Peer Support Training Research Articles

Pragmatic pilot cluster randomised control trial of a school-based peer-led anti-smoking intervention for 13-14 year olds in Malaysia

PurposeThe purpose of this paper is to report the process evaluation of a pilot randomised control trial of an anti-smoking intervention for Malaysian 13-14-year olds, conducted in 2011/2012. It was hypothesised that trained peer supporters would promote non-smoking among classmates through informal conversations.Design/methodology/approachSmoking-related baseline and follow-up questionnaires were administered, seven months apart, to Form 1 students (n=2,118) attending eight schools across two districts in Sabah (Kota Kinabalu; Keningau). Concealed stratified randomisation assigned two schools per district to the control and intervention arms. Control schools received usual care. Intervention schools received usual care and the peer supporter intervention. Peer supporters completed smoking-related knowledge and attitudes questionnaires before and after peer supporter training and peer supporter training evaluation questionnaires. They also discussed the peer supporter training and role in focus groups immediately following training (n=4) and three months later (n=3), and additionally, recorded post-training anti-smoking activity in diaries.FindingsThe pilot trial found that student recruitment was high (baseline students matched at follow-up n=1,681 (79 per cent of class-registered students). More boys (n=38) than girls (n=35) attended peer supporter training. Post-training, most peer supporters had improved smoking-related knowledge (n=55; 75 per cent) and attitudes (n=57; 78 per cent) and returned diaries (n=49; 67 per cent). Some focus group boys reported they were reluctant peer supporters and/or found resisting smoking difficult.Practical implicationsFuture trials would benefit from outlined modifications to peer supporter selection, recruitment and training and additionally, assessments of context and intervention acceptability and reach.Originality/valueTrials of complex public health interventions are scarce in economically developing countries.

Training peers to support older people with chronic low back pain following physiotherapy discharge: a feasibility study

ObjectiveTo determine the feasibility and acceptability of a training programme for peer volunteers to support older adults with chronic low back pain (CLBP) following discharge from physiotherapy. DesignFeasibility study. SettingCommunity-based. Participants17 adults (4 male, 13 female) with CLBP or experience of supporting someone with CLBP enrolled and 12 (2 male, 10 female) completed the volunteer training. InterventionVolunteers took part in a face-to-face or blended delivery peer support training programme based on the Mental Health Foundation’s “Principles into Practice” and adapted for CLBP by the study team. Main outcome measuresRecruitment/retention rates; demographics; time & resources used to deliver training; training evaluation (questionnaire); knowledge questionnaire, and self-efficacy questionnaire. Results17 participants enrolled on the training programme (11 face-to-face, 6 blended delivery). 12 (71%) completed the training (73% face-to-face, 67% blended delivery). The training was positively evaluated. All but two participants passed the knowledge quiz at the end of the training, and the majority of self-efficacy scores (90%) were high. ConclusionsIt is feasible to develop, implement and evaluate a peer support training programme for the facilitation of CLBP self-management in older adults following discharge from physiotherapy. Blended delivery of training may facilitate the recruitment of greater numbers of peer support volunteers in future studies. Supported self-management of CLBP pain is widely recommended but can be difficult to achieve. Peer support might be a promising method of facilitating CLBP self-management without additional burden to health services, and should be further evaluated in a larger study.

REACT: A paraprofessional training program for first responders-A pilot study.

The purpose of this study was to evaluate a newly designed peer support training program for first responders titled Recognize, Evaluate, Advocate, Coordinate, and Track (REACT). REACT was developed in partnership with public safety agencies to address the need for promoting psychological health. This resulted in the development of a program that uses train-the-trainer methodology to address primary prevention of stress injuries. REACT was an all-day training that consisted of four modules, each featuring instruction and practice. Six public safety agencies totaling 30 individuals (76.9% from four fire departments, 23.1% from two emergency communication centers) participated in REACT. The primary outcomes were knowledge and training-related self-efficacy; secondary outcomes included general self-efficacy, resilience, and improved attitudes and expectations. A peer-support model, using a train-the-trainer methodology, is a promising approach for addressing the promotion of psychological health.

