Peer Support System Research Articles

Recreational Therapists and the Duty of Care

Background: A variety of residential and experiential therapeutic programs exist for youth who experience emotional, behavioral, or substance abuse problems that are not adequately responsive to traditional treatment options. While evaluations of programs are available in the literature, investigation of the experiences of professionals who undergird these programs and oversee reentry of youth back into their communities is lacking. Purpose: The research reported here aimed to explicate the experiences of recreational therapists. Methodology/Approach: Qualitative design was used to collect and analyze data. Semistructured interviews were employed, and data were analyzed by content analysis. Findings/Conclusions: Findings indicated recreational therapists were optimistic, intrinsically motivated to spend time outdoors, became personally invested in their work and experienced personal growth from their work. They required additional systems of support and guidance to effectively counter compassion fatigue and associated burnout. Measures for organizations to effectively counter compassion fatigue through enhancement of peer support systems and self-care guidance are needed. Implications: The results provided insight into the characteristics, needs, and experiences of recreational therapists who work with high-promise youth. Further, the work provided a proposed change to current models of compassion satisfaction and compassion fatigue subscale interactions in this population.

The effects of participation in hearing voices groups on components of mental health recovery: an exploratory comparative study

ABSTRACT Background Hearing Voices Groups (HVGs) are a peer support system for people with acoustic-verbal hallucinations. Few empirical studies have assessed their effectiveness. The main objective of this study is to evaluate a wide range of effects of HVGs and to compare them to those of regular therapeutic groups. Method This comparative study is based on the responses of 20 French-speaking voice- hearers to an original self-administered questionnaire on the effects of their participation in a HVG in addition to a recovery assessment, the STORI. Our control group is composed of participants in Metacognitive Training programs (MCT, n = 14). Results Results show a good homogeneity between the two populations in terms of sociodemographics, diagnosis, care pathways, and stages of recovery. The averages of the total satisfaction scores are very similar (162.15/230 for the HVG and 165.28 for the MCT groups) and indicate a very positive appraisal. Some differences can be observed in the type of benefits derived. Discussion HVGs can be considered as settings that favour recovery and could have a complementary role, especially for users who would otherwise tend to leave or avoid the conventional field of psychiatric treatment.

Building a Culture of Support at a Pediatric Surgery Center Through Multidisciplinary Peer Support

IntroductionSurgeons and perioperative staff experience high rates of burnout manifesting as exhaustion, depersonalization, and lack of achievement. Consequences include increases in errors and adverse patient events. Little data exist regarding the effectiveness of multidisciplinary peer support systems in combatting burnout. We sought to improve staff morale through establishment of a formally trained, multidisciplinary peer support team. MethodsSelfselected surgeons, anesthesiologists, and nurses were formally trained as Peer Responders as part of an institutional peer support program. All perioperative staff at our pediatric surgery center (n = 120) were surveyed before initiation of the program and then 1-mo and 12-mo after initiation. Primary outcomes were unit morale, unit support, and peer approachability. Kruskal–Wallis tests and Chi-squared tests were used for comparison of primary outcomes among surveys and by position with an alpha value of 0.05 set for significance. Institutional review board approval was waived. ResultsThe survey response rates were 57.5%, 32.5%, and 37.5% chronologically. After 1 year, there were statistically significant increases in unit support (P < 0.01) and peer approachability (P < 0.001), and a nonstatistically significant increase in unit morale (P = 0.22). On subgroup analysis by staff role, surgeons were least likely to utilize peer support. ConclusionsA multidisciplinary peer support team is an effective and easily reproducible means of building a culture of support and improving morale among perioperative staff. Surgeons were least likely to seek interprofessional peer support. Consequently, surgeon-specific strategies may be necessary. Further investigations are ongoing regarding secondary effects on staff burnout rates, patient safety, and quality of care.

Friends, peers and safeguarding

Friends, peers and safeguarding

Feasibility testing of a peer support programme for prisoners with common mental disorders and substance use.

