise of service users in service implementation. While co-production is often considered a net positive for the co-producing organisation, this can depend on how, with whom, and to what extent co-production is conducted. This study uses qualitative interview data from 26 employees at syringe service programs (SSPs) in a midwestern US state to examine how SSPs implement co-production, and how this challenges or maintains current power dynamics. As the structure of SSPs has been changing from a grassroots, peer-based model to one that includes the expertise of professional medical staff, it is important to consider what these changes might mean for co-production in the field. SSPs have a rich history of being peer-led, and this project uses interviews with SSP staff to determine how the transition into professional and bureaucratic organisations has affected co-production, and in turn, organisational power dynamics. Findings show that respondents reiterate the importance of co-producing services, although there are significant challenges in implementing co-production in an equitable and liberatory way. Staff (both peer providers and non-peer providers alike) remain enthusiastic about the role that peers play in the organisation and are able to acknowledge barriers in collaborative efforts. Implications for the use of co-production in rapidly changing fields is discussed.

Mothers with Intellectual/Developmental Disabilities and Behavioral Health Conditions and Community Experts Provide Recommendations for Treatment/Services, Systems, and Research.

Mothers with intellectual and developmental disabilities (IDD) are vulnerable to perinatal complications and adverse outcomes. Their vulnerabilities may also be exacerbated by co-occurring behavioral health (BH) conditions. Their wellbeing may be compromised by a lack of tailored treatments or by treatments and services that are inaccessible, irrelevant, and/or ineffective. A five-session virtual Ideas Lab workshop series was implemented to bring together diverse community experts (n = 30), including mothers with IDD/BH, to discuss the experiences of mothers and set priorities for treatment/services, systems, and research. Participants completed background and evaluation surveys and brainstormed, grouped, and ranked items of importance, which fell into two broad categories: (1) cross-cutting themes drawn from lived experience with recommendations applicable to all substantive domains (i.e., accessibility, diversity, adverse experiences and trauma, and trust) and (2) substantive themes with specific recommendations for treatment/services and systems (i.e., services and supports, peer support, provider practices and training, and systems navigation/transformation). Research recommendations were generated in all discussions and emerged in relation to all themes, underscoring the importance of including mother-driven questions and priorities in research agendas and strengthening researcher training and skills to engage mothers with IDD/BH and other community members actively, and in meaningful ways.

'Being a part of something': Experiences and perceived benefits of young adult peer mentors with intellectual/developmental disabilities and co-occurring mental health conditions.

Peer-provided services are a common model for addressing mental health concerns. Peer providers report a range of benefits and challenges associated with their role. However, there is little information about the experiences of peer providers with intellectual/developmental disabilities. To explore the experiences of young adult peer-providers with intellectual/developmental disabilities in the context of a mental health intervention. We conducted interviews with four young adults with intellectual/developmental disabilities and their parents and teachers to understand their experiences providing a peer mentoring mental health intervention. Young adult peer mentors perceived themselves as responsible for maintaining the mentoring relationship, delivering the intervention and acting as helpers and independent professionals. The experiences of young adult peer mentors were driven by the temporal, institutional and social contexts of their work. Peer mentoring was an enjoyable, social activity. Mentors, parents and teachers emphasised how taking on the peer mentoring role during the transition to adulthood and within the capital-rich university context led to a sense of pride and professional development. Further, these contexts may have led mentors to emphasise their intervention-delivery, helper and professional roles over relationship maintenance. Context may shape the perceived roles and benefits for young adult peer mentors with intellectual/developmental disabilities.

Exploring driver and user perspectives of service quality in sharing economy transport platforms

With the rise of the sharing economy, companies such as Uber have emerged as an alternative to traditional transport methods. Digital sharing economy platforms enable the encounter of two types of ‘users’: peer providers (i.e. drivers) and travellers (commonly referred as users). To acknowledge the needs of both the user and the provider, we must understand their perceptions of service quality (SQ) in this new context. However, existing research about SQ in platform-based transport focuses only on the users’ perspective. Given that peer providers are an essential part of peer-to-peer transport services, this exploratory study aims to capture the perceptions of SQ from the perspective of users and drivers. Relying on service quality theory, two quality assessment scales are designed for the users and the providers, respectively. Based on the data obtained from 646 users and drivers, Structural Equation Modelling (SEM) is used to validate the proposed scales. This study contributes to the literature of quality management in the sharing economy and provides valuable insights for platform managers.

