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Giraldo A, Shah P, Zerbo E, Nyaku AN. The role of recovery peer navigators in retention in outpatient buprenorphine treatment: a retrospective cohort study. Ann Med 2024; 56:2355566. [PMID: 38823420 PMCID: PMC11146239 DOI: 10.1080/07853890.2024.2355566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 03/24/2024] [Indexed: 06/03/2024] Open
Abstract
BACKGROUND Racial and ethnic disparities are evident in the accessibility of treatment for opioid use disorder (OUD). Even when medications for OUD (MOUD) are accessible, racially and ethnically minoritized groups have higher attrition rates from treatment. Existing literature has primarily identified the specific racial and ethnic groups affected by these disparities, but has not thoroughly examined interventions to address this gap. Recovery peer navigators (RPNs) have been shown to improve access and overall retention on MOUD. PATIENTS AND METHODS In this retrospective cohort study, we evaluate the role of RPNs on patient retention in clinical care at an outpatient program in a racially and ethnically diverse urban community. Charts were reviewed of new patients seen from January 1, 2019 through December 31, 2019. Sociodemographic and clinical visit data, including which providers and services were utilized, were collected, and the primary outcome of interest was continuous retention in care. Bivariate analysis was done to test for statistically significant associations between variables by racial/ethnic group and continuous retention in care using Student's t-test or Pearson's chi-square test. Variables with p value ≤0.10 were included in a multivariable regression model. RESULTS A total of 131 new patients were included in the study. RPNs improved continuous retention in all-group analysis (27.6% pre-RPN compared to 80.2% post-RPN). Improvements in continuous retention were observed in all racial/ethnic subgroups but were statistically significant in the non-Hispanic Black (NHB) group (p < 0.001). Among NHB, increases in continuous retention were observed post-RPN in patients with male sex (p < 0.001), public health insurance (p < 0.001), additional substance use (p < 0.001), medical comorbidities (p < 0.001), psychiatric comorbidities (p = 0.001), and unstable housing (p = 0.005). Multivariate logistic regression demonstrated that patients who lacked insurance had lower odds of continuous retention compared to patients with public insurance (aOR = 0.17, 95% CI 0.039-0.70, p = 0.015). CONCLUSIONS RPNs can improve clinical retention for patients with OUD, particularly for individuals experiencing several sociodemographic and clinical factors that are typically correlated with discontinuation of care.
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Affiliation(s)
- Arley Giraldo
- Department of Psychiatry, NYU Grossman School of Medicine, NYC, NY, USA
| | - Payal Shah
- Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Erin Zerbo
- Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA
- Independent Private Practice, Montclair, NJ, USA
| | - Amesika N. Nyaku
- Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA
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Doris O, Morrissey EC. Experiences of students with chronic illness in university education in Ireland. Chronic Illn 2024:17423953241282246. [PMID: 39233585 DOI: 10.1177/17423953241282246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/06/2024]
Abstract
OBJECTIVE The aim of this study was to explore the experiences of university students with a chronic illness in Ireland. The study also aimed to gain insight into students' experiences with Disability Support Services (DSS) and identify gaps where additional supports and resources are needed. DESIGN Cross-sectional qualitative study. METHODS Fourteen students from three Irish universities participated in semi-structured interviews. The interviews were audio-recorded, transcribed, and analysed through the six-step process of reflexive thematic analysis. RESULTS Four themes were developed: (1) The burden of managing a chronic illness alongside university education; (2) Interruptions, disruptions and alterations to college life; (3) Flexible supports for fluctuating conditions; (4) Achieving in educating while living with a chronic illness. CONCLUSIONS Participants reported a physical and emotional burden. Despite engaging in rigorous management strategies, many participants missed lectures and socialising with peers. Some found the supports from DSS to be useful, however many were unsure if they qualified for support, or found the supports available to be generic and inadequate for their needs. There is significant scope for the delivery of both teaching and DSS to be improved for this cohort, ensuring that all students, regardless of their health status, have equal opportunities for success.
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Affiliation(s)
- Olga Doris
- School of Psychology, University of Galway, Galway, Ireland
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Satcher MF, Belenko S, Coetzer-Liversage A, Wilson KJ, McCart MR, Drazdowski TK, Fallin-Bennett A, Zaller N, Schultheis AM, Hogue A, Vest N, Sheidow AJ, Del Pozo B, Watson DP, Hibbard PF, Stevens R, Stein LAR. Linkage facilitation for opioid use disorder in criminal legal system contexts: a primer for researchers, clinicians, and legal practitioners. HEALTH & JUSTICE 2024; 12:36. [PMID: 39207608 PMCID: PMC11363440 DOI: 10.1186/s40352-024-00291-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 08/08/2024] [Indexed: 09/04/2024]
Abstract
At the intersection of drug policy, the opioid crisis, and fragmented care systems, persons with opioid use disorder (OUD) in the United States are significantly vulnerable to contact with the criminal legal system (CLS). In CLS settings, provision of evidence-based treatment for OUD is variable and often secondary to punitive approaches. Linkage facilitation at every touch point along the CLS Sequential Intercept Model has potential to redirect persons with OUD into recovery-oriented systems of care, increase evidence-based OUD treatment connections, and therefore reduce CLS re-exposure risk. Research in this area is still nascent. Thus, this narrative review explores the state of the science on linkage facilitation across the varied CLS contexts, including general barriers, facilitators, and opportunities for using linkage facilitation for OUD treatment and related services. Following the CLS Sequential Intercept Model, the specific CLS contexts examined include community services, police encounters, the courts (pre- and post-disposition), incarceration (pre-trial detention, jail, and prison), reentry (from jails, prisons, and unified systems), and community supervision (probation and parole). Examples of innovative linkage facilitation interventions are drawn from the Justice Community Opioid Innovation Network (JCOIN). Areas for future research and policy change are highlighted to advance the science of linkage facilitation for OUD services in the CLS.
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Affiliation(s)
- Milan F Satcher
- Department of Community & Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
- Department of Community & Family Medicine, Dartmouth Health, Lebanon, NH, USA.
- Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.
| | - Steven Belenko
- Department of Criminal Justice, Temple University, Philadelphia, PA, 19122, USA
| | | | | | | | | | - Amanda Fallin-Bennett
- University of Kentucky College of Nursing, Lexington, KY, USA
- Voices of Hope, Lexington, KY, USA
| | - Nickolas Zaller
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Alysse M Schultheis
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA
| | - Aaron Hogue
- Partnership to End Addiction, New York, NY, USA
| | - Noel Vest
- Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
| | - Ashli J Sheidow
- Lighthouse Institute, Chestnut Health Systems, Bloomington, IL, USA
| | - Brandon Del Pozo
- Division of General Internal Medicine, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Dennis P Watson
- Lighthouse Institute, Chestnut Health Systems, Bloomington, IL, USA
| | | | - Randy Stevens
- Hope for New Hampshire Recovery, Manchester, NH, USA
| | - L A R Stein
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
- Department of Behavioral & Social Sciences, Brown University, Providence, RI, USA
- Department of Behavioral Healthcare, Developmental Disabilities & Hospitals, Cranston, RI, USA
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Opie JE, Vuong A, Maylea C, Khalil H, Brown L, Macafee A, Ah Ket B, Pearce N, Guerin N, McIntosh JE. Understanding Lived Experience Organizations: A Systematic Scoping Review of Organizational Elements and Characteristics. Psychiatr Serv 2024:appips20230643. [PMID: 39188148 DOI: 10.1176/appi.ps.20230643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/28/2024]
Abstract
OBJECTIVE Mental health lived experience organizations (LEOs) and their lived experience workforce are increasingly recognized as invaluable. However, a deeper understanding of the elements that enhance or inhibit LEOs' efficacy is required to learn how to sustain LEOs and support their workforce. Rapid international expansion has resulted in significant LEO growth and change, challenging many LEOs to adapt. With this rapid expansion, the field is evolving faster than many LEOs can keep pace with. This review, codesigned and coproduced in partnership with a LEO to draw on both lived experience and academic perspectives, aims for a deeper understanding of which elements within a LEO enhance or inhibit its efficacy, growth, and support for its lived experience workforce. METHODS A systematic search of peer-reviewed and non-peer-reviewed literature, following the PRISMA-ScR guidelines and JBI methodology, identified 60 records published in English between 2000 and 2022. RESULTS The results indicate general agreement regarding which LEO elements are important (e.g., culture, leadership, board composition, organizational structure, financial arrangements, and professionalization). However, considerable disagreements exist regarding the relative influence of several of these elements, especially funding arrangements, in which funder and LEO values often diverge; training for increased lived experience professionalization; and partnerships with medical model-focused mental health services. CONCLUSIONS Organizational disagreements relate to managing future LEO growth and advancing the lived experience workforce while preserving LEOs' unique characteristics that make them valued mental health services. Further research should examine community differences among LEOs, including hybrid LEOs within services and non-LEO mental health organizations.
