Promote Peer Support Research Articles

Designing illustrative social media stories to promote adolescent peer support and healthy sexual behaviors.

ObjectiveAdolescent females in the United States continue to have unmet sexual and reproductive healthcare needs. Research shows that interventions incorporating peer support can augment perceived self-efficacy and reinforce healthy behaviors. Yet, few user-centered digital sexual health interventions incorporate peer support, and aim to change perceptions of peer norms and model social skills. The objective of this study was to design and demonstrate the receptivity of adolescent females to illustrated digital social media stories that promote healthy sexual behaviors and peer social support.MethodsWe conducted a three-phase study approved by our Institutional Review Board. In Phase 1, we presented sexually active adolescent female emergency department patients aged 14–19 with eight sexual health scenarios via a survey study. Participants wrote three text messages addressed to the protagonist of each scenario which motivated and encouraged her to consider the use of contraceptives. Messages were scored based on the construct of peer support (emotional, tangible, informational, and belonging). In Phase 2, we worked with a professional artist and screenwriter to design digital sexual health comics using the gathered messages. In Phase 3, we gathered feedback on the comics from adolescent female emergency department patients.ResultsFemales (n = 22) provided 352 messages. Using top rated messages, we designed five digital visualizations in a running story called Mari tells it like it is. Each story incorporated 5–12 peer-authored quotes. We inserted the final images into Instagram®. Additional females (n = 39) found the images “relatable,” “super-realistic,” and “educational.”ConclusionCollecting peer-authored texts from our local adolescent community led to the creation of well-received sexual health visualizations. This novel method of design incorporated adolescent voices to promote peer support and healthy behaviors.

Redefining help through peer support.

WHAT IS KNOWN ON THE SUBJECT?: Traditional mental health services are not meeting the needs of service users. Peer support is an alternative approach of providing support founded on relationship where there is respect and shared responsibility. Peer support relationships are mutual and reciprocal. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The experience of peer-led care can be transformative. A key aspect is the validation and valuing of lived experience and being seen as a person not as an illness. The nature and quality of relationships is paramount and needs to be based on equity. WHAT ARE THE IMPLICATIONS FOR MENTAL HEALTH NURSING?: Nurses have a key role to advocate and promote peer support services. Relationships need to be based on respect and "being alongside" service users in their recovery journey rather than trying to "fix the problem." ABSTRACT: Introduction Peer-led services provide an approach to support based on mutuality, respect and shared experience. Aim To provide an understanding of my experiences of receiving help from a peer-led service. Method Journaling experiences captured in detail the reality of my experiences at the time and were used to inform this paper. Results The Narrative describes entering a Peer-Led Acute Alternative Service when I was amid a mental health crisis and feeling broken. Here, relationships were based on connecting with others who have experienced similar struggles, being seen as an individual rather than a patient, treated with dignity and respect, being heard, having my feelings acknowledged rather than medicated and feeling understood. This created a shift in me to a place of healing and finding meaning in my experiences of mental distress which led to me training in peer support. Discussion Peer-led services can be a transformative experience which redefines the relationship and shifts the person from being a passive recipient of help to an active participant in their recovery. Choice and increased options for peer services as an integral aspect of services available for individuals on their mental health journey is critical.

Factors That Influence Physical Activity Among Older Adults Living in Rural Community in Wangthong District, Phitsanulok, Thailand

This study aimed to assess the individual, interpersonal, and environmental factors that relate to physical activity (PA) among older adults in rural communities in Wangthong district, Phitsanulok, Thailand. A cross-sectional study was conducted on 545 elders by multi-stage sampling. The data were collected via a validated questionnaire. Multiple logistic regression analysis was performed to identify potential determinants of PA. Factors including youngest-old (adjusted OR 1.55, 95% CI [1.05–2.28]), high level of income (adjusted OR 1.89, 95% CI [1.17–3.19]), being a member of the elders’ club (adjusted OR 1.68, 95% CI [1.15–2.46]), and high level of perceived self-efficacy (adjusted OR 1.79, 95% CI [1.23–2.61]) indicated higher likelihood of PA ( p < .05). Interventions to improve PA among older people should include improving physical environmental attributes, creating more inexpensive and less time-consuming alternatives for PA, promoting peer support networks and activities to enhance self-efficacy.