“Happy, just talking, talking, talking”: Community strengthening through mobile phone based peer support among refugee women

Resettled refugees face lack of information and support, due to disrupted community and cultural mismatch. In this context, we provided 111 refugee women peer support training and a restricted-dial unlimited-call mobile phone in Melbourne, Australia. We gathered demographic, phone call, pre and post intervention questionnaires, and interview data.The provided resources synergised with existing resources such as social capital and information demand, resulting in changes to resource allocation and social processes, such as economic resource reallocation, information sharing, personal agency, and social support. These changes impacted areas such as employment, education, transportation and domestic violence, leading to improved individual lives and community functioning.

Teens engaged in collaborative health: The feasibility and acceptability of an online skill-building intervention for adolescents at risk for depression

BackgroundThere is an ongoing need for effective and accessible preventive interventions for adolescent depression and substance abuse. This paper reports on a field trial of an online indicated preventive intervention, ProjectTECH, which is based on cognitive-behavioral therapy (CBT) techniques. The study aims to gather information about the feasibility and acceptability of this program. Secondary aims of this study were to examine the impact of the program on depression symptoms, perceived stress, positive affect, and substance use and to compare differences between groups that were led by a peer versus those that were led by a licensed clinician. MethodsHigh school students (n=39) were recruited primarily through social media advertisements, and assigned to four groups of 8–12 individuals to collaboratively participate in an 8week peer network-based online preventive intervention which were led by a trained peer guide or a licensed clinician. Participants were provided with didactic lessons, CBT-based mood management tools, and peer networking features, and completed quantitative and qualitative feedback at baseline, midpoint, end of intervention, and 1month follow-up. ResultsThe program attracted and retained users primarily from social media and was used frequently by many of the participants (system login M=25.62, SD=16.58). Participants rated the program as usable, and offered several suggestions for improving the program, including allowing for further personalization by the individual user, and including more prompts to engage with the social network. From baseline to end of intervention, significant decreases were observed in depressive symptoms and perceived stress (p's<0.05). Significant increases in positive affect were observed from baseline to midpoint (p<0.05) and no changes were observed in substance use, although the rate of substance use was low in this sample. While this study had low power to detect group differences, no consistent differences were observed between participants in a peer-led group and those in a clinician-led group. ConclusionsResults of this study indicate that ProjectTECH, an indicated preventive intervention for high school-aged adolescents, demonstrates both feasibility, acceptability, and short-term, longitudinal psychological benefits for participants. Future iterations of the program may benefit from close attention to user interface design and the continued use of trained peer support guides.

Effectiveness of one-to-one peer support for patients with severe mental illness – a randomised controlled trial

BackgroundOne-to-one peer support is a resource-oriented approach for patients with severe mental illness. Existing trials provided inconsistent results and commonly have methodological shortcomings, such as poor training and role definition of peer supporters, small sample sizes, and lack of blinded outcome assessments. MethodsThis is a randomised controlled trial comparing one-to-one peer support with treatment as usual. Eligible were patients with severe mental illnesses: psychosis, major depression, bipolar disorder or borderline personality disorder of more than two years’ duration. A total of 216 patients were recruited through in- and out-patient services from four hospitals in Hamburg, Germany, with 114 allocated to the intervention group and 102 to the control group. The intervention was one-to-one peer support, delivered by trained peers and according to a defined role specification, in addition to treatment as usual over the course of six months, as compared to treatment as usual alone. Primary outcome was self-efficacy measured on the General Self-Efficacy Scale at six-month follow-up. Secondary outcomes included quality of life, social functioning, and hospitalisations. ResultsPatients in the intervention group had significantly higher scores of self-efficacy at the six-month follow-up. There were no statistically significant differences on secondary outcomes in the intention to treat analyses. ConclusionsThe findings suggest that one-to-one peer support delivered by trained peer supporters can improve self-efficacy of patients with severe mental disorders over a one-year period. One-to-one peer support may be regarded as an effective intervention. Future research should explore the impact of improved self-efficacy on clinical and social outcomes.