A Turn of the Tables: Psychological Contracts and Word of Mouth about Sharing Economy Platforms When Consumers Get Reviewed

Abstract The Peer-to-Peer sector of the sharing economy relies on reputation systems through which consumers and providers review each other. Whereas prior research has examined the effects of reviews by consumers on providers and firms, this research examines, for the first time, a turn of the tables in which consumers are evaluated. Across a pilot and seven studies (five preregistered), using multiple actual behaviors and sharing contexts, results reveal that a negative review of the consumer from the peer provider leads to negative word of mouth (NWOM) about the platform. Drawing from psychological contract theory, the research demonstrates that this effect is mediated by consumers' perceived betrayal by the platform. Two sets of moderators are identified. The first set establishes that a breach of consumers' psychological contract with the platform underlies the effect. In the second set, platform policies that may render a breach more or less consequential can intensify or mitigate consumer reactions. Specifically, making the review private (vs. public) and providing opportunities for justice restoration (response, revenge, and dispute) attenuate the effect of review valence on betrayal and NWOM. Implications for sharing economy platform managers and consumers are discussed.

"Getting the Staff to Understand It:" Leadership Perspectives on Peer Specialists Before and After the Implementation of a Peer-Delivered Healthy Lifestyle Intervention.

Over the past two decades, there has been increased recognition of the effectiveness of peer delivered services, with prior research highlighting the benefits for both recipients of peer services and peer providers. Despite this, peer specialists report challenges to their work such as experiencing stigma associated with their role and difficulty integrating into a non-peer dominated workforce. The study sought to explore the perceptions of agency leadership from three supportive housing agencies regarding peer specialists and peer-delivered services within their organization before and after a peer-led intervention to promote healthy lifestyles for people with SMI. Semi-structured qualitative interviews were conducted with agency leadership and analyzed using a content analysis approach. Findings from this study contribute to the literature on the peer specialist workforce by identifying factors (e.g., agency's prior experience employing peer specialists) and potential strategies (e.g., exposure to peer services) impact the level of workplace integration of peer specialists.

Shared Decision Making and Peer Support: New Directions for Research and Practice.

Shared Decision Making and Peer Support: New Directions for Research and Practice.

Working With Survivors of Human Trafficking: Results From a Needs Assessment in a Midwestern State, 2019.

While the needs of human trafficking survivors have been documented in the academic discourse, the saliency of such needs is understudied. This study aimed to reveal the critical needs of service provision for human trafficking survivors in a Midwestern state as perceived by multidisciplinary service providers. Targeting health care, social service, law enforcement, public health, and other service providers involved in anti-human trafficking service delivery, we disseminated a survey using purposive and snowball sampling. Drawing from survey responses collected in 2019 from 107 service providers working with 422 survivors of human trafficking in the previous 12 months in a Midwestern state, we examined the saliency of needs from the perspective of service providers in the health care, criminal justice, and social service sectors. Respondents indicated on a Likert scale (1-5) the level of need for 37 social, health care, and legal services in their communities. The top-indicated needs statewide were mental health care, shelter/housing, peer mentorship programs, legal services, transportation, and provider training in juvenile courts, schools, law enforcement, and health care settings on human trafficking. The results suggest the need for statewide responses, such as legal assistance networks, telemental health options, and enhanced training collaborations between interpersonal violence and anti-human trafficking service providers. The study findings are generalizable beyond the study site in 3 ways that can guide strategic action: (1) they provide a framework for state-level analysis and strategic planning that parallels the results; (2) they show that regional variation is possible and should be accounted for in state-level study design, analysis, and strategic planning; and (3) the implications for housing assistance, legal assistance, mental health/substance use disorder-related health care, and training are scalable.