The prevalence of mental disorders and substance use among prisoners is high. Convicted prisoners of 'good behaviour' can be part of a peer support system in prisons. To evaluate the feasibility of a peer support programme for prisoners with common mental disorders and substance use in prison. The study used a mixed method research design, with a quasi-experimental approach (single group pre-post without control). It was conducted in two phases: Phase I. Thirty-five peers/convicted prisoners were recruited through advertisements on the prisoners' community radio station. Volunteers with good behaviour reports were given training over 5days to recognise mental and substance use disorders and provide basic peer support in prison; their attitudes and knowledge were tested before and after the training. Feasibility of the peer support programme was tested by (i) recording the number of cases identified and referred, (ii) pre- and post-evaluation of well-being, coping, and symptom severity of those supported and (iii) evaluating qualitatively the experience of the peer supporters and service users. Thirty-five peer supporters identified 49 cases over 3months. These cases showed significant improvement in well-being (Z -1.962; p<0.050) and reduction in symptom severity (Z -1.913; 0.056). There was a significant improvement in the peers supporters' self-esteem from pre- to post-training (t -3.31; p<0.002), improvement in their benevolence (t -4.37; p<0.001) and a significant reduction in their negative attitudes to mental illness (Z -3.518; p<0.001). A thematic model of peer support encompassed self-experienced benefits for the peer supporter, wider recognition of peer supporters in the prison, challenges to this kind of support, experience of training and visions for future work. The peer support programme was experienced positively by the peer-supporters and supported. Common mental disorders, substance use and suicidality were recognised and appropriately referred. A full-scale evaluation of this promising programme is warranted.

Individualized peer support needs assessment for families with eating disorders

BackgroundPeer support among family members is important in cases of mental illness, but there has been limited practice or research on individual peer support specific to families taking care of patients with eating disorders (EDs). To conduct peer support activities, it is necessary to clarify the needs of families.ObjectivesThe objective of this study are to identify the needs for group and individual peer support and the characteristics of family members with EDs who are willing to receive and provide individual peer support.MethodA cross-sectional questionnaire survey was conducted for family members with EDs recruited via the Internet. The questionnaires included demographic information on respondents and their patients, questions about the need for family peer support, interest in offering peer support, and social resources. All participants were given the General Health Questionnaire (GHQ-12), the Zarit Caregiver Burden Interview (J-ZBI_8), and the Anorectic Behavior Observation Scale (ABOS).ResultsOut of 314 respondents, 87.3% believed that a group peer support system was necessary, whereas 56.7% believed that an individual peer support system was necessary. As to whether they want to use individual peer support, 70 (22.4%) stated “Extremely YES” and 99 (31.7%) stated “Moderately YES.” Family members who were willing to receive individual peer support used more social resources and had higher scores on the GHQ and J-ZBI_8. Regarding the provision of peer support, 38 (12.2%) responded “very interested and willing to provide it if possible” and 87 (27.9%) responded “interested and willing to study.” Those with a high willingness to provide peer support used more social resources and had lower ABOS scores; however, 38 respondents (45.7%) exceeded the GHQ mental health screening cutoff (3/4).ConclusionFamily members with ED had a strong need for family peer support Those willing to receive individual peer support suffered from poor mental health and high burden of care. Family members willing to provide peer support tended to have patients whose EDs symptoms had already improved, but their own mental health was not necessarily good. Training for potential peer supporters is needed to implement peer support.

Work-related experiences of consultant psychiatrists during the COVID-19 response: qualitative analysis.

