Peer Support Research Articles

A Needs-Based Assessment of Older Immigrants Experiencing Loneliness and Social Isolation and the Effectiveness of Interventions Responding to the Identified Needs: An Umbrella Review and Research Update

ABSTRACT This umbrella review and research update explores experiences of loneliness and social isolation in older immigrants to understand their support needs and the effectiveness of current interventions. Nine quantitative and qualitative studies discussing loneliness and/or social isolation in older immigrants were identified. Six key themes emerged: language and cultural barriers, life-course intersections, family relationships and obligations, meaningful opportunities as a counter-strategy, regaining self-esteem, and effectiveness of peer/community support. Assessment of needs was a central topic in the literature. Peer and community support is an effective intervention targeting loneliness and social isolation in older immigrants as it connects participants and creates meaningful relationships.

The Journey From Nonimmersive to Immersive Multiuser Applications in Mental Health Care: Systematic Review

Background Over the past 25 years, the development of multiuser applications has seen considerable advancements and challenges. The technological development in this field has emerged from simple chat rooms through videoconferencing tools to the creation of complex, interactive, and often multisensory virtual worlds. These multiuser technologies have gradually found their way into mental health care, where they are used in both dyadic counseling and group interventions. However, some limitations in hardware capabilities, user experience designs, and scalability may have hindered the effectiveness of these applications. Objective This systematic review aims at summarizing the progress made and the potential future directions in this field while evaluating various factors and perspectives relevant to remote multiuser interventions. Methods The systematic review was performed based on a Web of Science and PubMed database search covering articles in English, published from January 1999 to March 2024, related to multiuser mental health interventions. Several inclusion and exclusion criteria were determined before and during the records screening process, which was performed in several steps. Results We identified 49 records exploring multiuser applications in mental health care, ranging from text-based interventions to interventions set in fully immersive environments. The number of publications exploring this topic has been growing since 2015, with a large increase during the COVID-19 pandemic. Most digital interventions were delivered in the form of videoconferencing, with only a few implementing immersive environments. The studies used professional or peer-supported group interventions or a combination of both approaches. The research studies targeted diverse groups and topics, from nursing mothers to psychiatric disorders or various minority groups. Most group sessions occurred weekly, or in the case of the peer-support groups, often with a flexible schedule. Conclusions We identified many benefits to multiuser digital interventions for mental health care. These approaches provide distributed, always available, and affordable peer support that can be used to deliver necessary help to people living outside of areas where in-person interventions are easily available. While immersive virtual environments have become a common tool in many areas of psychiatric care, such as exposure therapy, our results suggest that this technology in multiuser settings is still in its early stages. Most identified studies investigated mainstream technologies, such as videoconferencing or text-based support, substituting the immersive experience for convenience and ease of use. While many studies discuss useful features of virtual environments in group interventions, such as anonymity or stronger engagement with the group, we discuss persisting issues with these technologies, which currently prevent their full adoption.

Community-Based Mental Health Improvement Initiatives: A Narrative Review and Indiana Case Study.

There is a global mental health crisis: mental illness is underrecognized, underdiagnosed, and undertreated with adverse effects on mental, physical, and social health. In the United States, there is an insufficient number of traditional psychiatric and psychological resources to provide the mental health care needed to solve this crisis. Community-based interventions could be an important adjunct to traditional mental health care. An evaluation of peer-reviewed articles was performed describing community-based interventions and identified 3 approaches with some evidence of effectiveness: (1) interventions that enhance community mental health literacy to improve recognition of early signs of mental illness for early engagement and provide community, family, and peer support; (2) community clinics providing social, medical, and mental health care and support to transition-age youth (15-25 years); and (3) social networking activities to enhance interactions among elders suffering from social isolation and loneliness. Multisector, multidisciplinary, and multicomponent interventions involving health care providers and community-based organizations had the best evidence of effectiveness and should target transition-age youth and elders.