"Not Alone in Loneliness": A Qualitative Evaluation of a Program Promoting Social Capital among Lonely Older People in Primary Health Care.

The weekly group-based program “Paths: from loneliness to participation” was conducted face-to-face over 15 sessions by nurses, social workers and volunteers in primary care in Catalonia (Spain) to alleviate loneliness among older people by promoting peer support and participation in community assets. We aimed at exploring participants’ experiences of loneliness and participation prior to the program and its perceived benefits. The qualitative design was descriptive-interpretative. Data were collected through three focus groups and 41 interviews applying a semistructured topic guide involving 26 older participants, six professionals and nine volunteers. Participant-observation of all sessions involved the 38 older people who started the program. A thematic content analysis was applied. Older persons with diverse profiles of loneliness and participation explained different degrees of decrease in loneliness, an increase in participation in local community assets, companionship, peer support and friendship, and an empowerment process. Successful cases reported improvements in mental wellbeing and recovering the sense that life was worth living. Loneliness persisted among some widowed participants and vulnerabilities hampered some benefits. Participants, professionals and volunteers reported different degrees of success in older people to alleviate loneliness by enhancing social relationships and activities through complex processes interrelated with health and socioeconomic factors.

Testing an analogue game to promote peer support and person‐centredness in education for people with diabetes: A realist evaluation

AimTo explore the outcomes of testing an analogue game to incorporate person‐centredness and peer dialogues in group‐based diabetes education targeting people with diabetes.DesignRealist evaluation using quantitative and qualitative methods to explore context, mechanisms and outcomes of the intervention.MethodsIn March–July 2019, the game was tested among 76 people with type 2 diabetes and 17 professionals in 19 settings across nine Danish municipalities. Data consisted of game tests, interviews and questionnaires. Data were analysed using systematic text condensation and descriptive statistics.ResultsOutcomes of using the game were as follows: (a) a playful atmosphere; (b) active engagement; c) reflections on diabetes‐specific experiences; (d) focused dialogues; (e) professionals gaining insight into the needs of participants; and (f) professionals experiencing peer dialogue as important to incorporate into education. Questionnaire responses showed that 92% people with diabetes and 94% professionals found that the game incorporated person‐centredness and peer dialogues into education.

Understanding Users' Perspectives of Psychosocial Mechanisms Underpinning Peer Support Work in Chile.

This study explores the beliefs and attitudes about the psychosocial mechanisms of peer support work among users who participated in Critical Time Intervention-Task Shifting (CTI-TS), which tested the acceptability and feasibility of a peer support work model to improve community-based mental health care for individuals with psychosis in Latin America. We conducted a secondary analysis of 15 in-depth interviews with CTI-TS participants in Chile, using the framework method and defined the framework domains based on five major mechanisms of peer support work identified by a recent literature review. The analysis revealed that users' perceptions of peer support work mechanisms were strongly shaped by personal motivations, beliefs about professional hierarchies, familial support, and the Chilean mental health system's incipient recovery orientation. The findings underscore the importance of adopting culturally tailored strategies to promote peer support work, such as involving mental health professionals and fostering equal-powered relationships between PSWs and users.

