Telephone-based Peer Support Research Articles

Effectiveness of the mom supports mom peer support intervention in treating antenatal mental health difficulties in women

ProblemUp to 75 % of at-risk perinatal women do not receive treatment in Czechia. BackgroundPregnant women with mental health difficulties are more likely to undergo less controversial nonpharmaceutical treatment during pregnancy, but structural and psychological barriers interfere with their capacity to seek professional help. AimWe tested the effectiveness of the telephone-based peer support intervention Mom Supports Mom (MSM) in Czech pregnant women at risk of mental disorder. MethodsThe Edinburgh Postnatal Depression Scale (EPDS) was used to assess risk in women (EPDS ≥ 10). Women at risk were randomized into two groups; the intervention group received the MSM, while the control group received the care as usual, which did not contain any psychological support intervention. One month after completing the EPDS, the women's mental statuses were again measured and compared, this time with data before and after the intervention, using the Perinatal Anxiety Screening Scale (PASS) to measure anxiety, the EPDS to measure depression, the Prenatal Psychosocial Profile (PPP) to measure stress, and the Prenatal Attachment Inventory – Revised (PAI-R) to measure attachment. The trial was registered under the name Pregnancy without psychosocial stress (ClinicalTrials.gov ID NCT04853693). FindingsA total of 167 women were included in the study and randomized into two groups. Depressive symptoms did not decrease (Cohen´s d; 95 % CI = 0.48; 0.17–0.79; p = .002), but levels of anxiety (Cohen´s d; 95 % CI = 0.44; 0.13–0.75; p = .005) and psychosocial stress (Cohen´s d; 95 % CI = 0.55; 0.20–0.82; p = .002) were reduced in women in the intervention group compared with women in the control. In addition, prenatal attachment increased among intervened women (Cohen´s d; 95 % CI = 0.48; 0.17–0.79; p = .002). DiscussionThe telephone-based peer support intervention MSM is effective in reducing stress and anxiety and increasing prenatal attachment but does not reduce depression among high-risk women.

Peer support during in vivo exposure homework increases likelihood of prolonged exposure therapy completion

ABSTRACT Exposure-based treatments such as prolonged exposure therapy (PE) are effective for veterans with PTSD. However, dropout rates as high as 50% are common. The Department of Veterans Affairs employs peers to increase mental health treatment engagement, however peers are not routinely used to help patients complete PE homework assignments. The present study included 109 veterans who decided to drop out from exposure-based treatment after completing seven or fewer sessions and used a randomized controlled design to compare PE treatment completion rates in response to 2 forms of peer support: (1) standard weekly telephone-based peer support vs. (2) peer-assisted in vivo exposure, wherein peers accompanied veterans (virtually or in person) during a limited number of in vivo exposure assignments. There were no differences between instrumental vs general peer support conditions as randomized. However, post hoc analyses indicated that 87% of those who completed at least one peer-assisted in vivo exposure completed treatment, compared to 56% of those not completing any peer-assisted in vivo exposure. The dose effect of peer-assisted in vivo exposure increased to 93% with 2 or more peer-assisted exposures, and 97% with 3 or more peer-assisted exposures. The present study suggests that augmenting PE with instrumental peer support during in vivo exposure homework may reduce dropout if completed. Future research should test whether the impact of peer-assisted in vivo exposure is enhanced when offered at the beginning of treatment as opposed to waiting until the point of dropout.

Preventing postnatal depression in new mothers using telephone peer support: protocol for the DAISY (Depression and AnxIety peer Support studY) multi-centre randomised controlled trial

IntroductionPostnatal depression affects up to one in six new mothers in Australia each year, with significant impacts on the woman and her family. Prevention strategies can be complicated by a...

From Fathers to Fathers—Telephone-Based Peer Support: A Feasibility Study

Background: Men can struggle with adapting to their new roles as they transition into fatherhood. While social support has been shown to be effective at aiding this transition, little research has focused on the implementation of, and satisfaction with, telephone-based peer support for new fathers. Aims: This qualitative study aimed to investigate the implementation of, and satisfaction with, a telephone-based peer support program for new fathers. Methods: A qualitative study with 13 interviews of first-time fathers and peers was analysed using content analysis, in accordance with Elo and Kyngäs. Individual interviews were conducted using a semi-structured interview guide that lasted between 30–45 min. Results: Two themes emerged from the fathers’ interviews (n = 6): (1) conditions that affect the telephone support experience; and (2) the importance of support. The fathers appreciated the confirmation stories shared by their peers, as these stories served as valuable examples that they could adapt and incorporate into their own parenting approaches. Two themes emerged from the peer interviews (n = 7): (1) peers’ own role and experience; and (2) the Importance of listening to fathers. Peers felt appreciated and acted like role models for new fathers, helping them to adjust to parenting life. Study limitations: The results may not transfer to multi-time fathers. Conclusions: The findings of this study provide valuable insights into the potential benefits and challenges of implementing a telephone-based peer support program for first-time fathers, which could further inform similar interventions.