Beyond Hemoglobin A1c—Outcomes That Matter to Individuals With Type 1 Diabetes in Adopting Digital Health Interventions for Self-Management Support: Qualitative Study

Background Type 1 diabetes is a demanding chronic condition that requires diligent blood glucose monitoring and timely insulin administration by patients who must integrate self-management into their daily lives. Objective This study aimed to better understand what outcome measures are important to individuals living with type 1 diabetes (T1D) in Ontario, Canada, to help inform the development of type 1 diabetes virtual self-management Education and support (T1ME) trial. Methods A qualitative approach was used, in which we conducted 6 focus groups with a total of 24 adult participants living with T1D (from age 18 to >65 years) in Ontario. Each focus group was semistructured in nature; participants were encouraged to talk openly about their experiences with T1D self-management and provide their perspectives on more focused topics such as technology and relationships with health care providers. Results An interpretive analysis helped us devise a framework for our results that centered around 6 main discussion themes: (1) adapting self-management to meet evolving needs, (2) looking “beyond A1c” toward more personalized indicators of glycemic management, (3) the benefits and challenges of adopting new T1D technology, (4) establishing trusting relationships with diabetes care providers, (5) perceived benefits of peer support, and (6) pre– and post–COVID-19 perspectives on virtual care. Conclusions Our goal is for these findings to help facilitate the development of patient-oriented outcome measures that are in line with the unique needs and preferences of T1D patients in this new, more virtual landscape of clinical care, education, and self-management support.

Overlooked professionalism-Individual factors for success of peer support workers

The peer support worker is becoming increasingly more relevant also due to the new personnel regulations. Therefore, the question arises which individual conditions for success are available for the implementation of peer support workers. This study is a subproject of ImpPeer-Psy5 study financed by Innovation Funds, which investigates the nationwide requirements for the implementation of peer support workers in care financed by health insurance funds (German Social Act V, SGB V). Using a comparative thematic analysis, 57 problem-oriented interviews with peer support workers (PSW), employees and users as well as a focus group based on this were examined. This study was predominantly implemented by a researcher who already had experience in psychiatry and crises. From the perspective of the employees interviewed, sympathy and personality are the core factors for a successful implementation of peer support workers. In contrast, a professional coping with one's own crisis and recovery experience as well as diverse previous life and occupational experiences were prioritized by the PSWs. In order to effectively incorporate the impulse of peer support workers, a recognition of the professional identity of the PSWs is necessary. In particular, settings that separate the tasks between the professional groups in a less hierarchical manner and rely on building relationships, such as domestic treatment, are particularly suited for the implementation of PSWs.

An environmental scan of limb loss rehabilitation centers across Canada.

The clinical landscape of limb loss rehabilitation across Canada is poorly delineated, lacks standard rehabilitation guidelines, and is without a shared clinical database. To address these gaps, the objective of the present study was to undertake an environmental scan of the rehabilitation centers across Canada that provide inpatient and/or outpatient services to the limb loss community. An environmental scan was conducted to describe the rehabilitation service structure, program services, and outcome measures of sites across Canada. A survey was sent to 36 rehabilitation centers providing care to people with amputations. Of the 36 centers, 31 completed the survey (11 = Ontario; 8 = Quebec; 6 = British Columbia; 2 = Saskatchewan; 2 = New Brunswick; 1 = Alberta; 1 = Manitoba). Twenty-five provided both inpatient and outpatient services, 1 provided inpatient care only, and 5 provided only outpatient services. Interprofessional services were provided to a wide range of upper extremity amputation and lower extremity amputation patient populations. Range of motion was the most commonly collected outcome for both patients with upper extremity amputation and lower extremity amputation. With regard to prosthetics and orthotics fabrication, 9 of the sites had these services on-site while 15 had off-site fabricators, 6 had both, and 1 provided no response. Our findings highlight that limb loss rehabilitation and prosthetic care delivery is variable across Canada with respect to clinical team members, locations of services, and complementary services such as mental health treatments and peer support groups.