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Affiliation(s)
- Jessica E Opie
- Bouverie Centre (Opie, Vuong, McIntosh), School of Psychology and Public Health (Opie, Vuong, Khalil, McIntosh), and La Trobe Law School (Maylea), La Trobe University, Melbourne; School of Public Health, University of Texas Health Science Center at Houston, Houston (Brown); Victorian Mental Illness Awareness Council, Melbourne (Macafee, Ah Ket, Guerin); Library, La Trobe University, Bendigo, Victoria, Australia (Pearce)
| | - An Vuong
- Bouverie Centre (Opie, Vuong, McIntosh), School of Psychology and Public Health (Opie, Vuong, Khalil, McIntosh), and La Trobe Law School (Maylea), La Trobe University, Melbourne; School of Public Health, University of Texas Health Science Center at Houston, Houston (Brown); Victorian Mental Illness Awareness Council, Melbourne (Macafee, Ah Ket, Guerin); Library, La Trobe University, Bendigo, Victoria, Australia (Pearce)
| | - Christopher Maylea
- Bouverie Centre (Opie, Vuong, McIntosh), School of Psychology and Public Health (Opie, Vuong, Khalil, McIntosh), and La Trobe Law School (Maylea), La Trobe University, Melbourne; School of Public Health, University of Texas Health Science Center at Houston, Houston (Brown); Victorian Mental Illness Awareness Council, Melbourne (Macafee, Ah Ket, Guerin); Library, La Trobe University, Bendigo, Victoria, Australia (Pearce)
| | - Hanan Khalil
- Bouverie Centre (Opie, Vuong, McIntosh), School of Psychology and Public Health (Opie, Vuong, Khalil, McIntosh), and La Trobe Law School (Maylea), La Trobe University, Melbourne; School of Public Health, University of Texas Health Science Center at Houston, Houston (Brown); Victorian Mental Illness Awareness Council, Melbourne (Macafee, Ah Ket, Guerin); Library, La Trobe University, Bendigo, Victoria, Australia (Pearce)
| | - Louis Brown
- Bouverie Centre (Opie, Vuong, McIntosh), School of Psychology and Public Health (Opie, Vuong, Khalil, McIntosh), and La Trobe Law School (Maylea), La Trobe University, Melbourne; School of Public Health, University of Texas Health Science Center at Houston, Houston (Brown); Victorian Mental Illness Awareness Council, Melbourne (Macafee, Ah Ket, Guerin); Library, La Trobe University, Bendigo, Victoria, Australia (Pearce)
| | - Alexandra Macafee
- Bouverie Centre (Opie, Vuong, McIntosh), School of Psychology and Public Health (Opie, Vuong, Khalil, McIntosh), and La Trobe Law School (Maylea), La Trobe University, Melbourne; School of Public Health, University of Texas Health Science Center at Houston, Houston (Brown); Victorian Mental Illness Awareness Council, Melbourne (Macafee, Ah Ket, Guerin); Library, La Trobe University, Bendigo, Victoria, Australia (Pearce)
| | - Blossom Ah Ket
- Bouverie Centre (Opie, Vuong, McIntosh), School of Psychology and Public Health (Opie, Vuong, Khalil, McIntosh), and La Trobe Law School (Maylea), La Trobe University, Melbourne; School of Public Health, University of Texas Health Science Center at Houston, Houston (Brown); Victorian Mental Illness Awareness Council, Melbourne (Macafee, Ah Ket, Guerin); Library, La Trobe University, Bendigo, Victoria, Australia (Pearce)
| | - Natalie Pearce
- Bouverie Centre (Opie, Vuong, McIntosh), School of Psychology and Public Health (Opie, Vuong, Khalil, McIntosh), and La Trobe Law School (Maylea), La Trobe University, Melbourne; School of Public Health, University of Texas Health Science Center at Houston, Houston (Brown); Victorian Mental Illness Awareness Council, Melbourne (Macafee, Ah Ket, Guerin); Library, La Trobe University, Bendigo, Victoria, Australia (Pearce)
| | - Nicola Guerin
- Bouverie Centre (Opie, Vuong, McIntosh), School of Psychology and Public Health (Opie, Vuong, Khalil, McIntosh), and La Trobe Law School (Maylea), La Trobe University, Melbourne; School of Public Health, University of Texas Health Science Center at Houston, Houston (Brown); Victorian Mental Illness Awareness Council, Melbourne (Macafee, Ah Ket, Guerin); Library, La Trobe University, Bendigo, Victoria, Australia (Pearce)
| | - Jennifer E McIntosh
- Bouverie Centre (Opie, Vuong, McIntosh), School of Psychology and Public Health (Opie, Vuong, Khalil, McIntosh), and La Trobe Law School (Maylea), La Trobe University, Melbourne; School of Public Health, University of Texas Health Science Center at Houston, Houston (Brown); Victorian Mental Illness Awareness Council, Melbourne (Macafee, Ah Ket, Guerin); Library, La Trobe University, Bendigo, Victoria, Australia (Pearce)
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Osborn M, Ball T, Rajah V. Peer Support Work in the Context of Intimate Partner Violence: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2024:15248380241271350. [PMID: 39165104 DOI: 10.1177/15248380241271350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/22/2024]
Abstract
Peer support models of service provision have become increasingly prevalent in recent decades across multiple health and human services fields. In this scoping review, we examine peer support work within the context of intimate partner violence (IPV) service provision, including an examination of how this approach is conceptualized, the mechanisms underlying it, the impact of professionalism, and the benefits and challenges experienced by IPV peer support workers (PSWs). Three social science databases were searched with keywords related to IPV and peer support work, with additional articles and materials identified via targeted Google searches. The final sample of materials meeting criteria for the study (i.e., focusing on trained peer workers and their experiences serving IPV survivor clients) includes 10 papers and reports published from 1983 to 2022. We find that peer support work is conceptualized as a holistic alternative to traditional forms of IPV service provision, and that PSWs are viewed as occupying a unique role in relation to clients that enhances their ability to provide comprehensive care. However, we also identify several challenges resulting from the increasing professionalization of the IPV field, including a lack of role clarity for PSWs, a need to balance structure and flexibility in peer work service settings, and skepticism toward PSWs from credentialed professionals. Lastly, we find that although PSWs experience advantages from providing services, including enhanced personal growth and healing, they also navigate challenges related to maintaining their own emotional well-being and would benefit from additional training and institutional support.
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Affiliation(s)
| | - Tanyanne Ball
- John Jay College of Criminal Justice, New York, NY, USA
- City University of New York, USA
| | - Valli Rajah
- John Jay College of Criminal Justice, New York, NY, USA
- City University of New York, USA
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6
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Valjanow A, Weis J. One-to-one peer-coaching for patients with cancer - results of a pilot study. J Cancer Res Clin Oncol 2024; 150:385. [PMID: 39110146 PMCID: PMC11306543 DOI: 10.1007/s00432-024-05913-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Accepted: 07/29/2024] [Indexed: 08/10/2024]
Abstract
PURPOSE Cancer is a life threatening disease with negative impact on quality of life and psychological well-being. In international studies, one-to-one peer support and counseling have been shown to improve the psychological well-being of cancer patients. In the study presented, we developed and evaluated an innovative program of peer-coaching. In this program at the University Hospital of Freiburg, cancer survivors were trained to support peers by sharing experience. METHODS In the project, N = 25 cancer survivors were trained to conduct supportive one-to-one conversations with acute patients or patients in aftercare. Based on a prospective observational study, patients were interviewed using questionnaires before and after the conversations. We assessed expectations and experiences with the peer-coaching as well as psychosocial parameters (PHQ9, GAD7, SSUK, NCCN-distress thermometer). RESULTS A total of 52 patients had at least one contact with a peer-coach. Most of the patients attended 1-3 sessions. In total, 85 contacts pairing peer-coaches with patients were conducted. Patients showed on average a high level of distress but a low rate of psychiatric comorbidity. The supportive conversations met the patients` needs. Sharing experiences and empowerment were the most relevant benefits for the patients. Both patients and trained peers showed high satisfaction levels with the program. CONCLUSION Our findings support the feasibility and utility of a peer-coaching program in which trained cancer survivors, acting as peer-coaches, support other patients during or after their oncological treatment. In a further study, the efficacy of peer-coaching should be investigated based on a randomized-controlled trial. TRIAL REGISTRATION The trial was registered in the German Clinical Trials Register (No. DRKS DRKS00017500) on 12.12.2019.
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Affiliation(s)
- Alice Valjanow
- Comprehensive-Cancer Centre Freiburg (CCCF), Department of Self-Help Research University Clinic, Medical Faculty of the Albert-Ludwigs University, Hugstetterstr. 49, Freiburg, 79106, Germany
| | - Joachim Weis
- Comprehensive-Cancer Centre Freiburg (CCCF), Department of Self-Help Research University Clinic, Medical Faculty of the Albert-Ludwigs University, Hugstetterstr. 49, Freiburg, 79106, Germany.
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Leah P, Riewpaiboon W, Sirirungruang I, Visuttipun P. Feasibility of online psychosocial interventions to promote mental health recovery and well-being. Int J Soc Psychiatry 2024:207640241264656. [PMID: 39104060 DOI: 10.1177/00207640241264656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
BACKGROUND Amid the increasing trend and huge impact of mental illness, psychosocial support (PSS) has been asserted to support individuals' recovery. Unfortunately, about 80% of affected people cannot access care as needed. Meanwhile, digital technology has a considerable role in closing service gaps. AIMS This convergent parallel mixed methods study examines existing mental health service utilization, users' needs for PSS, and feasibility of online PSS development. METHODS A cross-sectional interview survey was conducted using a semi-structured questionnaire at a super tertiary psychiatric hospital in Thailand from March to May 2023, with three groups of service users, having self-perceived conditions/diagnosis of schizophrenia (n = 100), mood disorders (n = 84), and others including alcohol and substance use, anxiety and personality disorders (n = 52). Four focus group discussions with three user groups (n = 16) and one multidisciplinary provider group (n = 7) were parallelly executed. Quantitative and qualitative data were convergently analyzed using descriptive and inferential statistics, and thematic and content analysis. RESULTS Critical shortcomings of PSS were indicated by 75.8% of user participants. Six common types of self-determined PSS were psychoeducational program, support group, skills training, counseling, supported employment, and complimentary therapy. While psychoeducational program was feasible, support group, and counseling were possibly featured within the 'all-at-once' online intervention development. CONCLUSIONS PSS development based on users' needs can promote clinical and personal recovery outcomes, and close the service gaps. Users with mood disorders have the potential for online interventions. Peer-provider formalization, co-production approach, community engagement, digital literacy, infrastructures, and equal access factors are crucial for sustainable development.