Cost analysis of a peer support programme for patients with type 2 diabetes: a secondary analysis of a controlled trial.

This study aimed to explore if group-based peer support as an additional component to a disease management programme (DMP) in type 2 diabetes can reduce the number of prescribed drugs; hospital admissions; and length of hospital stay and therefore be a cost-effective model. Controlled study based on a secondary data analysis of a cluster randomized trial. Our study population was general practitioners and patients in the province of Salzburg. The 24-months intervention consisted of regular group meetings facilitated by trained peer supporters. The groups exercised together, discussed diabetes related topics, and received support by professionals. Data was anonymously collected on clusters through the statutory health insurance. Data were available of 118 (82.5%,17 clusters of the patients in the original randomized trial) participants in the intervention and 143 (77.3%,19 clusters) in the control groups. The length of hospital stay was shorter in the intervention groups compared with controls. The mean difference during the 24-month study period was -40.13 days (95% CI - 78.54 to - 1.71, P = 0.041) in favour of the intervention groups. No differences were seen in the number of prescribed drugs and hospital admission. Estimated yearly savings by reducing the length of hospital stay was €1660.60 per patient. A group-based peer support programme as an additional component of a DMP in type 2 diabetes is a promising approach to optimize diabetes care and to enhance lifestyle interventions in primary care. Peer support seems to reduce length of hospital stay and could therefore be a cost-effective model.

Peer support training: values, achievements and reflections

Peer support training: values, achievements and reflections

Subjective evaluation of a peer support program by women with breast cancer: A qualitative study.

The aim of this study was to determine the subjective evaluation of a breast cancer peer support program based on a survey of the participants who completed the program. Semistructured interviews were held with 10 women with breast cancer. The responses were subject to a qualitative inductive analysis. Women with breast cancer who participated in the breast cancer peer support program evaluated the features of the program and cited benefits, such as "Receiving individual peer support tailored to your needs," "Easily consulted trained peer supporters," and "Excellent coordination." Also indicated were benefits of the peer support that was received, such as "Receiving peer-specific emotional support," "Obtaining specific experimental information," "Re-examining yourself," and "Making preparations to move forward." The women also spoke of disadvantages, such as "Strict management of personal information" and "Matching limitations." In this study, the subjective evaluation of a peer support program by women with breast cancer was clarified . The women with breast cancer felt that the program had many benefits and some disadvantages. These results suggest that there is potential for peer support-based patient-support programs in medical services that are complementary to the current support that is provided by professionals.

Peer Support Training Improved the Glycemic Control, Insulin Management, and Diabetic Behaviors of Patients with Type 2 Diabetes in Rural Communities of Central China: A Randomized Controlled Trial.

BackgroundThe efficacy of peer support in Chinese diabetes patients is still uncertain. The purpose of this study was to observe the effects of a peer support program on the outcomes of patients with type 2 diabetes who received community-based insulin therapy in rural communities of central China.Material/MethodsTwo hundred and eight eligible patients with type 2 diabetes were randomly assigned into the traditional training group (control group, n=111) and peer support intervention group (peer group, n=97) between June 2013 and January 2014 in 2 rural communities of Jingzhou area, China. Both groups received 3-month traditional training, followed by another 4-month traditional training or peer support training, respectively. At baseline and 7 months after treatment, the blood glycemic level was evaluated by biochemical detection. Capacities of self-management and knowledge related to insulin usage were assessed by questionnaire survey.ResultsNinety-seven and ninety patients completed this study in the control group and peer group, respectively. There was no significant difference in age, gender, diabetes duration, insulin usage time, and complications between the 2 groups at baseline (P>0.05). Compared with the control group, peer group patients achieved a more significant decrease in blood glycosylated hemoglobin levels (P<0.05), increase in knowledge related to insulin usage, and increase of diabetes self-management ability (P<0.05).ConclusionsPeer support intervention effectively improves outcomes of patients with type 2 diabetes in rural communities of central China.