Is proactive telephone-based breastfeeding peer support a cost-effective intervention? A within-trial cost-effectiveness analysis of the ‘Ringing Up about Breastfeeding earlY’ (RUBY) randomised controlled trial

ObjectiveThe ‘Ringing Up about Breastfeeding earlY’ (RUBY) randomised controlled trial showed increased breastfeeding at 6 months in participants who received the proactive telephone-based peer support breastfeeding intervention compared with participants...

Abstract P378: Design of the Equity in Prevention and Progression of Hypertension by Addressing Barriers to Nutrition and Physical Activity (EPIPHANY) Study: A Cluster Randomized Trial

Introduction: High rates of hypertension and poverty in the rural South contribute to health disparities with Black adults experiencing higher rates of cardiovascular disease than White adults. Clinical trials have shown that lifestyle interventions like the Dietary Approaches to Stop Hypertension diet and increasing physical activity reduce the risk for hypertension. However, suboptimal implementation indicates a need to identify mechanisms of prevention in rural populations impacted by negative social determinants of health that can make achieving healthy lifestyle behaviors more challenging. Methods and Results: The EPIPHANY (Equity in Prevention and Progression of Hypertension by Addressing barriers to Nutrition and Physical activitY) Study is a cluster randomized controlled trial testing a multilevel intervention designed to reduce community and individual barriers to a healthy lifestyle to lower blood pressure (BP) among rural, Black adults. EPIPHANY is enrolling and randomizing 20 churches in the Black Belt region of Alabama. Health education fairs offered to all churches are being used to screen and enroll Black adults with elevated BP or stage 1 hypertension (120-139 mm Hg and diastolic BP <90 mm Hg) who are not recommended for antihypertensive medication, according to the 2017 American College of Cardiology/ American Heart Association BP guideline. Participants (n=240) in churches randomized to the control condition are offered access to online resources including cooking demonstrations and exercise classes. Participants (n=240) in churches randomized to the intervention are receiving access to online resources; telephone-based peer support for lifestyle modification, goal setting and problem solving; funding for churches to develop programs to address food access and/or barriers to physical activity; and training of church members to serve as peer health advocates to deliver training for church members on lifestyle modification. We will employ a Type 1 Hybrid Implementation-effectiveness design to assess the effectiveness and implementation of this multi-level intervention, using the RE-AIM framework. BP, social determinants of health, psychosocial factors, physical activity and diet are being assessed. The EPIPHANY trial began recruitment in August 2022 and has enrolled 18 and 25 Black adults in the first two churches randomized to the control and intervention conditions, respectively, and recruited four churches for the next wave of screenings. Conclusion: The EPIPHANY study is designed to prevent hypertension among rural, Black adults by addressing structural and individual barriers to lifestyle modification through peer support. The study could provide evidence for a feasible, scalable and sustainable approach to preventing hypertension in rural, underserved communities.

Autopsy of a telephone-based peer support intervention: Exploring participants' perspectives of and experiences with a self-management support model for adults with type 2 diabetes from speciality care settings.

To explore participants' experiences with and perspective of a telephone-based, peer-led diabetes self-management intervention targeting adults with type 2 diabetes (T2D) from speciality care settings. We also sought to identify areas for improvement for future iterations of the intervention. This study recruited 25 adults with T2D from the intervention arm of a randomized controlled trial of a peer support intervention for diabetes. Individuals took part in semi-structured interviews that explored the following topics: perceived impact of the intervention, relationship with peer leader, desirable characteristics in a peer leader, and suggestions for improving the intervention. Focus groups were recorded, transcribed, quality checked, coded, and analysed to develop themes and subthemes. Four core themes emerged: (1) importance of the 'participant-peer leader' match, (2) peer leader roles and responsibilities, (3) need for flexible support models, and (4) factors affecting intervention implementation and engagement. The quality of the participant-peer leader relationship appeared to be linked to intervention satisfaction. Beyond demographic features such as age and sex, key characteristics for forming a strong match included stage of life, lifestyle, diabetes-related factors, and communication style. Participants have unique ideas about what support should look like and preferences for how support is best delivered. Future models of peer support need to be customizable to individuals' needs and responsive to changes in life circumstances. If participants are the decision makers in the matching process, they may experience greater satisfaction and derive maximal benefits.