The Development and Process Evaluation of a 3-Day Acceptance and Commitment Therapy Group Program for Adolescent Cancer Survivors

BackgroundAdolescents diagnosed with cancer experience unique psychosocial concerns that persist beyond treatment completion into longer-term survivorship. Camp-based, group Acceptance and Commitment Therapy (ACT) programs are a potential model for providing evidence-informed psychological and peer support to adolescent cancer survivors.ObjectiveThis paper describes the development and exploration of the feasibility and acceptability of such a program, Places You’ll Go. This manualised program incorporates five 90-min group ACT sessions within a 3-day camp, teaching ACT strategies in the context of psychosocial impacts of cancer.MethodEight facilitators and twenty-eight Australian adolescent cancer survivors (68% female; age range 12–17 years, M = 15.4 years) participated in the program and evaluation. Feasibility was assessed using facilitator-reported session duration, attendance, quality and content fidelity; facilitators also completed interviews after program completion. Young people completed surveys on program acceptability at the end of each session and at program completion.ResultsAll planned sessions were delivered, with 97% attendance and high fidelity in manualised program delivery. All young people were mostly or very satisfied and would recommend the program to another cancer survivor. Opportunities for peer connection and skill development contributed to perceived program acceptability.ConclusionsThe Places You’ll Go program was acceptable and feasible to deliver. It is a promising community-based model for promoting peer support and well-being in adolescent cancer survivors, indicating the potential of ACT-based approaches for this population. Further work is underway to evaluate whether the program improves psychosocial wellbeing among participants, and if this is linked to the therapeutic mechanisms underpinning ACT.

Getting motivated: long-term perspectives on engaging in community-based programs after acquired brain injury

ABSTRACT Background Low motivation is a common problem after acquired brain injury (ABI) and can persist for years after injury. Little is known, however, about perspectives of motivation with respect to engaging in the community, many years after ABI. Purpose To explore the client with ABI perspective of motivation and engagement in individuals based in community ABI programs. Method Interpretive description methods were utilized. Semi-structured interviews were conducted with 21 individuals with an ABI. Findings Participants felt that both internal factors, such as feelings of hope, and external factors, such as social support, influence levels of motivation to engage. When positive internal and external motivators were enhanced, and negative internal and external motivators reduced, this gave rise to a sense of choice and control, which led to increased engagement. Implications Fostering positive aspects of rehabilitation and increasing choice and control may promote engagement. External motivators, such as reducing repetitiveness and promoting peer support, are motivators that community and clinical settings can implement relatively easily, whilst internal motivators such as attitudes toward therapy may need to be addressed continuously to enhance motivation and engagement.

Empowerment Experience of Mentally Ill Persons Providing Peer Support

Purpose: This study aimed to describe the empowerment experience of mentally ill persons providing support. Methods: Three supporters were recruited. A small group interview was conducted with supporters in November 2018. The transcribed data were analyzed using a qualitative case study. Results: Three primary themes and seven sub-themes emerged as follows. The first theme is “Personal empowerment,” including 1) Remove the sense of helplessness, 2) Be confident, and 3) Establish self-identity. The second theme is “interpersonal empowerment”, including 1) Breaking out of isolation and taking an interest in peers, and 2) Assert opinion to family. The last theme was “political empowerment”, including 1) Want to legalize peer support program, and 2) Move to promote peer support program. Conclusion: Through the activities of support, mentally ill persons have diverse empowerment experiences. The results of this study indicated that legislation of the support program is necessary to improve their empowerment experience. And it calls for study focusing on the effectiveness and necessity of support programs.

Body Dissatisfaction and Depressive Symptoms on the Threshold to Adolescence: Examining Gender Differences in Depressive Symptoms and the Impact of Social Support

The current study focused on the relationship between body dissatisfaction and depressive symptoms on the threshold of adolescence. We aimed to investigate the role of body dissatisfaction in gender differences in depressive symptoms, as well as the impact of social support from peers and parents. Mediation and moderation analyses were based on self-reports from a Norwegian population-based sample (the Tracking Opportunities and Problems Study) of 12- to 13-year-olds ( N = 547). Body dissatisfaction explained over 20% of the variance in depressive symptoms. The findings indicate that body dissatisfaction mediates gender differences in depressive symptoms, and that peer support moderates the positive association between body dissatisfaction and depressive symptoms. This is in line with Stress Exposure and Stress-Buffering models. The findings indicate that to prevent depressive symptoms in the transition into adolescence, focus should be on promoting body satisfaction, especially in girls, as well as promoting peer support for adolescents already struggling with body dissatisfaction.