Research has begun to draw attention to the challenges mental health professionals faced in delivering services during the COVID-19 pandemic response. However, few studies have examined the specific experiences of consultant psychiatrists. To examine the work-related experiences and psychosocial needs of consultant psychiatrists situated in the Republic of Ireland arising from the COVID-19 response. We interviewed 18 consultant psychiatrists and analysed data using inductive thematic analysis. Work-related experience of participants was characterised by increased workload associated with assumption of guardianship of physical and mental health of vulnerable patients. Unintended consequences of public health restrictions increased case complexity, limited availability of alternative supports and hindered the practice of psychiatry, including inhibiting peer support systems for psychiatrists. Participants perceived available psychological supports as generally unsuitable for their needs given their specialty. Long-standing under-resourcing, mistrust in management and high levels of burnout exacerbated the psychological burden of the COVID-19 response. The challenges of leading mental health services were evident in the increased complexity involved in caring for vulnerable patients during the pandemic, contributing to uncertainty, loss of control and moral distress among participants. These dynamics worked synergistically with pre-existing system-level failures, eroding capacity to mount an effective response. The longer-term psychological well-being of consultant psychiatrists - as well as the pandemic preparedness of healthcare systems - is contingent on implementation of policies addressing long-standing under-investment in the services vulnerable populations rely on, not least community mental health services.

Career versus volunteer firefighters: Differences in perceived availability and barriers to behavioral health care.

Due to occupational stress and exposure to potentially traumatic events, firefighters are at an increased risk for the development of many behavioral health conditions. While volunteer and career firefighters represent two distinct subgroups, little research has examined differences in the availability of, and barriers to, behavioral health care between these populations. This study examined perceived availability and barriers to behavioral health care services among 2,156 career and 227 volunteer firefighters. Volunteer firefighters were less likely to report availability of drug and alcohol or family and couple services, but more likely to report availability of a trained peer support system and follow-up care compared to career firefighters. Volunteer firefighters were over five times more likely to consider cost a barrier to accessing behavioral health services compared to career firefighters; however, they were less likely to report lack of support from leadership, fear of breach of confidentiality, and clinicians who are unaware of work culture as barriers. Volunteer and career firefighters were equally likely to report stigma as a barrier. These findings have important implications for understanding how to strengthen departmental resources and to design targeted interventions to increase access to behavioral health services. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Digital Health: Is it the future for our lives?

Digital health is a revolution and it includes many different opportunities, in order to improve the patients’ quality of life in hospital and at homes. The digital health technologies include telehealth, mHealth applications, data analytics, remote patient monitoring. The benefits for patients, insurance companies and healthcare providers are many and one of the most important is a time and cost saving and the aggregation of data. The future leading healthcare system must be established on a framework, which include understanding of law, patients, who need these services, the appropriate technology (safe network for data aggregation, equipment), peer support systems and sustainability.

The BUDDYS System: A Unique Peer Support Strategy Among Anaesthesiology Residents During the COVID-19 Pandemic

The coronavirus disease 2019 pandemic stressed healthcare organizations. Initial efforts focused on supplies with a minimal empha- sis on frontline healthcare workers' wellbeing. Anaesthesiology residents represent vulnerable frontline healthcare workers because airway pro- cedures increase nosocomial infection risks. Peer support can promote healthcare workers' wellbeing during crises; its application to graduate medical trainees is underrepresented in the literature. We implemented a quality improvement project to improve wellbeing among anaesthesiol- ogy residents via a peer support system called BUilding Dynamic Duos for Your Support. BUilding Dynamic Duos for Your Support consists of pairing 2 anaesthesiology residents with instructions to support each other in anticipation of a coronavirus disease 2019 case surge. A lecture presentation introduced this system to the residents and described frequent check-ins with another resident. We evaluated the initiative with a survey 2-4 weeks postimplementation. BUilding Dynamic Duos for Your Support began in April 2020 and involved 88 residents. Survey respondents (n = 58) indicated that BUilding Dynamic Duos for Your Support had a positive impact on their wellbeing. BUilding Dynamic Duos for Your Support implementation had no additional costs, requiring minimal resource dedication. BUilding Dynamic Duos for Your Support promoted wellbeing among anaesthesiology trainees. This quality improvement project highlights the positive impact of a peer support system on anaesthesiology residents' wellbeing with a potential broader application to graduate medical education.