Introducing Chaplaincy to Japanese Society

This paper examines the meaning of the introduction of Clinical Pastoral Education (CPE) to Japan, as an example of one of the religious activities accepted in public space in a secular Japanese society. For over half a century, Christian clerics have tried to introduce the idea of chaplaincy to Japan, and Buddhists have attempted to develop a Buddhist form of hospice palliative care. The Japan Society for Spiritual Care was established in 2007 and began an accreditation process of ecumenically designed “spiritual caregivers,” bringing interested parties together in Japan for education, peer support, and continuous training in spiritual care. The outpouring of national grief in response to accidents or natural disasters encouraged sponsors to create CPE training institutions at some universities. Challenging the Japanese understanding of the separation of religion and state, the introduction of chaplaincy can be seen as a case of religious practice that is accepted in public space.

Brief report: A randomized controlled trial examining peer support and behavioral weight loss treatment

Peer support among adolescents has been positively associated with heath behaviors; however, enhancing peer support for weight loss has rarely been studied among adolescents. This study examined whether a peer support training component delivered to enhance a standard weight loss program led to improved outcomes. Forty-one overweight adolescent females were randomly assigned to a Standard or Enhanced Peer Support intervention. The Enhanced group received in person peer support skills training and practiced skills using social networking. At 16 weeks, participants in the Enhanced condition reported significantly increased perceptions of friend support. Both groups demonstrated significant weight loss (6.4 lbs, ± 8.3). Attendance and self-monitoring were associated with weight loss. Perceptions of peer support can be increased with a peer training component, but did not increase weight loss during the short term.

Implementation of a "second victim" program in a pediatric hospital.

A formal support program for pharmacy employees involved in adverse drug events, patient-related injuries, and other traumatic work experiences is described. Healthcare workers are sometimes referred to as the "second victims" of patient care mishaps due to the anxiety, loss of confidence, and career uncertainty they may experience. After a survey indicating that about 30% of its staff had been involved in a second-victim event, the Nationwide Children's Hospital (NCH) pharmacy department implemented a peer-based support initiative (the YOU Matter program) based on an established three-tiered intervention model. All staff members are trained to identify second victims. The core of the program is a team of trained peer supporters who serve as first responders; if additional support is required, referrals to behavioral health, social work, and employee assistance personnel are made as appropriate. Staff members involved in troubling work-related events can seek support via a Web-based portal for event reporting and discussion. Since the launch of the NCH second victim program, the team of trained peer supporters has been expanded from 13 to over 120. In a postimplementation survey, 85% of the NCH pharmacy department staff indicated that the YOU Matter program has been beneficial. The majority of the NCH pharmacy staff reported that the department benefited from implementation of the second victim program. A survey conducted five months after implementation of the program revealed that 3 respondents had personally used the program and 11 had referred a coworker to a peer supporter.

Peer support groups, mobile phones and refugee women in Melbourne.

In this article, we discuss qualitative findings basing on the experiences of refugee women living in Melbourne, Australia, who participated in a peer support training programme and received a free mobile phone. We pay attention to social support as a health enhancing strategy and empowerment that occurred among the participants. Participation in peer support groups and access to a mobile phone were beneficial for the women. Peer support functioned as social support among group members. The programme allowed the women to be connected to their families and the wider communities and assisted them to access health care and other settlement aspects with greater ease. It also increased personal empowerment among the women. Our programme shows that by tapping on community resources to ameliorate personal or resettlement issues, the burden on service providers can be reduced. Our findings also offer a model for future research and programmes regarding refugee people elsewhere.

