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Meza BPL, Pollack CE, Tilchin C, Jennings JM, Latkin CA, Cather C, Dickerson F, Evins AE, Wang NY, Daumit GL, Yuan C, Gudzune KA. Social networks of people with serious mental illness who smoke: potential role in a smoking cessation intervention. J Ment Health 2024:1-10. [PMID: 38588708 PMCID: PMC11458813 DOI: 10.1080/09638237.2024.2332807] [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: 07/08/2022] [Accepted: 02/06/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Smoking is a major contributor to morbidity and mortality among individuals with serious mental illness (SMI) and social networks may play an important role in smoking behaviors. AIMS Our objectives were to (1) describe the network characteristics of adults with SMI who smoke tobacco (2) explore whether network attributes were associated with nicotine dependence. METHODS We performed a secondary analysis of baseline data from a tobacco smoking cessation intervention trial among 192 participants with SMI. A subgroup (n = 75) completed questions on the characteristics of their social network members. The network characteristics included network composition (e.g. proportion who smoke) and network structure (e.g. density of connections between members). We used multilevel models to examine associations with nicotine dependence. RESULTS Participant characteristics included: a mean age 50 years, 49% women, 48% Black, and 41% primary diagnosis of schizophrenia/schizoaffective disorder. The median personal network proportion of active smokers was 22%, active quitters 0%, and non-smokers 53%. The density of ties between actively smoking network members was greater than between non-smoking members (55% vs 43%, p = .02). Proportion of network smokers was not associated with nicotine dependence. CONCLUSIONS We identified potential social network challenges and assets to smoking cessation and implications for network interventions among individuals with SMI.
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Affiliation(s)
- Benjamin P. L. Meza
- Division of General Internal Medicine and Health Services Research, University of California Los Angeles, Los Angeles, CA, USA
| | - Craig E. Pollack
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
| | - Carla Tilchin
- Center for Child and Community Health Research (CCHR), Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jacky M. Jennings
- Center for Child and Community Health Research (CCHR), Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Carl A. Latkin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Corinne Cather
- Center of Excellence for Psychosocial and Systematic Research, Harvard Medical School, Boston, MA, USA
- Center for Addiction Medicine, Massachusetts General Hospital, Boston, MA, USA
| | | | - Anne E. Evins
- Center of Excellence for Psychosocial and Systematic Research, Harvard Medical School, Boston, MA, USA
- Center for Addiction Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Nae-Yuh Wang
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Gail L. Daumit
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Christina Yuan
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kimberly A. Gudzune
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Garver-Apgar CE, Morris CM, Pavlik J, Lenartz T, Hamm M. Peer-Facilitated Tobacco Cessation in a Prison Setting: A Proof of Concept Study. Tob Use Insights 2023; 16:1179173X231168511. [PMID: 37051590 PMCID: PMC10084529 DOI: 10.1177/1179173x231168511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
Abstract
Background Despite the vast human and economic costs associated with tobacco use among U.S. inmates, smoking remains a largely ignored public health epidemic. Incarcerated individuals smoke at 3 to 4 times the rate of the general population and face tobacco-related health disparities. Purpose This paper reports results from a single arm, pre/post pilot study designed to test the feasibility and initial effectiveness of an inmate-administered group tobacco cessation intervention within a men’s pre-release program run by the Arizona Department of Corrections. Methods Corrections staff and inmate peer mentors were trained in the DIMENSIONS: Tobacco Free Program, a manualized 6-session tobacco cessation group curriculum. Group sessions used evidence-based interventions for assisting inmates develop skills to live tobacco and nicotine free. In 2019-2020, 39 men who reported tobacco use voluntarily participated in one of three cessation groups. Wilcoxen signed-rank tests evaluated changes across group sessions in frequency of tobacco use and attitudes about nicotine-free living post release. Results Most participants attended all six group sessions (79%) and made one or more quit attempts (78%). Overall, 24% of the sample reported quitting tobacco, and significant reductions in tobacco use were reported after only two sessions. Participants further reported significant positive changes in knowledge, plans, support, and confidence to live tobacco-free lives post-release. Conclusions To our knowledge, this is the first study to demonstrate that, with minimal investment, implementation of an evidence-based, peer-led tobacco free program is feasible and effective within an incarcerated population uniquely vulnerable to the burden of tobacco.