Psychographic characteristics, tobacco, and alcohol use in a sample of young adults on the U.S./México border

Few studies using psychographic segmentation have been conducted; even fewer in minority samples. Study aims were to identify psychographic clusters and their relation to tobacco and alcohol use within a predominantly Hispanic (87%) young adult (ages 18–25) sample. Participants (N=754; 72.5% female; Mage=20.7 [2.2]) completed the following measures online: sociodemographics, tobacco use history, the Daily Drinking Questionnaire (Collins, Parks, & Marlatt, 1985), a social activities scale, a psychographic survey, a music preference item, the Brief Sensation Seeking Scale (Hoyle, Stephenson, Palmgreen, Lorch, & Donohew, 2002), and the Mini-International Personality Item Pool (Donnellan, Oswald, Baird, & Lucas, 2006). Two step cluster analysis identified two groups. ‘Popular Extroverts’ (49.3% of sample) reported higher: extroversion scores F(1, 652)=40.03, sensation seeking scores F(1, 652)=20.38, alcohol use (greater number of drinks per week [F(1, 652)=9.69]; and past month binge drinking [χ² (1)=12.80]), and lifetime tobacco use (χ² [1]=10.61) (all ps≤0.002). ‘Mainstream/Conventionals’ (50.7% of sample) reported greater intentions to smoke in the next month F(1, 284)=11.81, p=0.001. ‘Popular Extroverts’ may benefit from prevention/cessation messaging promoting peer support and intensity-oriented activities. For ‘Mainstream/Conventionals,’ messaging communicating negative attitudes toward smoking and the tobacco industry may be effective. Future directions include testing targeted messages which may be incorporated into mass media tobacco and alcohol interventions for young adults on the U.S./México border.

From Action Learning to Bonding Social Capital? The Potential of Action Learning Sets Among Isolated Rural Clergy

Clergy often struggle with the sense of isolation associated with the unique demands of parish ministry. This sense can be heightened when serving in rural communities, where the burden of isolation may include working with small numbers, experiencing social isolation, and lacking colleagues for daily prayers and sharing ideas. A mechanism that can address structural issues and promote peer support could go some way to managing isolation. This article examines recognised theory and practice of one potential solution: action learning (AL). Reflecting New Testament leadership dynamics, AL sets are utilised increasingly within Church leadership development programmes. It is argued that the potential benefits of a stand-alone AL intervention for isolated rural clergy are two-fold: this pedagogical approach enables set members to engage with and reflect on real-life problems in collaboration with colleagues, and can also generate enduring social capital through the valuable networks set members build in the process.

Foundation for the Future: Meeting the Psychosocial Needs of Children Living With HIV in South Africa and Uganda

Successes in diagnosing and treating pediatric HIV have necessitated care that extends beyond basic medical needs. However, capacity for providing childhood psychosocial support (PSS) remains limited. Programmatic research with young PLHIV, care providers and parents in Uganda and South Africa explored challenges in meeting the psychosocial needs of HIV-positive children. Three areas for childhood PSS were examined: disclosure, stigma, and grief/bereavement. This research identified programming gaps, strategies and good practices in five focal areas: providing immediate postdiagnosis support, stigma reduction, capacity building, addressing grief, and promoting peer support. Recommendations are presented for enhancing PSS for HIV-positive children in resource-limited settings.