Out of the mouths of Peer Leaders: Perspectives on how to improve a telephone‐based peer support intervention in type 2 diabetes

To explore the experiences of peer leaders with respect to delivering core components of a 12-month, telephone-based peer support intervention in type 2 diabetes within a tertiary-care setting. Seventeen peer leaders were recruited and interviewed. Interviews lasted approximately 20 to 45min, were audio-taped, and transcribed verbatim. The transcripts were analysed by two team members using the qualitative descriptive approach. Peer leaders reported mutually beneficial and reciprocal relationships with participants. They encountered challenges in maintaining regular contact with participants and in motivating them to make lifestyle changes. To improve the programme, peer leaders suggested having more frequent - but shorter - training sessions and reducing the diabetes education component of the training programme. To enhance the intervention fidelity and retention rate, they recommended matching peer leaders to participants on more meaningful variables (e.g. diabetes-related commonalities, personality, life experiences, etc.) beyond just gender, geographic proximity and availability. They also requested more frequent face-to-face contacts with participants (Modality of Contact), and additional ongoing support from the research team. Peer leaders were satisfied with the intervention design. However, future studies may consider more comprehensive peer leader-matching algorithms and increased opportunities for in-person communication modalities. gov Identifier: NCT02804620.

First-time mothers\u2019 experiences of receiving proactive telephone-based peer support for breastfeeding in Australia: a qualitative study

BackgroundThe RUBY randomised controlled trial was found to be effective in promoting breastfeeding continuation, in the setting of a high income country, through a program of proactive telephone-based peer support in the first 6 months postpartum. This paper explores women’s experiences of receiving the peer support intervention in the RUBY trial.MethodsTen in-depth, face-to-face interviews were conducted between December 2015 and November 2016 in Metropolitan Melbourne, and regional Victoria, Australia. Participants were women who received the peer support intervention in the RUBY trial and were between 11 and 15 months postpartum at the time of interview. Interviews were underpinned by social support theories and were analysed using inductive thematic analysis.ResultsA global theme of ‘non-judgemental support and guidance’ was identified, which included five organising themes. Four of the organising themes centred on the support from the peer, in which women felt the support was a ‘positive experience with empathy and understanding’, ‘non-judgemental’, ‘practical advice’, and a ‘social connection that was more than just breastfeeding’. In contrast to the support from peers was the theme ‘not all support from family and friends is supportive’.ConclusionParticipants, including those who considered that they had adequate and available family and friend support for breastfeeding, valued and appreciated the non-judgemental, empathetic and understanding support from peers. This support, facilitated by the anonymity of the telephone-based program, allowed open and honest conversations, normalising women’s experiences and helping them feel less alone in their challenges with breastfeeding and transition to motherhood. These findings can inform the design, and upscaling, of innovative and sustainable peer support models, ensuring delivery of effective and engaging support with a broad population reach.