Healthcare worker perspectives on HIV status sharing intervention components for partnered, Black sexual minority men in South Africa

ABSTRACT: Background Globally, there is suboptimal coverage of antiretroviral treatment to treat and prevent HIV. It is crucial for individuals to know their partner’s HIV status so they may use all appropriate and available prevention tools. For sexual minority men in South Africa, a population known to face intersecting forms of marginalization including a disparate burden of HIV incidence, there are challenges to status sharing. Objective We explore perspectives of healthcare workers (HCW) with expertise providing services to sexual minority men to identify strategies to support HIV status sharing. Methods As part of a larger study designed to improve HIV-related health outcomes for sexual minority men, we conducted one focus group discussion (participant n = 4) and two in-depth-interviews with HCW. We used thematic analysis to synthesize qualitative themes and identify corresponding implications for interventions. Results HCW each had 5–23 years of experience. We identified three implementation considerations to support sharing of HIV status: (1) ensuring partner support for sharing status while circumventing risk of personal harms, (2) facilitating concordant couple-based peer support and belonging, and (3) leveraging the strengths of mass media as educational tools. Conclusion HCW highlighted that sharing that one is living with HIV is a sensitive and potentially dangerous process that can be managed by involving both partners in the process. This process may be supported by incorporating HIV status sharing narratives in popular media.

From Pain To Purpose: Do Former Cancer Family Caregivers Benefit From Providing Online Peer Support?

From Pain To Purpose: Do Former Cancer Family Caregivers Benefit From Providing Online Peer Support?

Hubungan Dukungan Teman Sebaya dan Kelekatan Orang Tua Terhadap Kecerdasan Emosional pada Siswa Sekolah Menengah Kejuruan (SMK)

The objective of this research is to determine the relationship between peer support and parental attachment with emotional intelligence in Vocational High School (SMK) students. The variables used in this study are peer support and parental attachment as independent variables (X) and Emotional Intelligence as the dependent variable (Y). The researcher employed a quantitative correlational approach with a sample of 247 students using proportionate stratified random sampling. The research instruments utilized adapted scales for emotional intelligence, peer support, and parental attachment. The emotional intelligence scale was adapted from the Assessing Emotional Scale (AES) with a Cronbach’s Alpha reliability of 0.960, the peer support scale was adapted from the Peer Support Questionnaire (PSQ) with a Cronbach’s Alpha reliability of 0.782, and the parental attachment scale was adapted from the Parental Attachment Questionnaire (PAQ) with a Cronbach’s Alpha reliability of 0.820. The analysis results showed that the variables of peer support and parental attachment simultaneously indicated an R-Square score of 0.170 or 17.0%, suggesting that peer support and parental attachment are related to emotional intelligence by 17%, while the remaining 83% is influenced by other variables or factors outside of this study.

Commentary: The COVID-19 pandemic and its impact on adolescent development: Embracing a more ecological perspective.

To assess the impact of the COVID-19 pandemic on young people's functioning, relationships, and well-being, four systematic reviews were put together to shed light on school experiences, family and peer relationships, and civic engagement during the pandemic. The reviews presented research findings on the protective role of several personal and contextual resources including intrinsic motivation, self-efficacy, family, school, peer, and community support, as well as the harming effect of risk factors, such as poor mental health, COVID-19-related stressors, and technological challenges, thus highlighting the significant role of both personal and contextual factors in adolescent development and well-being. Equally important, the research findings collectively suggested an ecological perspective of the determining factors, although the focus was largely on factors in immediate contexts (family, school, peers, and local community). Adopting a more holistic approach that also considers factors in other ecological contexts (e.g., partnership between immediate contexts, the influence of cultural values and norms along with educational and developmental transitions) can be crucial in addressing the specific needs of young people across diverse contexts and cultures during a pandemic and in general. In addressing their needs, the ever-growing digital space of young people can be utilized to connect them to services and supportive networks in their contexts including distal ones.