Stress, positive psychology and the National Student Survey

The aim was to explore the predictive ability of sources of stress and a range of dispositional and coping behaviours on student satisfaction and motivation. Most research exploring sources of stress and coping in students construes stress as psychological distress, with little attempt to consider positive experiences of stress. A questionnaire was administered to 120 first–year UK psychology students. Questions were asked which measured sources of stresswhen rated as likely to contribute to distress (a hassle) and likely to help one achieve (an uplift). The sources of stress were amended from the UK National Student Survey (NSS, 2011). Support, control, self–efficacy, personality and coping style were also measured, along with their potential affect on course satisfaction, motivation and feeling part of a learning community. Thesources of stress likely to lead to distress were more often significant thansources of stress likely to lead to positive, eustress states. Ironically, factors one would consider would help students, such as the university support facilities, only did so when rated as a hassle, not as an uplift. Published university league tables draw heavily on student course satisfaction but this negatively correlated with intellectual motivation and feeling part of a learning community. This suggests course satisfaction alone reveals an incomplet picture of the student experience. Course educators need to consider how course experiences contribute not just to potential distress but to potential eustress. Teaching quality, effective support and work–life balance are key to student satisfaction and motivation. How educators interact with their students and the opportunities they create in and outside the class to promote peer support are likely to enhance satisfaction and motivation.

Health Professionals’ Preparation for Supporting Children and Parents Affected by Asthma and Allergies

Background: The objective of this study was to assess health professionals’ learning needs and preferences pertinent to the support and education of children with asthma and allergies. Method: A 26-item online survey (n = 47) and qualitative interviews (n = 10) elicited information from health professionals about the perceived support and education needs of children with asthma and allergies, health professionals experience and educational needs regarding support of children. Results: Health professionals believed that children needed professional education, support, and strategies to reduce effects of asthma and allergies. Time (66%) and cost (80.9%) were significant barriers to non-webbased education. Although these health professionals were interested in learning from and connecting with their own peers; promoting peer support for children with asthma and allergies received a lower rating on their list of education needs. Conclusions: This needs assessment study confirms that health professionals have limited time, funds, and options for asthma-and allergy-related professional development activities. It emphasizes the need for web-based education, group discussions, inclusion of information, and practical skills for teaching children. Understanding the value of incorporating peer support and social support into health programs may be limited.

Health Professionals’ Preparation for Supporting Children and Parents Affected by Asthma and Allergies

Although social support originates from sources both informal (eg, family, peers) and formal (eg, health professionals), most reported research focuses on informal support providers. The perspectives and learning needs of health professionals as potential support providers for children and families affected by asthma and allergies form a gap in the reported research. The objective of this study was to assess health professionals’ learning needs and preferences pertinent to the support and education of children with asthma and allergies. A 26-item online survey and qualitative interviews (n, 10) elicited information from health professionals about the perceived support and educational needs of children with asthma and allergies, experience and challenges working with children, health professionals’ educational needs regarding support of children, and continuing education needs and barriers. Health professionals believed that children needed professional education, support, and strategies to reduce the effects of asthma and allergies on their lifestyle. Time (66.0%) and cost (80.9%) were significant barriers to non-Web-based education, but only 14.6% rated time and cost a barrier to Web-based education. Family or work commitments were slightly greater obstacles for non-Web-based education (63.8%) than for Web-based education (51.2%). Although these health professionals were interested in learning from and connecting with their peers, promoting peer support for children with asthma and allergies received a lower rating on their list of educational needs. This needs assessment study confirms that health professionals have limited time, funds, and options for asthma- and allergy-related professional development activities. It validates the need and value of Web-based education with access to an instructor, experts, and group discussions, and it supports the inclusion of asthma-specific information and practical skills for teaching children and for addressing challenges when teaching. Exposure to and understanding of the value of incorporating peer support and social support into existing health programs may be limited.