Abstract TP38: Evaluation Of A Stroke Survivor To Survivor Program

Background: Since 2015 a Primary Stroke Center in the Midwest has had a Stroke Survivor to Survivor Program (SS2S). The SS2S program was developed by a local non-profit organization whose mission is to provide advocacy, support, education and resources to stroke survivors and their families. SS2S is a telephone-based peer support program that aims to encourage, support, network, and provide resources to stroke survivors post discharge. The SS2S program provides at least 2 monthly calls from trained SS2S stroke volunteers to participants and/or caregivers. The volunteers educate on treatment and appointment adherence, offer community resources, information on support groups, access to Podcasts, and a connection to survivors and/or caregivers with other survivors. Purpose: An evaluation of SS2S was conducted to inform program effectiveness, as well as identify opportunities for program improvement for replication and scalability. Methods: The evaluation study was a one-group, post-only design. Adults who experienced a stroke and received treatment at the study hospital were eligible to participate. Participants who met the inclusion criteria were invited to participate in the SS2S program evaluation. A third party conducted the interviews using a semi-structured interview guide approved by the IRB. Interviews were transcribed and coded for themes using an inductive and deductive thematic approach and analyzed using NVivo 12. Results: Interviews were conducted for four months. 32 participants were contacted, 6 agreed to a full interview and 2 agreed to provide limited feedback. The majority were male and had at least 2 calls with a SS2S volunteer. The majority indicated they had a positive experience. Both participants and coordinators agreed that stroke survivors with residual stroke complications, limited resources and limited social support would benefit from the program the most. The majority of participants agreed that they enjoyed receiving a follow up phone call and were encouraged by them. Conclusions: Although the study sample size was small, the results support the SS2S program aims. The program works best when it connects patients with relevant and timely resources as well as offers the survivors the emotional support to talk freely and feel heard.

Telephone-based peer support intervention to reduce depressive symptoms in women with coronary heart disease, a randomized controlled trial in Germany

ABSTRACT Depressive symptoms in patients with coronary heart disease (CHD) predict adverse outcomes regarding e.g. cardiovascular complications. We trained women with CHD to support female peers through telephone-based counseling and tested whether depressive symptoms can be reduced, and perceived social support can be improved by the intervention over six months. 108 women with CHD and self-reported depressive or anxiety symptoms were included in a randomized controlled trial. The intervention group was offered immediate telephone-based peer support for six months, while the waiting list control group received the intervention with a 6-months delay. Primary outcomes were depressive symptoms and perceived social support immediately after the intervention period and at 6-months-follow-up. 40% of the women made use of the peer support. During the first six months, both groups showed a reduction in depressive symptoms (IIG: t(169) = −1.79, p = .08; WCG: t(169) = −2.76, p = .007) and a significant improvement in social support (IIG: t(175) = 3.54, p < .001; WCG: t(175) = 3.36, p < .001). We found no significant group × time interactions. There was no influence of telephone-based peer support on depressive symptoms and social support. We discuss potential causes for both lack of specific treatment effects and the general improvement over time in both groups.

Peer-Assisted Lifestyle (PAL) intervention: a protocol of a cluster-randomised controlled trial of a health-coaching intervention delivered by veteran peers to improve obesity treatment in primary care

IntroductionAmong US veterans, more than 78% have a body mass index (BMI) in the overweight (≥25 kg/m2) or obese range (≥30 kg/m2). Clinical guidelines recommend multicomponent lifestyle programmes to promote...

Proactive telephone-based peer support for breastfeeding: a cross-sectional survey of women’s experiences of receiving support in the RUBY randomised controlled trial

ObjectiveThe Ringing Up about Breastfeeding earlY (RUBY) randomised controlled trial (RCT) of proactive telephone-based peer support for breastfeeding found that infants of women allocated to the intervention were more likely...

Volunteers' experiences of providing telephone-based breast-feeding peer support in the RUBY randomised controlled trial.

The Ringing Up About Breastfeeding earlY (RUBY) randomised controlled trial (RCT) found that a telephone-based peer volunteer support intervention increased breast-feeding duration in a setting with high breast-feeding initiation. This sub-study of the RUBY RCT describes the motivation, preparation and experiences of volunteers who provided the peer support intervention. An online survey was completed by 154 (67 %) volunteers after ceasing volunteering. Volunteers provided peer support to primiparous women (n 574) who birthed at one of three public hospitals in Melbourne, Australia, between February 2013 and December 2015. Volunteers (n 230) had themselves breastfed for at least 6 months and received 4 h of training for the role. The median number of mothers supported was two (range 1-11), and two-thirds of respondents supported at least one mother for 6 months. Volunteers were motivated by a strong desire to support new mothers to establish and continue breast-feeding. Most (93 %) considered the training session adequate. The majority (60 %) reported following the call schedule 'most of the time', but many commented that 'it depends on the mother'. Overall, 84 % of volunteers were satisfied with the role and reported that the experience was enjoyable (85 %) and worthwhile (90 %). Volunteers agreed that telephone support for breast-feeding was valued by women (88 %) and that the programme would be effective in helping women to breastfeed (93 %). These findings are important for those developing similar peer support programmes in which recruiting volunteers and developing training requirements are an integral and recurrent part of volunteer management.