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Affiliation(s)
- Peanchanan Leah
- Faculty of Medicine Ramathibodi Hospital, Ratchasuda Institute, Mahidol University, Salaya, Nakhon Pathom, Thailand
| | - Wachara Riewpaiboon
- Faculty of Medicine Ramathibodi Hospital, Ratchasuda Institute, Mahidol University, Salaya, Nakhon Pathom, Thailand
| | - Issavara Sirirungruang
- Faculty of Medicine Ramathibodi Hospital, Ratchasuda Institute, Mahidol University, Salaya, Nakhon Pathom, Thailand
| | - Paranee Visuttipun
- Faculty of Medicine Ramathibodi Hospital, Ratchasuda Institute, Mahidol University, Salaya, Nakhon Pathom, Thailand
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Branjerdporn G, Kimball H, Pirotta R, Branjerdporn N, Collins T, Bowman G, Gillespie KM. Characteristics and outcomes of community-based perinatal peer support: Protocol for a systematic review. PLoS One 2024; 19:e0303277. [PMID: 38950030 PMCID: PMC11216617 DOI: 10.1371/journal.pone.0303277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 04/04/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND Mental health issues and parenting difficulties in the perinatal period are common, and have significant negative impacts on individuals, families, and broader society. Community-based peer support programs might be an effective adjunct to standard mental health interventions in perinatal mental health issues, specifically where low-cost interventions are required, or access to professional care is limited. METHODS A systematic review will be undertaken. Searches will be conducted on four electronic databases (Pubmed, Embase, Cinahl, and PsycINFO), using terms related to perinatal mental health and peer support. Literature will be screened by title and abstract and then by full text. Selected studies will be evaluated using the Quality Assessment with Diverse Studies (QuADS) tool. Data relevant to community-based perinatal peer support intervention characteristics and outcomes will be extracted, and synthesised narratively. DISCUSSION This review will contribute to the existing evidence about perinatal mental health peer support, by synthesising information about community-based interventions specifically. The findings will be used to inform the design, implementation, and evaluation of a community-based perinatal mental health peer support program in urban and rural/remote hospital and health services in Australia. TRIAL REGISTRATION Systematic review registration: CRD42023451568.
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Affiliation(s)
- Grace Branjerdporn
- Mater Health, Catherine’s House for Mothers, Babies and Families, South Brisbane, Queensland, Australia
- Mater Research Institute—University of Queensland, South Brisbane, Queensland, Australia
| | - Hayley Kimball
- Mater Research Institute—University of Queensland, South Brisbane, Queensland, Australia
| | - Reaksmey Pirotta
- Mater Research Institute—University of Queensland, South Brisbane, Queensland, Australia
| | | | - Taryn Collins
- Mater Health, Catherine’s House for Mothers, Babies and Families, South Brisbane, Queensland, Australia
| | - Genevieve Bowman
- Mater Health, Catherine’s House for Mothers, Babies and Families, South Brisbane, Queensland, Australia
| | - Kerri M. Gillespie
- Mater Research Institute—University of Queensland, South Brisbane, Queensland, Australia
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Horn K, Mathis SM, Nagle L, Hagaman A, Dunkenberger MB, Pack R. Is peer support a tipping point for the opioid use disorder crisis in Appalachia? Research holds the answer. Harm Reduct J 2024; 21:122. [PMID: 38914988 PMCID: PMC11197219 DOI: 10.1186/s12954-024-01041-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 06/14/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND The present commentary highlights the pressing need for systematic research to assess the implementation and effectiveness of medications for opioid use disorder, used in conjunction with peer recovery support services, to improve treatment outcomes for individuals with opioid use disorder in Central Appalachia. This region, encompassing West Virginia, Eastern Kentucky, Southwest Virginia, East Tennessee, and Western North Carolina, has long grappled with a disproportionate burden of the opioid crisis. Due to a complex interplay of cultural, socioeconomic, medical, and geographic factors, individuals in Central Appalachia face challenges in maintaining treatment and recovery efforts, leading to lower success rates. APPROACH To address the issue, we apply an exploratory approach, looking at the intersection of unique regional factors with the utilization of medications for opioid use disorder, in conjunction with peer recovery support services. This combined treatment strategy shows promise in addressing crucial needs in opioid use disorder treatment and enhancing the recovery journey. However, there are significant evidence gaps that need to be addressed to validate the expected value of incorporating peer support into this treatment strategy. CONCLUSION We identify nine obstacles and offer recommendations to address the gaps and advance peer recovery support services research. These recommendations include the establishment of specific partnerships and infrastructure for community-engaged, peer recovery support research; improved allocation of funding and resources to implement evidence-based practices such as peer support and medication-assisted treatment; developing a more precise definition of peer roles and their integration across the treatment and recovery spectrum; and proactive efforts to combat stigma through outreach and education.
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Affiliation(s)
- Kimberly Horn
- Virginia Tech Institute for Policy and Governance, 201 W. Roanoke Street, Blacksburg, VA, 24061, USA.
| | - Stephanie M Mathis
- East Tennessee State University Addiction Science Center, 2109 West Market Street, Johnson City, TN, 37604, USA
| | - Lara Nagle
- Virginia Tech Institute for Policy and Governance, 201 W. Roanoke Street, Blacksburg, VA, 24061, USA
| | - Angela Hagaman
- East Tennessee State University Addiction Science Center, 2109 West Market Street, Johnson City, TN, 37604, USA
| | - Mary Beth Dunkenberger
- Virginia Tech Institute for Policy and Governance, 201 W. Roanoke Street, Blacksburg, VA, 24061, USA
| | - Robert Pack
- East Tennessee State University Addiction Science Center, 2109 West Market Street, Johnson City, TN, 37604, USA
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Lee SN, Yu HJ. Effectiveness of Peer Support Programs for Severe Mental Illness: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2024; 12:1179. [PMID: 38921293 PMCID: PMC11203176 DOI: 10.3390/healthcare12121179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/29/2024] [Accepted: 06/05/2024] [Indexed: 06/27/2024] Open
Abstract
(1) Background: While medication and various forms of psychotherapy are common treatments for severe mental illness, peer support programs have also proven to be effective in managing mental disorders. These programs, which involve individuals with similar experiences in navigating mental health challenges, aim to improve coping skills and foster supportive community networks. However, despite the prevalent mention of peer support programs, especially those with supervision, there has been no systematic review or meta-analysis of peer support supervision. This study aimed to systematically review and meta-analyze the forms and effectiveness of peer support programs for individuals with severe mental illnesses. (2) Methods: A literature search focusing on randomized controlled trials (RCTs) published between February 2003 and January 2024 was conducted. (3) Results: Sixteen RCTs meeting the inclusion criteria and involving a total of 4008 participants were reviewed. These studies utilized various peer support program strategies, with eight studies included in the qualitative analysis. The combined effect sizes for depressive symptoms (d = 0.12; 95% CI, -0.14, 0.37; p = 0.37), empowerment (d = 1.17; 95% CI, -0.81, 3.15; p = 0.25), quality of life (d = 0.70; 95% CI, -0.12, 1.52; p = 0.09), psychiatric symptoms (d = -0.05; 95% CI, -0.20, 0.10; p = 0.54), and self-efficacy (d = 0.20; 95% CI, 0.05, 0.36; p = 0.01) were assessed. (4) Conclusions: Our analysis emphasizes the need for further studies on peer support programs for individuals with severe mental illness, particularly those focused on self-efficacy outcomes across diverse geographic locations involving more countries and with larger scales to bolster the strength of the evidence.
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Affiliation(s)
| | - Hea-Jin Yu
- College of Nursing, Sahmyook University, Seoul 01795, Republic of Korea
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Haun MH, Girit S, Goldfarb Y, Kalha J, Korde P, Kwebiiha E, Moran G, Mtei R, Niwemuhwezi J, Nixdorf R, Nugent L, Puschner B, Ramesh M, Ryan GK, Slade M, Charles A, Krumm S. Mental health workers' perspectives on the implementation of a peer support intervention in five countries: qualitative findings from the UPSIDES study. BMJ Open 2024; 14:e081963. [PMID: 38749688 PMCID: PMC11097849 DOI: 10.1136/bmjopen-2023-081963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 04/03/2024] [Indexed: 05/18/2024] Open
Abstract
OBJECTIVE The introduction of peer support in mental health teams creates opportunities and challenges for both peer and non-peer staff. However, the majority of research on mental health workers' (MHWs) experiences with peer support comes from high-income countries. Using Peer Support In Developing Empowering Mental Health Services (UPSIDES) is an international multicentre study, which aims at scaling up peer support for people with severe mental illness in Europe, Asia and Africa. This study investigates MHWs experiences with UPSIDES peer support. DESIGN Six focus groups with MHWs were conducted approximately 18 months after the implementation of the UPSIDES peer support intervention. Transcripts were analysed with a descriptive approach using thematic content analysis. SETTING Qualitative data were collected in Ulm and Hamburg (Germany), Butabika (Uganda), Dar es Salaam (Tanzania), Be'er Sheva (Israel) and Pune (India). PARTICIPANTS 25 MHWs (19 females and 6 males) from UPSIDES study sites in the UPSIDES Trial (ISRCTN26008944) participated. FINDINGS Five overarching themes were identified in MHWs' discussions: MHWs valued peer support workers (PSWs) for sharing their lived experiences with service users (theme 1), gained trust in peer support over time (theme 2) and provided support to them (theme 3). Participants from lower-resource study sites reported additional benefits, including reduced workload. PSWs extending their roles beyond what MHWs perceived as appropriate was described as a challenge (theme 4). Perceptions about PSWs varied based on previous peer support experience, ranging from considering PSWs as equal team members to viewing them as service users (theme 5). CONCLUSIONS Considering local context is essential in order to understand MHWs' views on the cooperation with PSWs. Especially in settings with less prior experience of peer support, implementers should make extra effort to promote interaction between MHWs and PSWs. In order to better understand the determinants of successful implementation of peer support in diverse settings, further research should investigate the impact of contextual factors (eg, resource availability and cultural values). TRIAL REGISTRATION NUMBER ISRCTN26008944.