Peers for Progress: promoting peer support for health around the world

Peers for Progress, a global initiative of the American Academy of Family Physicians Foundation, developed out of the World Health Organization (WHO) Consultation on Peer Support Programmes in Diabetes as a strategic approach to promote best practices in peer support for health around the world. Why peer support. People often find themselves on their own to manage complex factors for behaviour change. Peer support can link people sharing experiences to provide the practical, emotional, and ongoing support that is critical to sustained behaviour change. The need. Diabetes is a global epidemic that affects all aspects of people's lives for the rest of their lives. The complexity of self-management requires ongoing support for effective and sustained management. Key principles, strategies, activities. Peers for Progress aims to strengthen evidence of the value of peer support through evaluation grants, encourage recognition of a state-of-the-art in peer support through defining key functions of support that can be tailored and applied globally, and promote peer support through networking with programmes and leaders around the world. People seeking to prevent or manage health conditions can be a powerful source of support to each other to manage complex behaviors. Peers for Progress has a defined functional framework for peer support's core functions, and is evaluating the scope and impact of peer support interventions based on this framework and a set of consensus evaluation measures. Peers for Progress looks to raise the visibility and applicability of peer support as good health care for all people.

Cross-cultural and international adaptation of peer support for diabetes management

Peer support may improve self-management among the millions of people with diabetes around the world. A major challenge to international promotion of peer support is allowing for tailoring to population, cultural, health system and other features of specific settings, while also ensuring congruence with standards for what peer support entails. One strategy to address this challenge was used in the Robert Wood Johnson Foundation Diabetes Initiative. Key functions of self-management-Resources and Supports for Self-Management-were identified. Individual programmes were then encouraged to implement these resources and support in ways that were feasible in their settings and responsive to the needs and perspectives of those they serve. Extending this to peer support, three Key functions are (i) assistance in managing and living with diabetes in daily life; (ii) social and emotional support and (iii) linkage to clinical care. International promotion may be advanced by emphasizing these key functions and then encouraging local variation in the specific ways they are addressed. Similarly, evaluation of the general benefits of peer support across several individual programmes may rest on measurement of implementation of the key functions, participants' reports of receipt of them and common end points. Challenges to promoting peer support include integrating peers amidst others in the health care system, harmonizing peers with family and other social networks, maintaining the engagement of peer supporters and those they assist and preventing training, quality improvement and professionalism from distorting the fundamental benefits of support from a peer.

Effects of psychosocial group rehabilitation on social functioning, loneliness and well‐being of lonely, older people: randomized controlled trial

This paper is a report of a study to explore the effects of psychosocial group nursing intervention on older people's feelings of loneliness, social activity and psychological well-being. Older people's loneliness is associated with low quality of life, and impaired health, increased use of health and social services and increased mortality. Previous intervention studies have achieved quite modest results. A randomized controlled trial was conducted between 2003 and 2006 using a group intervention aimed at empowering older people, and promoting peer support and social integration. A total of 235 people (>74 years) suffering from loneliness met 12 times with professional leaders in groups. The UCLA Loneliness Scale and Lubben's Social Network Scale were used at entry, after 3 and 6 months. Psychological well-being was charted using a six-dimensional questionnaire at baseline and 12 months later. A statistically significantly larger proportion of intervention group participants had found new friends during the follow-up year (45% vs. 32%, P = 0.048), and 40% of intervention group participants continued their group meetings for 1 year. However, no differences were found in loneliness or social networks between the groups. Psychological well-being score improved statistically significantly in the intervention groups [+0.11, 95% confidence interval (CI): +0.04 to +0.13], compared with the controls (+0.01, 95% CI: -0.05 to +0.07, P = 0.045). Feeling needed was statistically significantly more common in the intervention groups (66%) than in controls (49%, P = 0.019). New sensitive measurements of loneliness and social isolation are needed to measure fluctuations in feelings of loneliness and in social isolation.

Evaluation of a Therapeutic Camp Program for Adolescents with a Facial Difference

ABSTRACT A group program involving a therapeutic camp weekend was developed for adolescents living with a facial difference. The camp included a therapeutic program that emphasized peer support, task mastering, and self-reflection. Following the camp, evaluation surveys and two focus groups with adolescents and parents were conducted eliciting the perceived impacts of camp. Findings identify benefits of the camp group program including getting to know others, reducing isolation, increasing self-esteem and promoting peer support. Thoughtful recommendations by the campers themselves and the parents of the campers are presented. A social and therapeutic group intervention approach offers promise to adolescents with facial difference and their families.