The Influence of Breastfeeding Peer Support on Breastfeeding Satisfaction Among Japanese Mothers: A Randomized Controlled Trial.

Peer support may help mothers to feel satisfied with their breastfeeding and to continue breastfeeding. However, previous researchers have not examined the influence of peer support on the three breastfeeding-satisfaction domains. We aimed to examine the influence of telephone-based peer support on the following three domains of breastfeeding satisfaction among Japanese mothers: maternal satisfaction, perceived benefit to the infant, and lifestyle compatibility with breastfeeding. Breastfeeding mothers were recruited at four maternity hospitals in Japan to participate in a randomized controlled trial. Data were collected 1 month and 4 months postpartum. Among all of the participants (N = 114), those in the intervention group (n = 60) received telephone-based peer support until 4 months postpartum, and participants in the control group (n = 54) received conventional support. Breastfeeding satisfaction was measured using the short version of the revised Japanese Maternal Breastfeeding Evaluation Scale. Generalized estimating equations and effect size analyses were used to examine the influence of the intervention. On the subscale measuring lifestyle compatibility, participants with peer support had a higher score than those without peer support: regression coefficient 1.54 (95% confidence interval [0.03, 3.04]). The effect size was 0.40 standard deviations among participants with low and mid-level scores at baseline. Although peer support did not change maternal satisfaction or perceived benefit to the infant, it did increase lifestyle compatibility with breastfeeding among these Japanese mothers. This is evidence in favor of increasing the use of peer support.

Proactive Peer (Mother-to-Mother) Breastfeeding Support by Telephone (Ringing up About Breastfeeding Early [RUBY]): A Multicentre, Unblinded, Randomised Controlled Trial

BackgroundBreastfeeding rates are suboptimal internationally, and many infants are not receiving any breast milk at all by six months of age. Few interventions increase breastfeeding duration, particularly where there is relatively high initiation. The effect of proactive peer (mother-to-mother) support has been found to increase breastfeeding in some contexts but not others, but if it is shown to be effective would be a potentially sustainable model in many settings. We aimed to determine whether proactive telephone-based peer support during the postnatal period increases the proportion of infants being breastfed at six months of age. MethodsRUBY (Ringing Up about Breastfeeding earlY) was a multicentre, two-arm un-blinded randomised controlled trial conducted in three hospitals in Victoria, Australia. First-time mothers intending to breastfeed were recruited after birth and prior to hospital discharge, and randomly assigned (1:1) to usual care or usual care plus proactive telephone-based breastfeeding support from a trained peer volunteer for up to six months postpartum. A computerised random number program generated block sizes of four or six distributed randomly, with stratification by site. Research midwives were masked to block size, but masking of allocation was not possible. The primary outcome was the proportion of infants receiving any breast milk at six months of age. Analyses were by intention to treat; data were collected and analysed masked to group. The trial is registered with ACTRN, number 12612001024831. FindingsWomen were recruited between Feb 14, 2013 and Dec 15, 2015 and randomly assigned to peer support (n = 574) or usual care (n = 578). Five were not in the primary analysis [5 post-randomisation exclusions]. Infants of women allocated to telephone-based peer support were more likely than those allocated to usual care to be receiving breast milk at six months of age (intervention 75%, usual care 69%; Adj. RR 1·10; 95% CI 1·02, 1·18). There were no adverse events. InterpretationProviding first time mothers with telephone-based support from a peer with at least six months personal breastfeeding experience is an effective intervention for increasing breastfeeding maintenance in settings with high breastfeeding initiation. FundingThe Felton Bequest, Australia, philanthropic donation and La Trobe University grant.

Effect of peer support on health outcomes in patients with cardiac pacemaker implantation: A randomized, controlled trial.

The aim of this study was to examine the effect of a nurse-led telephone-based peer support program on health outcomes in patients after cardiac pacemaker implantation. Seventy six patients who received cardiac pacemaker implantation were recruited as participants and randomly assigned to either the peer support group or the usual care group. The usual care group received routine care and health education measures provided by nurses; the peer support group received telephone-based peer support. Health-related quality of life, self-care knowledge-attitudes-practice, postoperative anxiety and depression, compliance with attending scheduled follow-up visits, and the incidence of postoperative complications were evaluated at baseline and 6 months' postintervention for the two groups. The result showed that the interventions had a better effect on self-care knowledge-attitudes-practice, postoperative anxiety and depression, and compliance with attending scheduled follow-up visits in the peer support group than in the usual care group. This study confirms that telephone-based peer support improves self-care ability, compliance with attending scheduled follow-up visits, and reduces postoperative anxiety and depression more effectively than conventional nurse care among patients with cardiac pacemaker implantation.