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Affiliation(s)
| | - Selina Girit
- Department of Psychiatry II, Ulm University, Ulm, Germany
| | - Yael Goldfarb
- Department of Social Work, Ben-Gurion University of the Negev, Be'er-Sheva, Israel
| | - Jasmine Kalha
- Centre for Mental Health Law and Policy, Indian Law Society, Pune, India
| | - Palak Korde
- Centre for Mental Health Law and Policy, Indian Law Society, Pune, India
| | - Eric Kwebiiha
- Butabika National Referral Hospital, Kampala, Uganda
| | - Galia Moran
- Department of Social Work, Ben-Gurion University of the Negev, Be'er-Sheva, Israel
| | - Rachel Mtei
- Department of Health Systems, Impact Evaluation and Policy, Ifakara Health Institute, Dar es Salaam, Tanzania
| | - Jackline Niwemuhwezi
- Department of Health Systems, Impact Evaluation and Policy, Ifakara Health Institute, Dar es Salaam, Tanzania
| | - Rebecca Nixdorf
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lena Nugent
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Bernd Puschner
- Department of Psychiatry II, Ulm University, Ulm, Germany
| | - Mary Ramesh
- Department of Health Systems, Impact Evaluation and Policy, Ifakara Health Institute, Dar es Salaam, Tanzania
| | - Grace Kathryn Ryan
- Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Mike Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Ashleigh Charles
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Silvia Krumm
- Department of Psychiatry II, Ulm University, Ulm, Germany
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12
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Postma A, Ketelaar M, van Nispen Tot Sevenaer J, Downs Z, van Rappard D, Jongmans M, Zinkstok J. Exploring individual parent-to-parent support interventions for parents caring for children with brain-based developmental disabilities: A scoping review. Child Care Health Dev 2024; 50:e13255. [PMID: 38587275 DOI: 10.1111/cch.13255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 02/21/2024] [Accepted: 03/08/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Brain-based developmental disabilities (BBDDs) comprise a large and heterogeneous group of disorders including autism, intellectual disability, cerebral palsy or genetic and neurodevelopmental disorders. Parents caring for a child with BBDD face multiple challenges that cause increased stress and high risk of mental health problems. Peer-based support by fellow parents for a various range of patient groups has shown potential to provide emotional, psychological and practical support. Here, we aim to explore existing literature on individual peer-to-peer support (iP2PS) interventions for parents caring for children with BBDD with a view to (1) explore the impact of iP2PS interventions on parents and (2) identify challenges and facilitators of iP2PS. METHOD An extensive literature search (January 2023) was performed, and a thematic analysis was conducted to synthesize findings. RESULTS Fourteen relevant articles revealed three major themes regarding the impact of iP2PS on parents: (1) emotional and psychological well-being, (2) quality of life and (3) practical issues. Four themes were identified describing challenges and facilitators of iP2PS: (1) benefits and burden of giving support, (2) matching parent-pairs, (3) logistic challenges and solutions and (4) training and supervision of parents providing peer support. CONCLUSIONS This review revealed that iP2PS has a positive impact on the emotional and psychological well-being of parents, as well as the overall quality of life for families caring for a child with a BBDD. Individual P2PS offers peer-parents an opportunity to support others who are facing challenges similar to those they have experienced themselves. However, many questions still need to be addressed regarding benefits of different iP2PS styles, methods of tailoring support to individual needs and necessity of training and supervision for peer support providers. Future research should focus on defining these components and evaluating benefits to establish effective iP2PS that can be provided as standard care practice for parents.
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Affiliation(s)
- Amber Postma
- Department of Psychiatry and Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Marjolijn Ketelaar
- Department of Rehabilitation, Physical Therapy and Sports; Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
- De Hoogstraat, Rehabilitation, Utrecht, The Netherlands
| | | | - Zahra Downs
- Department of Psychiatry and Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Diane van Rappard
- Department of Psychiatry and Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Marian Jongmans
- Department of Pedagogical and Educational Sciences, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, The Netherlands
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Janneke Zinkstok
- Department of Psychiatry and Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry Nijmegen, Nijmegen, The Netherlands
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13
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Mirbahaeddin E, Chreim S. Transcending technology boundaries and maintaining sense of community in virtual mental health peer support: a qualitative study with service providers and users. BMC Health Serv Res 2024; 24:510. [PMID: 38658968 PMCID: PMC11040832 DOI: 10.1186/s12913-024-10943-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/02/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND This qualitative study explores the experiences of peer support workers (PSWs) and service users (or peers) during transition from in-person to virtual mental health services. During and following the COVID-19 pandemic, the need for accessible and community-based mental health support has become increasingly important. This research aims to understand how technological factors act as bridges and boundaries to mental health peer support services. In addition, the study explores whether and how a sense of community can be built or maintained among PSWs and peers in a virtual space when connections are mediated by technology. This research fills a gap in the literature by incorporating the perspectives of service users and underscores the potential of virtual peer support beyond pandemic conditions. METHODS Data collection was conducted from a community organization that offers mental health peer support services. Semi-structured interviews were conducted with 13 employees and 27 service users. Thematic analysis was employed to identify key themes and synthesize a comprehensive understanding. RESULTS The findings highlight the mental health peer support needs that were met through virtual services, the manifestation of technology-based boundaries and the steps taken to remove some of these boundaries, and the strategies employed by the organization and its members to establish and maintain a sense of community in a virtual environment marked by physical distancing and technology-mediated interrelations. The findings also reveal the importance of providing hybrid services consisting of a mixture of in person and virtual mental health support to reach a broad spectrum of service users. CONCLUSIONS The study contributes to the ongoing efforts to enhance community mental health services and support in the virtual realm. It shows the importance of virtual peer support in situations where in-person support is not accessible. A hybrid model combining virtual and in-person mental health support services is recommended for better accessibility to mental health support services. Moreover, the importance of organizational support and of equitable resource allocation to overcome service boundaries are discussed.
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Affiliation(s)
- Elmira Mirbahaeddin
- Telfer School of Management, University of Ottawa, 55 Laurier Ave E, K1N 6N5, Ottawa, ON, Canada.
| | - Samia Chreim
- Telfer School of Management, University of Ottawa, 55 Laurier Ave E, K1N 6N5, Ottawa, ON, Canada
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14
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Cha BS, Borghouts J, Eikey E, Mukamel DB, Schueller SM, Sorkin DH, Stadnick NA, Zhao X, Zheng K, Schneider ML. Variability in the Integration of Peers in a Multi-site Digital Mental Health Innovation Project. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024; 51:226-239. [PMID: 38246948 PMCID: PMC10850170 DOI: 10.1007/s10488-023-01331-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2023] [Indexed: 01/23/2024]
Abstract
Peer support specialists ("peers") who have the lived experience of, and are in recovery from, mental health challenges are increasingly being integrated into mental health care as a reimbursable service across the US. This study describes the ways peers were integrated into Help@Hand, a multi-site innovation project that engaged peers throughout efforts to develop and offer digital mental health interventions across counties/cities ("sites") in California. Using a mixed methods design, we collected quantitative data via quarterly online surveys, and qualitative data via semi-annual semi-structured phone interviews with key informants from Help@Hand sites. Quantitative data were summarized as descriptive findings and qualitative data from interviews were analyzed using rapid qualitative analysis methods. In the final analytic phase, interview quotes were used to illustrate the complex realities underlying quantitative responses. 117 quarterly surveys and 46 semi-annual interviews were completed by key informants from 14 sites between September 2020 and January 2023. Peers were integrated across diverse activities for support and implementation of digital mental health interventions, including development of training and educational materials (78.6% of sites), community outreach (64.3%), technology testing (85.7%), technology piloting (90.9%), digital literacy training (71.4%), device distribution (63.6%), technical assistance (72.7%), and cross-site collaboration (66.7%). Peer-engaged activities shifted over time, reflecting project phases. Peer-provided digital literacy training and technology-related support were key ingredients for project implementations. This study indicates the wide range of ways peers can be integrated into digital mental health intervention implementations. Considering contextual readiness for peer integration may enhance their engagement into programmatic activities.
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Affiliation(s)
- Biblia S Cha
- Department of General Internal Medicine, University of California, Irvine, Irvine, CA, USA.
- School of Medicine, University of California, Irvine, 100 Theory, Suite 120, Irvine, CA, 92697, USA.
| | - Judith Borghouts
- Department of General Internal Medicine, University of California, Irvine, Irvine, CA, USA
| | - Elizabeth Eikey
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, CA, USA
- The Design Lab, University of California, San Diego, San Diego, CA, USA
| | - Dana B Mukamel
- Department of General Internal Medicine, University of California, Irvine, Irvine, CA, USA
| | - Stephen M Schueller
- Department of Informatics, University of California, Irvine, Irvine, CA, USA
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Dara H Sorkin
- Department of General Internal Medicine, University of California, Irvine, Irvine, CA, USA
| | - Nicole A Stadnick
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Dissemination and Implementation Science Center, UC San Diego Altman Clinical and Translational Research Institute, La Jolla, CA, USA
- Child and Adolescent Services Research Center, San Diego, CA, USA
| | - Xin Zhao
- Department of General Internal Medicine, University of California, Irvine, Irvine, CA, USA
| | - Kai Zheng
- Department of Informatics, University of California, Irvine, Irvine, CA, USA
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15
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Hogue A, Satcher MF, Drazdowski TK, Hagaman A, Hibbard PF, Sheidow AJ, Coetzer-Liversage A, Mitchell SG, Watson DP, Wilson KJ, Muench F, Fishman M, Wenzel K, de Martell SC, Stein LAR. Linkage facilitation services for opioid use disorder: Taxonomy of facilitation practitioners, goals, and activities. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 157:209217. [PMID: 37981242 PMCID: PMC10922806 DOI: 10.1016/j.josat.2023.209217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 07/14/2023] [Accepted: 11/13/2023] [Indexed: 11/21/2023]
Abstract
INTRODUCTION This article proposes a taxonomy of linkage facilitation services used to help persons with opioid use disorder access treatment and recovery resources. Linkage facilitation may be especially valuable for persons receiving medication for opioid use disorder (MOUD) given the considerable barriers to treatment access and initiation that have been identified. The science of linkage facilitation currently lacks both consistent communication about linkage facilitation practices and a conceptual framework for guiding research. METHODS To address this gap, this article presents a taxonomy derived from expert consensus that organizes the array of practitioners, goals, and activities associated with linkage services for OUD and related needs. Expert panelists first independently reviewed research reports and policy guidelines summarizing the science and practice of linkage facilitation for substance use disorders generally and OUD specifically, then met several times to vet the conceptual scheme and content of the taxonomy until they reached a final consensus. RESULTS The derived taxonomy contains eight domains: facilitator identity, facilitator lived experience, linkage client, facilitator-client relationship, linkage activity, linkage method, linkage connectivity, and linkage goal. For each domain, the article defines basic domain categories, highlights research and practice themes in substance use and OUD care, and introduces innovations in linkage facilitation being tested in one of two NIDA-funded research networks: Justice Community Opioid Innovation Network (JCOIN) or Consortium on Addiction Recovery Science (CoARS). CONCLUSIONS To accelerate consistent application of this taxonomy to diverse research and practice settings, the article concludes by naming several considerations for linkage facilitation workforce training and implementation.