The environment is somewhat alike for different adaptive motivations: Machine learning reveals optimal motivational contexts involve collective support of parents, teachers, and peers

Achievement motivation is fundamental for human flourishing. While numerous adaptive motivational constructs have been proposed, they are often examined in isolation without considering their shared contextual roots. To identify the contextual factors underlying different forms of adaptive achievement motivation, we conducted comprehensive analyses by integrating a global student assessment dataset (n = 77,068 middle-school students across 19 countries, Mage = 15.79). We conducted a literature review and identified 27 potential predictors theoretically and empirically related to achievement motivation, including immediate contextual factors available in the dataset and distal contextual factors available from varying sources. Results from machine learning analyses showed convergent patterns of the contextual predictors for adaptive motivation (self-efficacy, learning goals, and task mastery orientation). Specifically, the optimal environment for adaptive motivation is characterized by the collective positive influence from parents, teachers, and peers, rather than depending on one exclusively. In comparison, the pattern of other less adaptive motivation constructs (fixed mindsets, performance goals, and fear of failure) is idiosyncratic. These findings provide synthesized evidence consolidating achievement motivation research, highlighting the shared contextual foundations for various adaptive motivations. This integrative approach clarifies that the optimal motivational contexts involve the collective social support of parents, teachers, and peers.

Exploring female fitness app users' motivations and perceptions: A qualitative study.

Women make up nearly 60% of fitness App users and play an important role in the operation and development of these Apps. Despite the widespread adoption of fitness Apps in recent years due to their many physical and mental benefits, the use of Apps tends to be short-term, and user engagement is relatively low. Little is known about the factors that motivate female users to consistently use fitness Apps. This study aimed to study attributes of fitness Apps that are most likely to influence female users during their use of Apps. The means-ends chain theory and the soft-laddering interview technique were used to analyze the attributes that influenced females' perceptions of fitness apps, focusing on the features most likely to provide them with benefits and value. The results of the study indicated that instructiveness, interaction, personalization, ease of use, and convenience were the most important attributes valued by female fitness App users; peer support, entertainment, and exercise adherence were the most important consequences; and health, self-fulfillment, enjoyment of life and sense of achievement were the most important values. The findings provide researchers and management of fitness Apps and women's sports with valuable insights from the means-ends chain theory, as well as suggestions for applying App design and promotion.

A prospective mixed‐methods pilot study of a novel group structured education programme for adults with cystic fibrosis diabetes

AbstractBackground: Cystic fibrosis diabetes (CFD) is associated with increased morbidity and mortality in adults with cystic fibrosis (CF). In addition, poor glycaemic control can result in microvascular complications. Group educational programmes for people with type 1 and 2 diabetes have been shown to improve diabetes outcomes. The national guidelines recommend that people with CFD should receive education regarding diabetes; however, specific CFD group education programmes have not been evaluated.Aims: This study aimed to test whether this novel diabetes contents and intervention for CFD based on the Beta Cell Education Resources for Training in Insulin and Eating (BERTIE) type 1 diabetes education programme was beneficial for adults with CFD. The adapted course, Improved Diabetes Education in Adults with Cystic Fibrosis (IDEA‐CF ), incorporated CFD‐specific topics and was delivered virtually via videoconference group sessions to facilitate peer learning and support without the risk of cross‐infection. A pilot study was conducted utilising this novel IDEA‐CF virtual structured program to ensure that the intervention met the patients’ educational needs.Methods: This randomised controlled multimethods pilot study recruited adults with CFD taking insulin therapy and cared for by a large regional CF centre. After providing written informed consent, the participants completed all the study forms and questionnaires before randomisation. Randomisation was performed using a computerised randomisation system that allocated adults with CFD into the intervention group (IDEA‐CF) or routine care group for the 12‐week study period. Participants who were randomised into the routine group continued to receive one‐on‐one education as before. Using the CF quality‐of‐life (QoL) questionnaire (revised Cystic Fibrosis Questionnaire [CFQ‐R]), outcomes were measured at baseline and 12‐week visits in both groups. The participants in the intervention group were asked to take part in a semistructured qualitative interview after the completion of the intervention, which was performed by a CF psychologist.Results: A total of 20 participants were recruited, with 18 completing the intervention and study follow‐up visits. In the CFQ‐R domains, physical functioning, emotional functioning, eating, role functioning and respiratory symptoms were significantly improved in the intervention group compared with the routine care group. The IDEA‐CF Knowledge Assessing Questionnaire (IDEA‐CF KAQ) scores in the intervention group improved compared with the IDEA‐CF KAQ scores in the control group, suggesting that education improves knowledge and understanding. The IDEA‐CF structured virtual group education group was well received, with participants valuing the educational content and the ability to interact with each other and to learn from their peers’ experiences constructively.Conclusions: Our study demonstrated that the IDEA‐CF education programme improved health‐related QoL and diabetes knowledge, as evidenced by the results of the IDEA‐CF KAQ. The participants valued the educational contents of the programme and reported a positive experience interacting with their peers.