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Affiliation(s)
| | - Chad M. Morris
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jim Pavlik
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Apata J, Goldman E, Taraji H, Samagbeyi O, Assari S, Sheikhattari P. Peer mentoring for smoking cessation in public housing: A mixed-methods study. Front Public Health 2023; 10:1052313. [PMID: 36726619 PMCID: PMC9885972 DOI: 10.3389/fpubh.2022.1052313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 12/07/2022] [Indexed: 01/07/2023] Open
Abstract
Introduction Tobacco use disproportionately affects low-income African American communities. The recent public housing smoke-free policy has increased the demand for effective smoking cessation services and programs in such settings. Methods This mixed-method pilot study explored feasibility and potential impact of a peer-mentoring program for smoking cessation in a public housing unit. The quantitative study used a quasi-experimental design while qualitative data were collected via focus group discussions with peer mentors and participants. Three residents of the public housing complex were trained as peer mentors. Each peer mentor recruited up to 10 smokers in the residence and provided them individual support for 12 weeks. All participants were offered Nicotine Replacement Therapy (NRT). A follow-up investigation was conducted 3 months after completion of the 12-week intervention. At baseline and follow-up, the participants' smoking status was measured using self-report and was verified using exhaled carbon monoxide (eCO) monitoring. Results The intervention group was composed of 30 current smokers who received the peer-mentoring intervention. The control group was composed of 14 individuals. Overall mean eCO levels dropped from 26 ppm (SD 19.0) at baseline to 12 (SD 6.0) at follow-up (P < 0.01). Participants who were enrolled in our program were more likely to have non-smoking eCO levels (<7 ppm) at follow-up (23.3%) compared to those who did not enroll (14.3%). Conclusion Our program is feasible for low-income predominantly African American communities. Using peers as mentors may be helpful in providing services for hard-to-reach populations. Given the non-randomized design of our study, randomized trials are needed to test the efficacy of our program in the future.
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Affiliation(s)
- Jummai Apata
- Center for Urban Health Disparities Research and Innovation, Morgan State University, Baltimore, MD, United States
| | - Erica Goldman
- Resident Services Inc., Housing Authority of Baltimore City, Baltimore, MD, United States
| | - Hamideh Taraji
- Prevention Science Research Center, Morgan State University, Baltimore, MD, United States
| | - Oluwatobi Samagbeyi
- Prevention Science Research Center, Morgan State University, Baltimore, MD, United States
| | - Shervin Assari
- Department of Urban Public Health, Charles R Drew University of Medicine and Science, Los Angeles, CA, United States
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA, United States
| | - Payam Sheikhattari
- School of Community Health and Policy, Morgan State University, Baltimore, MD, United States
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Cook JA, Steigman PJ, Swarbrick M, Burke-Miller JK, Laing TB, Vite L, Jonikas JA, Brown I. Outcomes of Peer-Provided Individual Placement and Support Services in a Mental Health Peer-Run Vocational Program. Psychiatr Serv 2022; 74:480-487. [PMID: 36254454 DOI: 10.1176/appi.ps.20220134] [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: 11/30/2022]
Abstract
OBJECTIVE The authors sought to determine whether staff at a peer-run agency could deliver supported employment services with high fidelity to the individual placement and support (IPS) model and whether employment outcomes of peer-delivered IPS plus work-specific health promotion were superior to usual supported employment services. METHODS Two teams from a vocational program of a large peer-run agency were studied from July 2015 to July 2017. One team received training and supervision in delivering IPS plus employment-focused physical wellness support and mentoring. The other team continued providing usual supported employment services. Study data included vocational outcomes from 348 clients served by the two teams (IPS, N=184; comparison condition, N=164) and the results of IPS fidelity reviews of the IPS team at study baseline, midpoint, and end. The authors modeled the primary outcome of competitive employment with random-effects logistic regression and adjusted propensity scores for age, gender, race, ethnicity, education, and months of service receipt. RESULTS Following training, the IPS team demonstrated acceptable and increasing fidelity to the IPS model, achieving "good fidelity" by the end of the 25-month observation period. Among IPS recipients, 43% achieved competitive employment versus 21% of comparison recipients (p<0.001). Multivariable analysis indicated that IPS recipients were significantly more likely to achieve competitive employment than individuals in the comparison group (OR=4.06, p<0.001). CONCLUSIONS Providing training in IPS along with health promotion to the behavioral health peer workforce may help address the severe shortage of IPS services and enhance the competitive employment outcomes of people served by peer-run programs.