Using Controlled Environment Agriculture as a Platform for STEM‐Training

The purpose of this summer STEM Bridge initiative was to provide incoming first‐year university students with interdisciplinary STEM training using a Controlled Environment Agriculture hydroponic container farming tech platform coupled with soft skills and increased early access to the campus facilities. A pilot was conducted during the summer of 2021 on the La Sierra University campus. The two‐week collaborative experience included faculty from eight academic units including from Science, Humanities, and Business. We offered students experiments and projects from hydroponic basics, use of sensors and computer control systems, to developing sales presentations and business models. This approach introduced students to career pathways– many within STEM, centered around a tech platform capable of contributing to real‐world solutions to long‐standing community problems. We also emphasized the importance of inclusive representation in STEM, the importance of access, and of including all voices. Students developed a meaningful peer and faculty support system and as an additional benefit became familiar with how to navigate the campus culture. Preliminary results indicate the students felt their foundational understanding of the sciences improved after attending STEM Bridge. A portion of the students indicated a newly acquired desire to obtain a terminal STEM degree after attending STEM Bridge. Most of the students felt an increase in awareness of resources on campus to support them academically and knowledge of their way around campus. All students felt an increase in preparedness for the academic rigors of college life while most students reported feeling an increase in their ability to manage their time well after the program.

Virtual Communities of Practice for Research Postgraduate Students: Determining Needs and Reducing Isolation

Postgraduate research is considered a lonely endeavour with students frequently experiencing social and intellectual isolation. Research offices in many higher education institutions have developed programmes to support supervisors and students undertaking research studies and supervision. These programmes include instruction on research techniques and methodologies but are often lacking in community-based approaches such as creating support and peer groups where students can share information and ideas directly. This study explores the use of online communities of practice as a support tool for postgraduate researchers in a university in Ireland. The research questions seek to determine the antecedents for successful implementation, the dominant problems associated with using online communities, and the motivators for, and barriers to, participation in communities of practice in this context. The study facilitates student collaboration by implementing a community of practice on an enterprise social network (ESN) platform. These platforms are increasingly used in industry to facilitate online community groups that collaborate professionally and socially. Professionally, ESN can be used as a platform to host virtual communities of practice (vCoP), where members can engage in sharing knowledge of their practice domains and experiences. The promotion of ESN and vCoP for this study is a joint initiative of the Research Support Office, the Students' Union, and the Postgraduate Society, who advocate for a strong peer to peer support system for postgraduate students. The study adopts an Action Research design and a mixed-methods approach, and data collection includes system use metrics, surveys, focus groups and interviews. The practical objective of the project is to manage the implementation of the virtual community as a peer-to-peer support environment, and success is determined primarily from usage statistics. This may lead to developing a framework for implementation that is generalisable to other higher education institutions.

'Someone like-minded in a big place': Autistic young adults' attitudes towards autistic peer support in mainstream education.

Autistic young people may struggle in mainstream schools and feel disconnected from their peers and their school. We know that autistic adults can benefit from spending time with other autistic people, but we don't know if this is the case for younger autistic people. We conducted interviews with 13 autistic young adults in the United Kingdom who recently left mainstream schooling. We asked them if they would have been interested in being involved in autistic peer support when they were at school, and if so, what that peer support should look like. Results indicated that autistic young people were enthusiastic about the idea of peer support. They thought it was important that peer support was flexible to suit their needs at different times, as well as inclusive, positive, and embracing neurodiversity. They also discussed the potential benefits and difficulties of having a peer support system within a school setting. This adds to the growing body of research on the potential benefits of autistic-autistic interactions on autistic people's well-being and sense of belonging. Findings can be used to help design pilot peer support projects in schools that can be tested to see how effective they are.

Breastfeeding Awareness and Empowerment (BAE): A Black Women-Led Approach to Promoting a Multigenerational Culture of Health.