Engaging endometrial cancer survivors as peer supporters for equitable cancer care: The SISTER Study training process

Engaging endometrial cancer survivors as peer supporters for equitable cancer care: The SISTER Study training process

‘Online boundary-work’: How people with diabetes negotiate what counts as legitimate knowledge in Facebook peer support groups

‘Online boundary-work’: How people with diabetes negotiate what counts as legitimate knowledge in Facebook peer support groups

How a buddy scheme created social and intercultural space for international and home students

Buddy schemes are a form of learning intervention that create a space for students to support each other by ‘sharing knowledge, ideas and experience between [...] participants’ (Boud, 2001, p.3). The author set up and conducted research to evaluate a buddy scheme to support international Nursing students on a one-year programme by matching them with a home-student buddy studying at the same level. This small-scale, qualitative study sought to investigate international and home students’ experiences of participating in the buddy scheme. An online survey asked students to evaluate their access to social and academic support before and during the scheme through textual and numerical questions. A self-selecting subgroup of participants subsequently took part in semi-structured interviews to reveal their experiences and insights. These were recorded and transcribed before the data were analysed using inductive textual analysis to identify key themes. In line with wider literature, this study found peer support has a positive influence on international students’ socio-cultural transition (McPherson, Punch and Graham, 2017; Shu et al., 2020; WONKHE, 2022), yet it is also ‘mutually beneficial’ (Boud, 2001, p.3), having a positive impact on both groups of students. Home students valued the opportunity to build relationships with peers they would not have otherwise met (Bethel, Ward and Fetvadjiev, 2020). This opportunity for intercultural exchange enriched their experience too. As such, this study adds weight to existing evidence that buddy schemes are a useful means by which UK universities can support international and home students.

Autistic psychiatrists' experiences of recognising themselves and others as autistic: a qualitative study.

Diagnosis of autism falls under the remit of psychiatry. Recognition that psychiatrists could be autistic is recent. Psychiatrists are the second largest specialty group in Autistic Doctors International, a peer support group for autistic doctors. To explore the experiences of autistic psychiatrists in relation to recognising themselves and others as autistic. This was a qualitative study using loosely structured interviews and an interpretive phenomenological analysis. Eight autistic senior psychiatrists based in the UK participated. One had a childhood diagnosis, two had been diagnosed in adulthood and the remainder self-identified as autistic as adults. Recognition of autism followed diagnosis of their children or encounters with autistic patients. Barriers to self-recognition included lack of autism training, the deficit-based diagnostic criteria and stereotypical views of autism. Recognising that they were autistic led to the realisation that many colleagues were also likely to be autistic, particularly in neurodevelopmental psychiatry. All participants reported the ability to quickly recognise autistic patients and to develop a good rapport easily, once they were aware of their own autistic identity. Difficulties recognising patients as autistic occurred before self-recognition when they shared autistic characteristics and experiences. 'If we don't recognise ourselves as autistic how on earth can we diagnose patients accurately?' Autistic psychiatrists face multiple barriers to recognising that they are autistic. Lack of self-recognition may impede diagnostic accuracy with autistic patients. Self-recognition and disclosure by autistic psychiatrists may be facilitated by reframing the traditional deficit-based view of autism towards a neurodiversity-affirmative approach, with consequent benefits for autistic patients.