Determinants of hospitalization in Chinese patients with type 2 diabetes receiving a peer support intervention and JADE integrated care: the PEARL randomised controlled trial

BackgroundIn a randomized controlled trial of 628 Chinese patients with type 2 diabetes receiving multidisciplinary care in the Joint Asia Diabetes Evaluation (JADE) Progam, 372 were randomized to receive additional telephone-based peer support (Peer Empowerment And Remote communication Linked by information technology, PEARL) intervention. After 12 months, all-cause hospitalization was reduced by half in the PEARL group especially in those with high Depression Anxiety and Stress Scale (DASS) scores.MethodsWe used stratified analyses, negative binomial regression, and structural equation modelling (SEM) to examine the inter-relationships between emotions, self-management, cardiometabolic risk factors, and hospitalization.ResultsHospitalized patients were older, more likely to have heart or kidney disease, and negative emotions than those without hospitalization. Patients with high DASS score who did not receive peer support had the highest hospitalization rates. After adjustment for confounders, peer support reduced the frequency of hospitalizations by 48% with a relative risk of 0.52 (95% CI 0·35–0·79;p = 0·0018). Using SEM, improvement of negative emotions reduced treatment nonadherence (Est = 0.240, p = 0.034) and hospitalizations (Est=−0.218, p = 0.001). The latter was also reduced by an interactive term of peer support and chronic kidney disease (Est = 0.833, p = < 0.001) and that of peer support and heart disease (Est = 0.455, p = 0.001).ConclusionsIn type 2 diabetes, improvement of negative emotions and peer support reduced hospitalizations, especially in those with comorbidities, in part mediated through improving treatment nonadherence. Integrating peer support is feasible and adds value to multidisciplinary care, augmented by information technology, especially in patients with comorbidities.Trial registrationNCT00950716 Registered July 31, 2009.

Perspectives of Women Considering Bilateral Prophylactic Mastectomy and their Peers towards a Telephone-Based Peer Support Intervention.

Prophylactic mastectomy is an effective strategy to reduce the risk of breast cancer for women carrying a BRCA1/2 germline mutation. This decision is complex and may raise various concerns. Women considering this surgery have reported their desire to discuss the implications of this procedure with women who have undergone prophylactic mastectomy. We conducted a qualitative study to describe the topics covered during a telephone-based peer support intervention between women considering prophylactic mastectomy (recipients) and women who had undergone this surgery (peers), and to explore their perspectives regarding the intervention. Thirteen dyads were formed and data from participant logbooks and evaluation questionnaires were analyzed using a thematic content analysis. Three main dimensions emerged: physical, psychological, and social. The most frequent topics discussed were: surgery (92%), recovery (77%), pain and physical comfort (69%), impacts on intimacy and sexuality (54%), cancer-related anxiety (54%), experience related to loss of breasts (46%). Peers and recipients report that sharing experiences and thoughts about prophylactic mastectomy and the sense of mutual support within the dyad contributed significantly to their satisfaction. Special attention should be paid to the similarities between personal and medical profiles in order to create harmonious matches.

The effect of a peer support intervention on early recovery outcomes in men recovering from coronary bypass surgery: A randomized controlled trial.

Examine the effect of a professionally-guided telephone peer support intervention on recovery outcomes including depression, perceived social support, and health services utilization after coronary artery bypass graft surgery (CABG). A randomized controlled trial was conducted with post-coronary artery bypass graft surgery men ( N=185) who were randomized before hospital discharge. The intervention arm received telephone-based peer support through weekly telephone calls from a peer volunteer over six weeks, initiated within 3-4 days of discharge. Although a significant difference was detected in pre-intervention depression scores at discharge, there were no differences between groups in changes in depression scores at six weeks ( p=0.08), 12 weeks (0.49) or over time ( p=0.51); and no significant differences in perceived social support scores over time ( p=0.94). At 12 weeks, the intervention group had significantly lower incidence of health services utilization (family physician ( p=0.02) and emergency room ( p=0.04)). Healthcare providers need to continue to investigate novel interventions to enhance social support and reduce depression in cardiac patients.