Critical gaps in the U.S. healthcare system perpetuate adverse reproductive health outcomes for Black people. Grounded in reproductive justice and trauma-informed care, Breastfeeding Awareness and Empowerment (BAE) has developed a program titled BAE Cafe to directly address these gaps by providing community-based lactation and perinatal mental health support. A literature review identified key programmatic gaps, namely, access to knowledge relevant to troubleshooting breastfeeding, peer support, community support and healthcare system support, and system-level factors that impede families and communities from accessing lactation support. This paper describes BAE Cafe through a group process observation and participant survey. The observation of groups highlighted the core elements of the BAE Cafe model: knowledge, support and mental health support in a peer driven format. Participant survey feedback was overwhelmingly positive and highlighted the critical importance of lactation support for Black women by Black women and BAE's role in participants' decisions to continue breastfeeding. BAE Cafe is a replicable, scalable, peer-driven and low-barrier intervention that has the potential to improve outcomes for Black families. Additional research and investment are now needed to assess large-scale implementation to reduce disparities and address health inequity across different contexts and settings.

Type 1 Diabetes Peer Support Groups

Type 1 diabetes (T1D) is emerging as a major healthcare challenge impacting a significant percentage of the population. Management of T1D remains a concern in India with the diversity in socio-economic backgrounds, poor literacy levels, and inadequate resources and facilities which impact timely diagnosis, treatment, and management of this condition. All over the world in general, and in India, many peer support groups have come into existence and are even blossoming. A peer support system instils a sense of security, allows for better care practices, and builds quality relationships and a sense of belonging which can help improve their glycemic control and self-confidence and help them live a good quality of life. There are more than 40 T1D peer support groups in India offering emotional and financial support, knowledge, clinic services, matrimonial support as well as guidance in specialized areas of need such as celiac disease, sports, etc. While there is a need to understand and evaluate the most effective way to deliver these programs to effectually meet the various needs of people with T1D, there is also a need to integrate the various T1D peer support programs in India as there are many good practices that one group can learn and emulate from the other. The aim of this review article is to share the experience of the authors and to review available literature on T1D peer support groups to understand the role and impact of peer support groups in improving health outcomes and quality of life in people with T1D.

Clues to Fostering a Program Culture of Academic Integrity: Findings from a Multidimensional Model

Drawing on the responses from a survey of 852 undergraduates in a business program in Canada we identified situational, personality and contextual variables correlated with business students’ self-reported rates of academic integrity violations. The most influential predictors of increasing rates were: greater estimates of peers’ violations, increasingly negative perceptions of the program’s academic integrity culture, and rating questionable academic behaviours less seriously. Individual priorities, personal characteristics and social support were less influential. We then analyzed our quantitative results in light of our deep understanding of the broader context in which the students were located to derive richer insights from the interplay of our independent variables. Importantly, our results indicated that program-led proactive messaging designed to foster a culture of academic integrity could effectively buffer tendencies towards academic dishonesty. Absent ongoing messaging, however, increasing academic pressures may have eroded those initial benefits. Moreover, we identified how repercussions of major academic integrity breaches could be long lasting suggesting an even greater need for fostering academic integrity culture a priori. Based on our results we recommended a public health practice of identifying positive deviants – individuals who thrive in hostile environments – and then, in an effort to change a peer support system that fostered increasing rates of violations into one that does the opposite, engaging with those individuals to understand why and how they resisted the status quo.

My body, my decision: the lived experience of young people with a variation in sex characteristics in New Zealand

Abstract Background Young people born with a variation in sex characteristics (VSC), or disorders of sex development (DSD) face numerous challenges in navigating issues relating to identity and to their lived and embodied experience. There is limited research amplifying the voices of young people with a VSC in the literature, especially in Aotearoa/New Zealand. There has been issues raised from a Humans Rights perspective which public health forums are yet to address. Methods This original qualitative study provides an up-to-date picture of the lived experiences of 10 young people with a VSC in Aotearoa/New Zealand using face to face interviews and thematic analysis. The research was conducted in collaboration with the advocacy group, Intersex Youth Aotearoa, and explored the level of support provided by health services, peers and advocacy groups in relation to the ways the participants viewed themselves and their bodies, and their health related decision-making. Results Our research reveals the pressure on young people with a VSC to conform to cultural and societal norms, specifically, heteronormative and traditional constructs of how male and female bodies should look prevalent within Aotearoa/NZ society. Such views, often held and perpetuated by health professionals and parents, contributed to the complexities surrounding identity, agency and acceptance of difference experienced by these young people. Young people wanted the right to bodily autonomy. Conclusions Implications of these findings are: better public education of VSC, development of resources for parents and young people and advocacy for psychological and peer support systems for young people.