Nurses' communication with families in the intensive care unit – a literature review

This review examined the literature across 12 years that explored nurses' perceptions of their role when communicating with families in adult intensive care units (ICUs). The objectives were: (1) to describe how ICU nurses facilitated communication with families; (2) the perceived barriers to that communication; (3) strategies to improve their skills. Evidence demonstrates that effective communication by health care providers can improve families' understanding of their situation and decrease their psychological burden. The continuous presence of ICU nurses, combined with the use of effective empathic communication skills, can impact on families' ICU experience in a positive way. Nevertheless, research continues to demonstrate that communication with families in ICU is inadequate and of poor quality. Eight databases were systematically searched to identify peer reviewed studies published in English between 2002 and 2014. The results are presented via a thematic literature review. Four major themes emerged from a synthesis of the review findings: 'Nurses as information and communication facilitators', 'Nurses as family support providers', 'Nurses' non-supportive behaviours' and 'Improving nurses' communication skills'. Most ICU nurses considered communicating with families a vital part of their role, and described supportive behaviours. However, they perceived significant barriers to effective communication; some as a result of active decisions on their part, and some beyond their control. These barriers often resulted in nurses believing that families received suboptimal information and support. Peer support and formal training were identified as key strategies to overcome inadequacies. This review summarizes nurses' perceptions of the means and barriers for communicating with families in ICUs. Intensive care nurses need skills and knowledge in how to communicate effectively with families. This skill can be learnt formally, or acquired from role modelling of more experienced peers.

Social connectedness and mobile phone use among refugee women in Australia.

The aim of this research was to inform the development of mobile phone-assisted health promotion programmes that support social connectedness among refuge women to enhance their mental, physical and social health. For refugees, relationship development during the early stages of resettlement is often difficult. Enhancing personal skills, and resources, can enhance relationships that provide social support. It can also contribute to the development of social relationships in communities and thence acculturation. Communication technologies can assist refugees, if their particular needs and capacities are taken into account. This paper reports a study of refugee women's experience of an intervention based on principles of empowerment and using peer support training and the provision of free mobile phones, and free calls, for at least 1 year. Potential participants were invited by the Afghan, Burmese and Sudanese community leaders to an information session, where the study was explained and invitations to participate extended. A snowball sampling technique was also used, where the first group of participants invited people they had relationships with to join the programme. One hundred and eleven participants were recruited from the three groups. All were from refugee backgrounds. Data collection consisted of: a pre- and post-intervention questionnaire; a log of outgoing phone calls; and in-depth interviews with a subgroup of the study population. The call logs described the patterns of interpersonal relationships facilitated by the mobile phones. In the interviews, characteristics of interpersonal social support, and relationships with heritage and host communities, were described. The quantitative data were analysed using descriptive statistics and the qualitative data using thematic analysis. By describing the conditions under which mobile phone technology can enhance interpersonal and community connectedness, we strengthen the evidence base for the use of mobile phone technology in health promotion programmes with refugee groups.

The effect of counselling-based training on online peer support

The aim of the current study is to investigate the impact of counselling-based training on online peer support by comparing the interventions of trained peer supporters as opposed to non-trained peer supporters. Two independent raters analysed 746 support posts published during a period of one year at the ‘Student to Student’ online peer support discussion forum at University of Athens. Results showed that the 30-hour counselling-based training used in this study allowed trained peer supporters to use basic counselling skills, such as open-ended and closed-ended questions and paraphrasing more often and even use relatively complex techniques, such as problem solving or definition of the main problem that non-trained supporters did not use at all or used very rarely. In addition, training did not seem to affect the peer support relationship, as indicated by the lack of differences between the two groups on empathy, acceptance and empowerment. Based on these findings, it was concluded that the training enhanced the peer support offered without compromising the nature of the relationship formed between peers. Therefore, brief counselling-based training can be an integral part of every peer-moderated online support programme.

Management of disorders of sex development.