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Affiliation(s)
- Judith A Cook
- Department of Psychiatry, University of Illinois Chicago College of Medicine, Chicago (Cook, Steigman, Burke-Miller, Jonikas); Collaborative Support Programs of New Jersey, Freehold (Swarbrick); Center of Alcohol and Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers, the State University of New Jersey, New Brunswick (Swarbrick); Baltic Street Advocacy, Employment, and Housing (AEH), Inc., New York City (Laing, Vite, Brown)
| | - Pamela J Steigman
- Department of Psychiatry, University of Illinois Chicago College of Medicine, Chicago (Cook, Steigman, Burke-Miller, Jonikas); Collaborative Support Programs of New Jersey, Freehold (Swarbrick); Center of Alcohol and Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers, the State University of New Jersey, New Brunswick (Swarbrick); Baltic Street Advocacy, Employment, and Housing (AEH), Inc., New York City (Laing, Vite, Brown)
| | - Margaret Swarbrick
- Department of Psychiatry, University of Illinois Chicago College of Medicine, Chicago (Cook, Steigman, Burke-Miller, Jonikas); Collaborative Support Programs of New Jersey, Freehold (Swarbrick); Center of Alcohol and Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers, the State University of New Jersey, New Brunswick (Swarbrick); Baltic Street Advocacy, Employment, and Housing (AEH), Inc., New York City (Laing, Vite, Brown)
| | - Jane K Burke-Miller
- Department of Psychiatry, University of Illinois Chicago College of Medicine, Chicago (Cook, Steigman, Burke-Miller, Jonikas); Collaborative Support Programs of New Jersey, Freehold (Swarbrick); Center of Alcohol and Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers, the State University of New Jersey, New Brunswick (Swarbrick); Baltic Street Advocacy, Employment, and Housing (AEH), Inc., New York City (Laing, Vite, Brown)
| | - Taina B Laing
- Department of Psychiatry, University of Illinois Chicago College of Medicine, Chicago (Cook, Steigman, Burke-Miller, Jonikas); Collaborative Support Programs of New Jersey, Freehold (Swarbrick); Center of Alcohol and Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers, the State University of New Jersey, New Brunswick (Swarbrick); Baltic Street Advocacy, Employment, and Housing (AEH), Inc., New York City (Laing, Vite, Brown)
| | - Laurie Vite
- Department of Psychiatry, University of Illinois Chicago College of Medicine, Chicago (Cook, Steigman, Burke-Miller, Jonikas); Collaborative Support Programs of New Jersey, Freehold (Swarbrick); Center of Alcohol and Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers, the State University of New Jersey, New Brunswick (Swarbrick); Baltic Street Advocacy, Employment, and Housing (AEH), Inc., New York City (Laing, Vite, Brown)
| | - Jessica A Jonikas
- Department of Psychiatry, University of Illinois Chicago College of Medicine, Chicago (Cook, Steigman, Burke-Miller, Jonikas); Collaborative Support Programs of New Jersey, Freehold (Swarbrick); Center of Alcohol and Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers, the State University of New Jersey, New Brunswick (Swarbrick); Baltic Street Advocacy, Employment, and Housing (AEH), Inc., New York City (Laing, Vite, Brown)
| | - Isaac Brown
- Department of Psychiatry, University of Illinois Chicago College of Medicine, Chicago (Cook, Steigman, Burke-Miller, Jonikas); Collaborative Support Programs of New Jersey, Freehold (Swarbrick); Center of Alcohol and Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers, the State University of New Jersey, New Brunswick (Swarbrick); Baltic Street Advocacy, Employment, and Housing (AEH), Inc., New York City (Laing, Vite, Brown)