Help when you need it: Perspectives of adults with T1D on the support and training they would have wanted when starting CGM

AimsThe purpose of this study was to explore preferences that adults with type 1 diabetes (T1D) have for training and support to initiate and sustain optimal use of continuous glucose monitoring (CGM) technology. MethodsTwenty-two adults with T1D (M age 30.95 ± 8.32; 59.1% female; 90.9% Non-Hispanic; 86.4% White; diabetes duration 13.5 ± 8.42 years; 72.7% insulin pump users) who had initiated CGM use in the past year participated in focus groups exploring two overarching questions: (1) What helped you learn to use your CGM? and (2) What additional support would you have wanted? Focus groups used a semi-structured interview guide and were recorded, transcribed and analyzed. ResultsOverarching themes identified were: (1) “I got it going by myself”: CGM training left to the individual; (2) Internet as diabetes educator, troubleshooter, and peer support system; and (3) domains of support they wanted, including content and format of this support. ConclusionThis study identifies current gaps in training and potential avenues for enhancing device education and CGM onboarding support for adults with T1D. Providing CGM users with relevant, timely resources and attending to the emotional side of using CGM could alleviate the burden of starting a new device and promote sustained device use.

Recovery Following Peer and Text Messaging Support After Discharge From Acute Psychiatric Care in Edmonton, Alberta: Controlled Observational Study.

BackgroundPeer support is an emotional, social, and practical help provided by nonprofessionals to assist others in sustaining health behaviors. Peer support is valued in recovery-oriented models of mental health and is becoming increasingly implemented at the organizational level. Text messaging is a relatively low-cost, high-impact, and easily scalable program that uses existing technology, is devoid of geographic barriers, and is easily accessible to end users.ObjectiveThis study aims to evaluate the effectiveness of an innovative peer support system plus a supportive text messaging program on the recovery of discharged patients from acute psychiatric care.MethodsThis prospective, rater blinded, controlled observational study included 181 patients who were discharged from acute psychiatric care. Patients were randomized to one of four conditions: treatment as usual (follow-up care), daily supportive text messages only, peer support only, or peer support plus daily supportive text messages. A standardized self-report measure of recovery (Recovery Assessment Scale [RAS]) was completed at baseline, 6 weeks, 3 months, and 6 months. Descriptive analysis, one-way analysis of variance, and repeated measures multivariate analysis of covariance were used to examine the changes in the RAS among the study groups and over the follow-up time points.ResultsA total of 65 patients completed the assessments at each time point. For the overall sample, higher scores were found for the peer support plus text message condition compared with the text message only and treatment as usual condition on several scales (ie, willingness to ask for help and personal confidence and hope) and total score on the RAS, after 6 months of intervention.ConclusionsPeer support plus supportive text messaging seems to result in improved recovery compared with other interventions. It may be advisable to incorporate the two interventions as part of routine practice for patients with psychiatric disorders upon hospital discharge.

A Questionnaire Survey on Adolescent and Young Adult Hiroba, a Peer Support System for Adolescent and Young Adult Cancer Patients at a Designated Cancer Center in Japan.

Adolescent and young adult (AYA) cancer patients have few opportunities to interact with peers in the hospital. AYA Hiroba, a peer support system for AYA cancer patients, was launched and held regularly at the National Cancer Center Hospital in Japan. This questionnaire survey was conducted to investigate the degree of satisfaction and opinions of AYA cancer patients regarding this program. Participants reported that the content was satisfying and useful. Their impressions suggested that AYA Hiroba is potentially effective for promoting interaction with the same generation, change in mood, and acquisition of information.