The medical term disorders of sex development (DSDs) is used to describe individuals with an atypical composition of chromosomal, gonadal and phenotypic sex, which leads to differences in the development of the urogenital tract and reproductive system. A variety of genetic factors have been identified that affect sex development during gonadal differentiation or in specific disorders associated with altered androgen biosynthesis or action. The diagnosis of DSDs in individuals and the subsequent management of patients and their families requires a targeted and structured approach, involving a multidisciplinary team with effective communication between the disciplines. This approach includes distinct clinical, imaging, laboratory and genetic evaluations of patients with DSDs. Although treatment of patients with DSDs can include endocrine and surgical options, many patients have concerns that arise from past incorrect treatments that were founded on the traditional binary concept of the sexes. To dispel these concerns, it is necessary to create centres of expertise for DSDs that include physicians, surgeons, psychologists and specialists in diagnostic procedures to manage patients and their families. Additionally, the inclusion of trained peer support in the multidisciplinary DSD team seems to be integral to the supportive management of patients with DSDs. Most importantly, dealing with DSDs requires acceptance of the fact that deviation from the traditional definitions of gender is not necessarily pathologic.

Peer support for stroke survivors: a case study.

BackgroundInnovative and sustainable programs are required to support the well-being of stroke survivors. Peer support is a potentially low cost way to enhance well-being of recent stroke survivors and the well-being and community reintegration of their peer supporters. This article describes the perceptions of stroke survivors, care partners, peer supporters, and professionals of an individual peer support program.MethodsAn instrumental case study design was used to examine a volunteer peer support program that provides acute care visits and telephone follow-up post-discharge. In particular, a) type of support provided, b) benefits for the stroke survivor and care partner, c) potential harms to the stroke survivor, d) impact of providing support on the peer supporter, and e) required processes were considered. Semi-structured interviews were carried out with 16 new stroke survivors and 8 care partners immediately following hospital discharge and then 6 months later, and with 7 peer supporters, 3 program co-ordinators and 4 health professionals to gather feedback from multiple stakeholders.ResultsEmotional, affirmational and informational support were perceived as being offered by the peer supporters. Peer visits were perceived as providing encouragement, motivation, validation, and decreased feelings of being alone. However, the visits were not perceived as beneficial to all stroke survivors. The impact on the peer supporters included increased social connections, personal growth, enjoyment, and feelings of making a difference in the lives of others. Involvement of the healthcare team, peer supporter training and a skilled coordinator were crucial to the success this program.ConclusionsPeer support can potentially enhance service to stroke survivors and promote community reintegration for peer volunteers. Further research is needed to determine the preferred format and timing of peer support, and the characteristics of stroke survivors most likely to benefit.

Job Satisfaction Level of Teachers’ Working in Private Institutes of Rahim Yar Khan (Pakistan)

The objective of present study was to analyze the job satisfaction level of teachers working in private institutions in Rahim Yar Khan Pakistan. For this purpose researchers build a conceptual model taking peer support, family insight, Intrinsic rewards, training and development as independent variables.For the data collection researchers developed five likerd scale questionnaires which have been distributed to the teachers working in private institutions. Total 145 questionnaire was distributed from which 122 questionnaire returned to us. From the filled questionnaires 14 were incomplete and rejects from analysis.Researchers use linear regression to analyze the impact of independent variables on the dependent variable job satisfaction. The results shows that intrinsic reward and leadership support have positive significant relationship with job satisfaction, but the family insights show negative significant relationship. Peer support training and development have positive insignificant relationship with our dependent variable job satisfaction.The researchers concludes that the teachers working in private institutions in Rahim yar Khan (Pakistan) demand respect from their head of institutes which are consider more valuable instead of monitory rewards. The insignificant impact of Peer support, training and development on our dependent variable job satisfaction which means that peer cannot support in the best interest of institution. The results proves as like experienced by the researchers working as a teacher in private institutes in Rahim Yar Khan (Pakistan).