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Affiliation(s)
- Aaron Hogue
- Partnership to End Addiction, 711 Third Avenue, 5th floor, New York, NY 10017, United States of America.
| | - Milan F Satcher
- Dartmouth Health and Geisel School of Medicine at Dartmouth College, United States of America
| | | | - Angela Hagaman
- East Tennessee State University, United States of America
| | | | | | | | | | | | | | - Frederick Muench
- Partnership to End Addiction, 711 Third Avenue, 5th floor, New York, NY 10017, United States of America
| | - Marc Fishman
- Maryland Treatment Centers, United States of America
| | - Kevin Wenzel
- Maryland Treatment Centers, United States of America
| | | | - L A R Stein
- Department of Psychology, University of Rhode Island, United States of America; Department of Behavioral & Social Sciences, Brown University, United States of America; Department of Behavioral Healthcare, Developmental Disabilities & Hospitals, RI, United States of America
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16
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Kim YR, An Z, Han SW, Ko JK, Hwa Kwag K. Recovery-focused self-help intervention using vodcasts for patients with personality disorder: feasibility randomised controlled trial. BJPsych Open 2024; 10:e31. [PMID: 38229480 PMCID: PMC10897696 DOI: 10.1192/bjo.2023.647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 11/23/2023] [Accepted: 12/14/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Availability of long-term psychological interventions for personality disorders is limited because of their high intensity and cost. Research in evidence-based, low-intensity interventions is needed. AIMS This study aimed to examine the feasibility, acceptability and potential impact of a low-intensity, digital guided self-help (GSH) intervention that is focused on emotion regulation, recovery-oriented and provides in-the-moment delivery for patients with personality disorders. METHOD We conducted a single-blind feasibility trial. A total of 43 patients with a personality disorder were recruited and randomly assigned to either a GSH arm (n = 22) or a treatment-as-usual arm (n = 21). The GSH intervention included a series of short videos offering psychoeducation and support, personalised feedback using text messages, and supportive telephone calls, for 4 weeks in addition to treatment as usual. Outcomes of emotional disturbance, emotion dysregulation, self-harm behaviours and decentring ability were measured at baseline, 4 weeks (end of intervention) and 8 weeks (follow-up). RESULTS All patients who attended the first session continued until the last session. There was an interaction effect between time and group on anxiety (P = 0.027, Δη2 = 0.10), where the GSH group showed a significant reduction in anxiety at follow-up (P = 0.003, d = 0.25). The GSH group increased in decentring ability at the end of intervention (P = 0.007, d = -0.65), and the decrease in self-harm behaviours continued until follow-up (P = 0.02, d = 0.57). CONCLUSIONS The results suggest that a personalised digital GSH with a focus on recovery could reduce anxiety and self-harm behaviours at short-term follow-up.
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Affiliation(s)
- Youl-Ri Kim
- Institute of Eating Disorders and Mental Health, Inje University, South Korea; and Department of Psychiatry, Ilsan Paik Hospital, Inje University, South Korea
| | - Zhen An
- Institute of Eating Disorders and Mental Health, Inje University, South Korea
| | - Soo Wan Han
- Institute of Eating Disorders and Mental Health, Inje University, South Korea
| | - Jeong Kyung Ko
- Institute of Eating Disorders and Mental Health, Inje University, South Korea
| | - Kyung Hwa Kwag
- Institute of Eating Disorders and Mental Health, Inje University, South Korea
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17
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Paradise RK, Wakeman SE. Recruiting and Retaining a Diverse and Skilled Addiction Treatment Workforce. SUBSTANCE USE & ADDICTION JOURNAL 2024; 45:10-15. [PMID: 38258849 DOI: 10.1177/29767342231210210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
National drug overdose deaths have been rising for decades, with particularly significant increases in recent years among populations of color. There is an urgent need for timely, accessible substance use disorder treatment, but workforce shortages across roles and settings impede the ability of the treatment system to meet the rising and evolving demand. In this Commentary, the authors discuss reasons for workforce shortages across roles, and offer recommendations for 8 areas of investment to grow and sustain a substance use and addiction care workforce prepared to address the overdose crisis in a racially equitable manner.
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Affiliation(s)
| | - Sarah E Wakeman
- Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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18
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Agarwal A, Nayak PK, van Brakel WH, van Wijk R, Jain A, Broekkamp H, Mol MM, Mishra CP. Impact of basic psychological support on stigma and mental well-being of people with disabilities due to leprosy and lymphatic filariasis: a proof-of-concept study. Int Health 2023; 15:iii59-iii69. [PMID: 38118159 PMCID: PMC10732683 DOI: 10.1093/inthealth/ihad096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/09/2023] [Accepted: 09/29/2023] [Indexed: 12/22/2023] Open
Abstract
BACKGROUND People with leprosy and lymphatic filariasis (LF)-related disabilities experience higher levels of poor mental well-being compared with the general community. Mental health services are often not available. This study was conducted to provide proof of concept that basic psychological support for people affected by neglected tropical diseases (BPS-N) can be given by peer supporters to reduce stigma, improve mental well-being and participation among clients. METHODS The BPS-N approach was tested in a quasi-experimental design using mixed methods. To provide psychological support using the BPS-N, peer supporters were selected and trained. They supported people with leprosy- and LF-related disabilities. Preintervention and postintervention, stigma, mental well-being, depression and participation were measured through standard scales within 4 wk of the intervention; differences were tested using standard tests of significance. RESULTS After 3 mo of intervention, the mean level of stigma had decreased (30.3 to 24, p<0.001); high mental well-being increased (0% to 13.3%, p<0.001); and moderate to severe depression decreased (88% to 47%, p<0.001). No significant change occurred in participation restrictions (87% to 92%, p=0.497). CONCLUSIONS Psychological peer support using the BPS-N guideline appears effective in reducing stigma and improving mental well-being and can be operationalised. However, this should be confirmed through a randomised controlled trial. CONTEXTE Les personnes atteintes de lèpre et de handicaps liés à la filariose lymphatique (FL) souffrent davantage d'un manque de bien-être mental que le reste de la population. Les services de santé mentale ne sont souvent pas disponibles hors des zones urbaines. Cette étude a été menée pour démontrer que le soutien psychologique de base pour les personnes atteintes de MTN (BPS-N) peut être dispensé par des pairs (dans une logique de transfert de tâches) afin de réduire la stigmatisation et d'améliorer le bien-être mental et la participation des clients. MÉTHODES L'approche du BPS-N a été testée dans le cadre d'un modèle quasi-expérimental utilisant des méthodes mixtes. Pour fournir un soutien psychologique à l'aide du BPS-N, des pairs ont été sélectionnés et formés. Ils sont venus en aide aux personnes atteintes de lèpre et de déficiences liées à la FL. Avant et après l'intervention, les éléments suivants ont été mesurés à l'aide d'échelles standardisées: niveau de stigmatisation, bien-être mental, symptômes dépressifs, et enfin, la participation sociale. Les différences ont été testées à l'aide de tests de signification standardisés. RÉSULTATS Après 3 mois d'intervention, le niveau moyen de stigmatisation a diminué (30,3 à 24, p<0 001) ; le niveau de bien-être mental a augmenté (0% à 13,3%, p<0 001) et la dépression modérée à sévère a diminué (88% à 47%, p<0 001). Aucun changement significatif n'a été observé en ce qui concerne les restrictions de participation (87% contre 92%, p=0 497). CONCLUSIONS Le soutien psychologique par les pairs utilisant la ligne directrice BPS-N semble efficace pour réduire la stigmatisation et améliorer le bien-être mental. Toutefois, cette efficacité doit être confirmée par un essai contrôlé randomisé. ANTECEDENTES Las personas con lepra y discapacidades relacionadas con la filariasis linfática (FL) sufren niveles más altos de malestar mental en comparación con la comunidad en general. Los servicios de salud mental no suelen estar disponibles a nivel periférico. Este estudio se llevó a cabo para proporcionar una prueba de concepto de que el Apoyo Psicológico Básico para personas afectadas por NTDs (BPS-N) puede ser dado por compañeros de apoyo (rotación de tareas) para reducir el estigma, mejorar el bienestar mental y la participación entre los clientes. MÉTODOS El enfoque BPS-N se probó en un diseño cuasi-experimental utilizando métodos mixtos. Para proporcionar apoyo psicológico con el BPS-N, se seleccionaron y formaron compañeros de apoyo. Apoyaron a personas con lepra y discapacidades relacionadas con la FL. El estigma, el bienestar mental, la depresión y la participación se midieron antes y después de la intervención, mediante escalas estándar; las diferencias se comprobaron mediante pruebas estándar de significación. RESULTADOS Después de 3 meses de intervención, el nivel medio de estigma disminuyó (30,3 a 24, p<0 001); el bienestar mental alto aumentó (0% a 13,3%, p<0 001) y la depresión moderada a grave disminuyó (88% a 47%, p<0 001). No se produjeron cambios significativos en las restricciones de participación (87% frente a 92%, p=0 497)). CONCLUSIONES El apoyo psicológico entre iguales, utilizando la guía BPS-N, parece eficaz para reducir el estigma y mejorar el bienestar mental. Sin embargo, esto debe confirmarse mediante un ensayo controlado aleatorizado.