Innovative healthcare solutions for resource-limited settings expanding pharmaceutical care to remote populations

Access to essential healthcare and pharmaceutical services remains a significant challenge in resource-limited settings. This paper explores innovative strategies for expanding pharmaceutical care to remote populations, focusing on the integration of mobile health technologies and community-based interventions. Mobile health (mHealth) technologies, including telemedicine and mobile pharmacies, offer a cost-effective means of delivering healthcare services, enhancing access, and improving real-time monitoring. Community-based interventions, such as the deployment of community health workers, health education campaigns, and peer support groups, play a critical role in addressing healthcare disparities and improving health literacy and medication adherence. The paper also discusses the integration of pharmaceutical care models, emphasizing the importance of collaboration among healthcare providers, pharmacists, and community health workers. Future directions highlight emerging innovations like AI and blockchain technology, while policy recommendations emphasize the need for investment in healthcare infrastructure, professional training, and regulatory support. By leveraging these strategies and innovations, healthcare outcomes and equity in resource-limited settings can significantly improve.

A four-factor model of executive function: Predicting physical and academic outcomes from cognitive assessments in adolescents

Impulsivity and cognitive function are essential for understanding behavioral regulation, particularly in relation to health-risk behaviors like substance use, physical activity, and academic performance. This study examined the factor structure underlying executive function in adolescents using the UPPS-P Impulsive Behavior Scale and NIH Toolbox Cognition Battery. We explored how parental monitoring moderates, and peer network health and perceived stress mediate, relationships between cognitive function and outcomes such as BMI, physical activity, and academic performance. Exploratory factor analysis (EFA) on 2228 observations identified a four-factor model (BIC = −97.92, RMSEA = 0.040, TLI = 0.936), validated by confirmatory factor analysis (CFA) (CFI = 0.961, RMSEA = 0.055). Structural equation modeling (SEM) on 5902 observations showed that parental monitoring moderated Factor 1 (adaptive impulsivity) in relation to physical activity and academic performance, while peer network health mediated Factor 2 (emotional impulsivity) effects on BMI and physical activity. This model underscores the influence of peer relationships, parental involvement, and stress on cognitive, health, and academic outcomes, suggesting that interventions enhancing peer support, reducing stress, and promoting healthy behaviors may improve adolescent well-being.

The critical need for child and youth perceptions of active living in India: capturing context complexity in rural and urban regions.

The physical inactivity pandemic not only has a negative impact on the physical and mental health of children and youth, but it is also a key contributor to the non-communicable disease (NCD) burden, particularly among low- and middle-income countries. The widespread effects of climate change, ranging from extreme weather events to worsening air quality, are exacerbating the physical inactivity pandemic, highlighting the need to undertake holistic interventions to address environmental barriers while promoting physical activity. Despite the potential benefits of active school transportation (AST) on physical activity and the environment, no study has examined the intersection between perceptions of AST, environmental perceptions, and moderate-to-vigorous physical activity (MVPA) among children and youth in India from a child and youth perspective. As a part of this cross-sectional, observational study, digital survey links were administered to 1,042 children and youth aged 5 to 17 (50.3% boys; 49.7% girls). Participants were recruited from 41 schools across 28 rural and urban regions in India. Children and youth provided information on various sociodemographic factors, perceptions of crime and air pollution, and peer support factors. MVPA data were collected using an adapted version of the IPAQ short-form questionnaire. The overall sample was stratified by age, gender, and location, resulting in a total of seven multiple linear regression models to assess the association between AST and MVPA. Children and youth who engaged in AST were associated with higher MVPA than those who did not engage in AST (β=18.020, 95% CI [5.890 to 30.149], p=0.004), after adjusting for age, gender, and location. In contrast, perceptions of high crime in the neighbourhood (β=-21.921, CI [-36.195 to -7.647], p=0.003) and perceptions of air pollution (β=-12.472, CI [-23.797 to -1.147], p=0.031) were associated with lower MVPA. Moreover, having active friends was associated with higher MVPA (β=32.391, CI [9.264 to 55.518], p=0.006) than not having active friends. AST was significantly associated with higher MVPA in the boys, rural, and aged 13 to 17 models; however, this association was not statistically significant in the girls, urban, and aged 5 to 12 models. These findings highlight that promoting AST can potentially promote MVPA and contribute to mitigating the NCD burden among children and youth in India. Future policies and interventions should prioritize initiatives that promote AST, considering diverse sociodemographic factors, and addressing environmental challenges such as perceptions of crime and air pollution.