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Affiliation(s)
- Ashok Agarwal
- NLR, Safdarjung Development Area, New Delhi-110016, India
| | | | | | - Robin van Wijk
- NLR, 1090HA Amsterdam, The Netherlands
- Erasmus Medical Center, 3015 GD Rotterdam, Netherlands
| | - Amit Jain
- NLR, Safdarjung Development Area, New Delhi-110016, India
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19
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Pointon-Haas J, Waqar L, Upsher R, Foster J, Byrom N, Oates J. A systematic review of peer support interventions for student mental health and well-being in higher education. BJPsych Open 2023; 10:e12. [PMID: 38098123 PMCID: PMC10755562 DOI: 10.1192/bjo.2023.603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 09/06/2023] [Accepted: 09/25/2023] [Indexed: 12/31/2023] Open
Abstract
BACKGROUND Higher education institutions (HEIs) are seeking effective ways to address the rising demand for student mental health services. Peer support is widely considered a viable option to increase service capacity; however, there are no agreed definitions of peer support, making it difficult to establish its impact on student mental health and well-being. AIMS This systematic review aims to better understand and evaluate peer support in HEIs. METHOD Five databases, OpenGrey and Grey Matters were searched in May 2021. Included studies were quantitative, longitudinal (with and without a control) or cross-sectional with a control. The vote-counting method was used for synthesis. The risk of bias was assessed with the National Institutes of Health Quality Assessment Tool. RESULTS Three types of peer support were represented in 28 papers: peer-led support groups, peer mentoring and peer learning. Peer learning and peer mentoring had more positive, significant results reported for the outcomes of anxiety and stress. Peer-led support groups were the only type targeting students with mental health difficulties. CONCLUSIONS The heterogeneity of measures and outcomes prevents firm conclusions on the effectiveness of peer support for mental health and well-being. Most studies were rated 'poor' or 'fair' in their risk of bias. There is not a solid evidence base for the effectiveness of peer support. Nonetheless, HEIs can use the terminology developed in this review for shared discussions that guide more robust research and evaluation of peer support as an intervention.
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Affiliation(s)
- Julia Pointon-Haas
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychology, King's College London, UK
| | - Luqmaan Waqar
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychology, King's College London, UK
| | - Rebecca Upsher
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychology, King's College London, UK
| | - Juliet Foster
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychology, King's College London, UK
| | - Nicola Byrom
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychology, King's College London, UK
| | - Jennifer Oates
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, UK
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Nicmanis M, Chur-Hansen A, Linehan K. The Information Needs and Experiences of People Living With Cardiac Implantable Electronic Devices: Qualitative Content Analysis of Reddit Posts. JMIR Cardio 2023; 7:e46296. [PMID: 37766632 PMCID: PMC10652197 DOI: 10.2196/46296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 09/06/2023] [Accepted: 09/27/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Cardiac implantable electronic devices (CIEDs) are used to treat a range of cardiovascular diseases and can lead to substantial clinical improvements. However, studies evaluating patients' experiences of living with these devices are sparse and have focused mainly on implantable cardioverter defibrillators. In addition, there has been limited evaluation of how people living with a CIED use social media to gain insight into their condition. OBJECTIVE This study aims to analyze posts from web-based communities called subreddits on the website Reddit, intended for people living with a CIED, to characterize the informational needs and experiences of patients. METHODS Reddit was systematically searched for appropriate subreddits, and we found 1 subreddit that could be included in the analysis. A Python-based web scraping script using the Reddit application programming interface was used to extract posts from this subreddit. Each post was individually screened for relevancy, and a register of participants' demographic information was created. Conventional qualitative content analysis was used to inductively classify the qualitative data collected into codes, subcategories, and overarching categories. RESULTS Of the 484 posts collected using the script, 186 were excluded, resulting in 298 posts from 196 participants being included in the analysis. The median age of the participants who reported this was 33 (IQR 22.0-39.5; range 17-72) years, and the majority had a permanent pacemaker. The content analysis yielded 5 overarching categories: use of the subreddit by participants, questions and experiences related to the daily challenges of living with a CIED, physical sequelae of CIED implantation, psychological experiences of living with a CIED, and questions and experiences related to health care while living with a CIED. These categories provided insight into the diverse experiences and informational needs of participants living with a CIED. The data predominantly represented the experiences of younger and more physically active participants. CONCLUSIONS Social media provides a platform through which people living with a CIED can share information and provide support to their peers. Participants generally sought information about the experiences of others living with a CIED. This was often done to help overcome a range of challenges faced by participants, including the need to adapt to living with a CIED, difficulties with navigating health care, psychological difficulties, and various aversive physical sequelae. These challenges may be particularly difficult for younger and physically active people. Health care professionals may leverage peer support and other aid to help people overcome the challenges they face while living with a CIED.
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Affiliation(s)
- Mitchell Nicmanis
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Anna Chur-Hansen
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Karen Linehan
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
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21
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Halsall T, Daley M, Hawke LD, Henderson J, Matheson K. "You can create a little bit more closure in your own story when someone really connects with it": exploring how involvement in youth peer support work can promote peer development. Int J Ment Health Syst 2023; 17:34. [PMID: 37875958 PMCID: PMC10594763 DOI: 10.1186/s13033-023-00608-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/12/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Peer support relates to the provision of social/emotional support that is delivered by individuals with lived experience of a key characteristic that is shared with clients. Although the main objective of peer support is to enhance client outcomes, through their involvement, peers derive a secondary benefit to their own personal development. This study applied a hybrid participatory-realist approach to identify what works, for whom, why and in what circumstances within the LOFT Transitional Age Youth (TAY) peer services. This paper presents findings related to the processes and possible benefits of being involved in peer work for the peer supporters themselves. METHODS Semi-structured interviews and focus groups were completed with peer and non-peer staff from the TAY program. A qualitative analysis applied a retroductive approach that involved both inductive and deductive processes to identify relevant themes. RESULTS Four program theories and one over-arching context were identified through the analyses. Program theories were related to: (1) enhancing self-efficacy and self-determination through peer involvement in program design, (2) increasing peer resiliency and self-care through effective supervision, (3) developing professional skills and opportunities for career advancement through peer practice and (4) overcoming stigma through the recognition of the value of peer lived experience. CONCLUSIONS Peer practice holds significant potential for the enhancement of the mental health system as well as to increase our understanding of stigma. The findings from this study offer critical new insights into the dynamics of how professional peer practice can support the personal development of youth peers and how programming can be intentionally designed to enhance these benefits.
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Affiliation(s)
- Tanya Halsall
- University of Ottawa Institute of Mental Health Research at The Royal, 1145 Carling Avenue, Ottawa, ON, K1Z 7K4, Canada.
- Department of Neuroscience, Carleton University, 1125 Colonel By Drive, Ottawa, ON, K1S 5B6, Canada.
| | - Mardi Daley
- LOFT Community Services, 721 Bloor St. W Suite 103, Toronto, ON, M6G 1L5, Canada
| | - Lisa D Hawke
- Centre for Addiction and Mental Health, 1000 Queen St W, Toronto, ON, M6J 1H4, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON, M5T 1L8, Canada
| | - Jo Henderson
- Centre for Addiction and Mental Health, 1000 Queen St W, Toronto, ON, M6J 1H4, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON, M5T 1L8, Canada
| | - Kimberly Matheson
- University of Ottawa Institute of Mental Health Research at The Royal, 1145 Carling Avenue, Ottawa, ON, K1Z 7K4, Canada
- Department of Neuroscience, Carleton University, 1125 Colonel By Drive, Ottawa, ON, K1S 5B6, Canada
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22
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Roennfeldt H, Chapman M, Runneboom C, Wang Y, Byrne L. Differences and Similarities Between Consumer- and Caregiver- or Family-Informed Peer Roles in Mental Health. Psychiatr Serv 2023; 74:1037-1044. [PMID: 36987707 DOI: 10.1176/appi.ps.20220386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
OBJECTIVE Peer workers are widely employed across the mental health sector in Australia, and these positions increasingly include people with experience as a service user (consumer peer workers) and people with experience as a family member (caregiver peer workers). The authors explored similarities and differences between the consumer and caregiver peer workforces and considered positions designed to combine consumer and caregiver perspectives. METHODS A mixed-methods design was used to analyze data from a nationwide Australian survey (N=882), including responses from peer staff with consumer and caregiver perspectives (N=558), and from mental health staff not designated as peer workers (N=324). RESULTS Most participants viewed the two perspectives as different in terms of values or goals (51%) and work practices (59%), with fewer stating that the two workforces had similar goals or values (45%) and work practices (37%). Qualitative findings provided insight into these differences and similarities, identifying differences in perspectives, priorities, and work practices but highlighting similarities in values between the two workforces. Qualitative data also revealed potential risks of employing peer workers in roles designed to use both kinds of experience for direct support roles but indicated potential for the combined perspective in other contexts. Both qualitative and quantitative data indicated that participants with consumer experience perceived greater differences between the role types than those with caregiver experience only. CONCLUSIONS The findings indicate similarities and differences between staff with consumer or caregiver perspectives and highlight the need for greater role clarity and the potential for conflict in positions where peer workers combine both perspectives.
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Affiliation(s)
- Helena Roennfeldt
- School of Management, RMIT University, Melbourne (all authors); Future of Work Institute, Faculty of Business and Law, Curtin University, Perth, Australia (Chapman, Runneboom); Program for Recovery and Community Health, Department of Psychiatry, Yale School of Medicine, Yale University, New Haven (Byrne)
| | - Melissa Chapman
- School of Management, RMIT University, Melbourne (all authors); Future of Work Institute, Faculty of Business and Law, Curtin University, Perth, Australia (Chapman, Runneboom); Program for Recovery and Community Health, Department of Psychiatry, Yale School of Medicine, Yale University, New Haven (Byrne)
| | - Cecilia Runneboom
- School of Management, RMIT University, Melbourne (all authors); Future of Work Institute, Faculty of Business and Law, Curtin University, Perth, Australia (Chapman, Runneboom); Program for Recovery and Community Health, Department of Psychiatry, Yale School of Medicine, Yale University, New Haven (Byrne)
| | - Ying Wang
- School of Management, RMIT University, Melbourne (all authors); Future of Work Institute, Faculty of Business and Law, Curtin University, Perth, Australia (Chapman, Runneboom); Program for Recovery and Community Health, Department of Psychiatry, Yale School of Medicine, Yale University, New Haven (Byrne)
| | - Louise Byrne
- School of Management, RMIT University, Melbourne (all authors); Future of Work Institute, Faculty of Business and Law, Curtin University, Perth, Australia (Chapman, Runneboom); Program for Recovery and Community Health, Department of Psychiatry, Yale School of Medicine, Yale University, New Haven (Byrne)
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23
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Smit D, Miguel C, Vrijsen JN, Groeneweg B, Spijker J, Cuijpers P. The effectiveness of peer support for individuals with mental illness: systematic review and meta-analysis. Psychol Med 2023; 53:5332-5341. [PMID: 36066104 PMCID: PMC10476060 DOI: 10.1017/s0033291722002422] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 07/05/2022] [Accepted: 07/12/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND The benefits of peer support interventions (PSIs) for individuals with mental illness are not well known. The aim of this systematic review and meta-analysis was to assess the effectiveness of PSIs for individuals with mental illness for clinical, personal, and functional recovery outcomes. METHODS Searches were conducted in PubMed, Embase, and PsycINFO (December 18, 2020). Included were randomized controlled trials (RCTs) comparing peer-delivered PSIs to control conditions. The quality of records was assessed using the Cochrane Collaboration Risk of Bias tool. Data were pooled for each outcome, using random-effects models. RESULTS After screening 3455 records, 30 RCTs were included in the systematic review and 28 were meta-analyzed (4152 individuals). Compared to control conditions, peer support was associated with small but significant post-test effect sizes for clinical recovery, g = 0.19, 95% CI (0.11-0.27), I2 = 10%, 95% CI (0-44), and personal recovery, g = 0.15, 95% CI (0.04-0.27), I2 = 43%, 95% CI (1-67), but not for functional recovery, g = 0.08, 95% CI (-0.02 to 0.18), I2 = 36%, 95% CI (0-61). Our findings should be considered with caution due to the modest quality of the included studies. CONCLUSIONS PSIs may be effective for the clinical and personal recovery of mental illness. Effects are modest, though consistent, suggesting potential efficacy for PSI across a wide range of mental disorders and intervention types.
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Affiliation(s)
- Dorien Smit
- Pro Persona Mental Health Care, Pro Persona Research, Depression Expertise Center, Nijmegen, The Netherlands
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Clara Miguel
- Department of Clinical, Neuro, and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Janna N. Vrijsen
- Pro Persona Mental Health Care, Pro Persona Research, Depression Expertise Center, Nijmegen, The Netherlands
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bart Groeneweg
- Dutch Depression (Patient) Association, Amersfoort, The Netherlands
| | - Jan Spijker
- Pro Persona Mental Health Care, Pro Persona Research, Depression Expertise Center, Nijmegen, The Netherlands
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro, and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Fortuna KL, Divatia S, Neupane S, Geiger P, Bohm A. " As soon as I start trusting human beings, they disappoint me, and now I am going to get on an app that someone could hack. I really do not want to take that chance": barriers and facilitators to digital peer support implementation into community mental health centers. Front Digit Health 2023; 5:1130095. [PMID: 37547620 PMCID: PMC10400290 DOI: 10.3389/fdgth.2023.1130095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 06/27/2023] [Indexed: 08/08/2023] Open
Abstract
Background Certified peer support specialists often use technologies such as smartphone applications to deliver digital peer support in community mental health centers. Certified peer support specialists are individuals with a mental health diagnosis, trained and accredited by their state to provide mental health support services. Digital peer support has shown promising evidence of promoting recovery, hope, social support, and medical and psychiatric self-management among patients with a diagnosis of a serious mental illness. Interest in digital peer support as part of the patient experience has grown. Understanding barriers and facilitators to the implementation process of digital peer support into community mental health centers is a critical next step to facilitate uptake. Methods Semi-structured qualitative interviews were conducted with 27 patient participants (N = 17 persons with serious mental illness; N = 10 certified peer support specialists) from an urban community mental health center. Participants responded to open-ended questions on the barriers and facilitators of engaging with digital peer support technologies within community mental health centers. The interview guide and the responses were categorized according to the Consolidated Framework for Implementation Science Research (CFIR) constructs. Results Nine barriers and two facilitators were identified for the implementation of digital peer support in community mental health centers. The overarching domains for the identified barriers included (1) intervention characteristics (i.e., adaptability, complexity, and cost), (2) inner settings (i.e., implementation climate, readiness for implementation, and access to knowledge and information), and (3) characteristics of individuals (i.e., knowledge and beliefs about the intervention and other personal attributes). The two facilitators identified included (1) intervention characteristics (i.e., relative advantage) and (2) outer setting (i.e., patient needs and resources). Conclusions The identified barriers and facilitators represent a starting point for developing or modifying digital peer support technology requirements to ease implementation in community mental health centers. Building technology requirements and implementation processes based on these findings may facilitate uptake of digital peer support technologies by people with serious mental illness and certified peer support specialists in community mental health centers.
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Affiliation(s)
- Karen L. Fortuna
- Department of Psychiatry, Dartmouth Centers for Health and Aging, Geisel School of Medicine, Lebanon, NH, United States
| | - Shreya Divatia
- Department of Psychiatry, Dartmouth Centers for Health and Aging, Geisel School of Medicine, Lebanon, NH, United States
| | - Sudeep Neupane
- Department of Public Health, Robbins College of Human Health and Sciences, Baylor University, Waco, TX, United States
| | - Pamela Geiger
- Department of Psychiatry, Dartmouth Centers for Health and Aging, Geisel School of Medicine, Lebanon, NH, United States
| | - Andrew Bohm
- Department of Psychiatry, Dartmouth Centers for Health and Aging, Geisel School of Medicine, Lebanon, NH, United States
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25
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Kitetele FN, Dageid W, Lelo GM, Akele CE, Lelo PVM, Nyembo PL, Tylleskär T, Kashala-Abotnes E. HIV Disclosure to Infected Children Involving Peers: A New Take on HIV Disclosure in the Democratic Republic of Congo. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1092. [PMID: 37508590 PMCID: PMC10377987 DOI: 10.3390/children10071092] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/13/2023] [Accepted: 06/17/2023] [Indexed: 07/30/2023]
Abstract
Appropriately informing HIV-infected children of their diagnosis is a real challenge in sub-Saharan Africa. Until now, there is no consensus on who ought to disclose and how to disclose. This paper describes the model for HIV status disclosure in which HIV-positive children/adolescents are informed about their diagnosis in a process conducted by young peers under healthcare worker (HCW) supervision in a hospital in Kinshasa, the Democratic Republic of Congo. This new take on HIV status disclosure involving peers includes four stages that help the trained peer supporters to provide appropriate counseling, taking into account the age and level of maturity of the child/adolescent: the preliminary stage, the partial disclosure stage, the full disclosure stage, and the post-disclosure follow-up stage. Of all children/adolescents whose HIV status disclosure data were documented at Kalembelembe Pediatric Hospital (KLLPH) between 2004 and 2016, we found that disclosure by peers was highly accepted by parents, children/adolescents, and health workers. Compared to children/adolescents disclosed to by HCWs or parents, children/adolescents disclosed to by peers had (a) fewer depressive symptoms reported, (b) better drug adherence resulting in higher viral load suppression, and (c) a higher proportion of survivors on treatment. We found that involving peers in the disclosure process of HIV is an important approach to ensure adherence to treatment, resilience, and mental wellbeing of HIV-infected children/adolescents.
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Affiliation(s)
- Faustin Nd Kitetele
- Department of Infectious Diseases, Kalembelembe Pediatric Hospital, Kinshasa 012, Democratic Republic of the Congo
- Centre for International Health (CIH), Department of Global Public Health and Primary Care, University of Bergen, 5020 Bergen, Norway
| | - Wenche Dageid
- Faculty of Psychology, University of Bergen, 5020 Bergen, Norway
| | - Gilbert M Lelo
- Centre Neuro-Psycho-Pathologique de Kinshasa (CNPP), University of Kinshasa, Kinshasa 012, Democratic Republic of the Congo
| | - Cathy E Akele
- Department of Infectious Diseases, Kalembelembe Pediatric Hospital, Kinshasa 012, Democratic Republic of the Congo
| | - Patricia V M Lelo
- Department of Infectious Diseases, Kalembelembe Pediatric Hospital, Kinshasa 012, Democratic Republic of the Congo
- Centre for International Health (CIH), Department of Global Public Health and Primary Care, University of Bergen, 5020 Bergen, Norway
| | - Patricia L Nyembo
- Programme National de Lutte Contre le SIDA, Kinshasa 012, Democratic Republic of the Congo
| | - Thorkild Tylleskär
- Centre for International Health (CIH), Department of Global Public Health and Primary Care, University of Bergen, 5020 Bergen, Norway
| | - Espérance Kashala-Abotnes
- Centre for International Health (CIH), Department of Global Public Health and Primary Care, University of Bergen, 5020 Bergen, Norway
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Opie JE, Vuong A, Macafee A, Khalil H, Pearce N, Jayakody E, Maylea C, McIntosh JE. Practice, governance, and culture characteristics of lived experience organisations, and evidence of efficacy: A scoping review protocol. PLoS One 2023; 18:e0283178. [PMID: 37146030 PMCID: PMC10162514 DOI: 10.1371/journal.pone.0283178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 02/24/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND Mental health policy and service design is increasingly recognizing the importance of the lived experience voice and its inclusion in all aspects of work. Effective inclusion requires a deeper understanding of how best to support lived experience workforce and community members to meaningfully participate in the system. OBJECTIVES This scoping review aims to identify key features of organizational practice and governance that facilitate the safe inclusion of lived experience in decision-making and practice within mental health sector contexts. Specifically, the review focuses on mental health organizations devoted to lived experience advocacy or peer support or those in which lived experience membership (paid or voluntary) is central to advocacy and peer support operations. METHODS This review protocol was prepared with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols and registered with the Open Science Framework. The review will be guided by the Joanna Briggs Institute methodology framework and is being conducted by a multidisciplinary team including lived experience research fellows. It will include published and grey literature, including government reports, organizational online documents, and theses. Included studies will be identified through comprehensive searches of five databases: PsycINFO (Ovid), CINAHL (EBSCO), EMBASE (Ovid), MEDLINE (Ovid), and ProQuest Central. Studies published in English from 2000 onwards will be included. Data extraction will be guided by pre-determined extraction instruments. Results will be presented in a Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews flow chart. Results will be presented in tabular form and narratively synthesized. The planned commencement and completion dates for this review were July 1, 2022 and April 1, 2023. DISCUSSION It is anticipated that this scoping review will map the current evidence base underpinning organizational practices in which lived experience workers are involved, specifically in the mental health system. It will also inform future mental health policy and research. TRIAL REGISTRATION Registration: Open Science Framework (registered: July 26, 2022; registration DOI: 10.17605/OSF.IO/NB3S5).
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Affiliation(s)
- Jessica E. Opie
- Bouverie Centre La Trobe University, Melbourne, Victoria, Australia
- La Trobe University, Melbourne, Victoria, Australia
| | - An Vuong
- Bouverie Centre La Trobe University, Melbourne, Victoria, Australia
- La Trobe University, Melbourne, Victoria, Australia
| | - Alexandra Macafee
- The Victorian Mental Illness Awareness Council (VMIAC), Melbourne, Victoria, Australia
| | - Hanan Khalil
- La Trobe University, Melbourne, Victoria, Australia
| | - Natalie Pearce
- Library, Latrobe University, Bendigo, Victoria, Australia
| | - Erandathie Jayakody
- The Victorian Mental Illness Awareness Council (VMIAC), Melbourne, Victoria, Australia
| | | | - Jennifer E. McIntosh
- Bouverie Centre La Trobe University, Melbourne, Victoria, Australia
- La Trobe University, Melbourne, Victoria, Australia
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27
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Mavragani A, Duffin S, Gough RE, Bath PA. Use of Online Health Forums by People Living With Breast Cancer During the COVID-19 Pandemic: Thematic Analysis. JMIR Cancer 2023; 9:e42783. [PMID: 36473015 PMCID: PMC9907982 DOI: 10.2196/42783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 11/24/2022] [Accepted: 12/05/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND At the time of the UK COVID-19 lockdowns, online health forums (OHFs) were one of the relatively few remaining accessible sources of peer support for people living with breast cancer. Cancer services were heavily affected by the pandemic in many ways, including the closure of many of the customary support services. Previous studies indicate that loneliness, anxiety, distress, and depression caused by COVID-19 were common among people living with breast cancer, and this suggests that the role of OHFs in providing users with support, information, and empathy could have been of increased importance at that time. OBJECTIVE This study aimed to examine how people living with breast cancer shared information, experiences, and emotions in an OHF during the COVID-19 pandemic. METHODS This qualitative study thematically analyzed posts from the discussion forums of an OHF provided by the UK charity, Breast Cancer Now. We selected 1053 posts from the time of 2 UK lockdowns: March 16, 2020, to June 15, 2020 (lockdown 1), and January 6, 2021, to March 8, 2021 (lockdown 3), for analysis, from 2 of the forum's boards (for recently diagnosed people and for those undergoing chemotherapy). We analyzed the data using the original 6 steps for thematic analysis by Braun and Clarke but by following a codebook approach. Descriptive statistics for posts were also derived. RESULTS We found that COVID-19 amplified the forum's value to its users. As patients with cancer, participants were in a situation that was "bad enough already," and the COVID-19 pandemic heightened this difficult situation. The forum's value, which was already high for the information and peer support it provided, increased because COVID-19 caused some special information needs that forum users were uniquely well placed to fulfill as people experiencing the combined effects of having breast cancer during the pandemic. The forum also met the emotional needs generated by the COVID-19 pandemic and was valued as a place where loneliness during the pandemic may be relieved and users' spirits lifted in a variety of ways specific to this period. We found some differences in use between the 2 periods and the 2 boards-most noticeable was the great fear and anxiety expressed at the beginning of lockdown 1. Both the beginning and end of lockdown periods were particularly difficult for participants, with the ends seen as potentially increasing isolation. CONCLUSIONS The forums were an important source of support and information to their users, with their value increasing during the lockdowns for a variety of reasons. Our findings will be helpful to organizations offering OHFs and to health care workers advising people living with breast cancer about sources of support.
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Affiliation(s)
| | - Suzanne Duffin
- Information School, Faculty of Social Sciences, University of Sheffield, Sheffield, United Kingdom
| | - Rosemarie E Gough
- School of Health and Related Research, Faculty of Medicine, Dentistry and Health, University of Sheffield, Sheffield, United Kingdom
| | - Peter A Bath
- Information School, Faculty of Social Sciences, University of Sheffield, Sheffield, United Kingdom
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28
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Krulic T, Brown G, Graham S, Hoy J, Bourne A. Revealing an enabling environment: How clinical community and clinical stakeholders understand peer navigation to improve quality of life for people living with HIV in Australia. Front Public Health 2023; 11:1101722. [PMID: 37151586 PMCID: PMC10157390 DOI: 10.3389/fpubh.2023.1101722] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 03/28/2023] [Indexed: 05/09/2023] Open
Abstract
People living with HIV have unique resources to offer each other and health systems. This study investigated how peer navigation might contribute to a socially supportive, health enabling environment in Victoria, Australia. We used semi-structured interviews with 30 program staff, management, peer workers and clinician stakeholders. Our analyses considered the interplay between the program, users, HIV-related stigma and discrimination and the health service environment. Peer relationships offered reassurance, acceptance and belonging, which people living with HIV can use to create personal change. Peer engagement coproduced insights for life with HIV and may help to overcome stigma and structural barriers to access services and community support. As a partnership between peer and clinical services, participants described how the program fostered appreciation of peer practices and insights, which were used to improve the quality and continuity of care offered in the state. These findings allude to the value of the community engagement and policy alignment peer responses produce and can be used to guide implementation of similar programs elsewhere.
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Affiliation(s)
- Timothy Krulic
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, VIC, Australia
- Living Positive Victoria, Melbourne, VIC, Australia
- *Correspondence: Timothy Krulic,
| | - Graham Brown
- The Centre for Social Impact, UNSW, Sydney, NSW, Australia
| | - Sara Graham
- Living Positive Victoria, Melbourne, VIC, Australia
| | - Jennifer Hoy
- Alfred Hospital Infectious Diseases Clinic, Melbourne, VIC, Australia
| | - Adam Bourne
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, VIC, Australia
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29
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Halsall T, Daley M, Hawke L, Henderson J, Matheson K. “You can kind of just feel the power behind what someone's saying”: a participatory-realist evaluation of peer support for young people coping with complex mental health and substance use challenges. BMC Health Serv Res 2022; 22:1358. [PMCID: PMC9667436 DOI: 10.1186/s12913-022-08743-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 10/27/2022] [Indexed: 11/17/2022] Open
Abstract
Abstract
Background
Youth peer support, as a practice that aligns youth engagement and participatory approaches, has become increasingly popular in the context of youth mental health services. However, there is a need for more evidence that describes how and why youth peer support practice might be effective. This study was designed to examine a peer support service for youth experiencing complex challenges with mental health, physical health and/or substance use to better understand key features and underlying mechanisms that lead to improved client outcomes.
Methods
We applied a hybrid realist-participatory approach to explore key issues and underlying theoretical assumptions within a youth peer support approach for young people (age 14–26) experiencing complex mental health and substance use challenges. We used semi-structured interviews and focus groups with staff, including peers (N = 8), clinical service providers and administrative staff (N = 15), to develop the theories and a client survey to validate them. Our qualitative thematic analysis applied a retroductive approach that involved both inductive and deductive processes. For the client survey (N = 77), we calculated descriptive statistics to examine participant profiles and usage patterns. Pearson correlations were examined to determine relationships among concepts outlined in the program theories, including context, mechanism and outcome variables.
Results
Our analyses resulted in one over-arching context, one over-arching outcome and four program theories. Program theories were focused on mechanisms related to 1) positive identity development through identification with peers, 2) enhanced social connections, 3) observational learning and 4) enhanced autonomy and empowerment.
Conclusions
This study serves as a unique example of a participatory-realist hybrid approach. Findings highlight possible key components of youth peer practice and shed light on the functional mechanisms that underlie successful peer practice. These key components can be examined in other settings to develop more comprehensive theories of change with respect to youth peer support and can eventually be used to develop guidelines and standards to strengthen practice. This research contributes to an expanding body of literature on youth peer support in mental health and connects peer practice with several social theories. This research begins to lay a foundation for enhanced youth peer support program design and improved outcomes for young people experiencing complex mental health and substance use challenges.
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Ho KHM, Yang C, Leung AKY, Bressington D, Chien WT, Cheng Q, Cheung DSK. Peer Support and Mental Health of Migrant Domestic Workers: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:7617. [PMID: 35805278 PMCID: PMC9265321 DOI: 10.3390/ijerph19137617] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/07/2022] [Accepted: 06/20/2022] [Indexed: 11/29/2022]
Abstract
The effectiveness of peer support in improving mental health and well-being has been well documented for vulnerable populations. However, how peer support is delivered to migrant domestic workers (MDWs) to support their mental health is still unknown. This scoping review aimed to synthesize evidence on existing peer support services for improving mental health among MDWs. We systematically searched eight electronic databases, as well as grey literature. Two reviewers independently performed title/abstract and full-text screening, and data extraction. Twelve articles were finally included. Two types of peer support were identified from the included studies, i.e., mutual aid and para-professional trained peer support. MDWs mainly seek support from peers through mutual aid for emotional comfort. The study's findings suggest that the para-professional peer support training program was highly feasible and culturally appropriate for MDWs. However, several barriers were identified to affect the successful implementation of peer support, such as concerns about emotion contagion among peers, worries about disclosure of personal information, and lack of support from health professionals. Culture-specific peer support programs should be developed in the future to overcome these barriers to promote more effective mental health practices.
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Affiliation(s)
- Ken Hok Man Ho
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong SAR, Shatin, N.T., Hong Kong SAR, China; (C.Y.); (W.T.C.)
| | - Chen Yang
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong SAR, Shatin, N.T., Hong Kong SAR, China; (C.Y.); (W.T.C.)
| | - Alex Kwun Yat Leung
- Department of Social Work, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China; (A.K.Y.L.); (Q.C.)
| | - Daniel Bressington
- College of Nursing and Midwifery, Charles Darwin University, Darwin 0815, Australia;
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong SAR, Shatin, N.T., Hong Kong SAR, China; (C.Y.); (W.T.C.)
| | - Qijin Cheng
- Department of Social Work, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China; (A.K.Y.L.); (Q.C.)
| | - Daphne Sze Ki Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China;
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