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Baker AL, McCarter K, Brophy L, Castle D, Kelly PJ, Cocks N, McKinlay ML, Brasier C, Borland R, Bonevski B, Segan C, Baird DE, Turner A, Williams JM, Forbes E, Hayes L, Attia J, Lambkin D, Barker D, Sweeney R. Adapting Peer Researcher Facilitated Strategies to Recruit People Receiving Mental Health Services to a Tobacco Treatment Trial. Front Psychiatry 2022; 13:869169. [PMID: 35722563 PMCID: PMC9199858 DOI: 10.3389/fpsyt.2022.869169] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/26/2022] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION One of the most challenging aspects of conducting intervention trials among people who experience severe mental illness (SMI) and who smoke tobacco, is recruitment. In our parent "QuitLink" randomized controlled trial (RCT), slower than expected peer researcher facilitated recruitment, along with the impact of COVID-19 pandemic restrictions, necessitated an adaptive recruitment response. The objectives of the present study were to: (i) describe adaptive peer researcher facilitated recruitment strategies; (ii) explore the effectiveness of these strategies; (iii) investigate whether recruitment strategies reached different subgroups of participants; and (iv) examine the costs and resources required for implementing these strategies. Finally, we offer experience-based lessons in a Peer Researcher Commentary. METHODS People were included in the RCT if they smoked at least 10 cigarettes a day and were accessing mental health support from the project's two partnering mental health organizations in Victoria, Australia. The majority of people accessing these services will have been diagnosed with SMI. Recruitment occurred over 2 years. We began with peer facilitated recruitment strategies delivered face-to-face, then replaced this with direct mail postcards followed by telephone contact. In the final 4 months of the study, we began online recruitment, broadening it to people who smoked and were accessing support or treatment (including from general practitioners) for mental health and/or alcohol or other drug problems, anywhere in the state of Victoria. Differences between recruitment strategies on key participant variables were assessed. We calculated the average cost per enrolee of the different recruitment approaches. RESULTS Only 109 people were recruited from a target of 382: 29 via face-to-face (March 2019 to April 2020), 66 from postcards (May 2020 to November 2020), and 14 from online (November to December 2020 and January to March 2021) strategies. Reflecting our initial focus on recruiting from supported independent living accommodation facilities, participants recruited face-to-face were significantly more likely to be living in partially or fully supported independent living (n = 29, <0.001), but the samples were otherwise similar. After the initial investment in training and equipping peer researchers, the average cost of recruitment was AU$1,182 per participant-~US$850. Face-to-face recruitment was the most expensive approach and postcard recruitment the least (AU$1,648 and AU$928 per participant). DISCUSSION Peer researcher facilitated recruitment into a tobacco treatment trial was difficult and expensive. Widely dispersed services and COVID-19 restrictions necessitated non-face-to-face recruitment strategies, such as direct mail postcards, which improved recruitment and may be worthy of further research. CLINICAL TRIAL REGISTRATION The trial is registered with ANZCTR (www.anzctr.org.au): ACTRN12619000244101 prior to the accrual of the first participant and updated regularly as per registry guidelines. The trial sponsor was the University of Newcastle, NSW, Australia.
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Affiliation(s)
- Amanda L Baker
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Kristen McCarter
- School of Psychological Sciences, College of Engineering, Science and Environment, University of Newcastle, Callaghan, NSW, Australia
| | - Lisa Brophy
- Social Work and Social Policy, School of Allied Health, Human Services and Sport, La Trobe University Melbourne, Melbourne, VIC, Australia.,Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - David Castle
- Centre for Complex Interventions, Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Peter J Kelly
- Illawarra Health and Medical Research Institute and the School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Nadine Cocks
- Research, Advocacy and Policy Development, Mind Australia Limited, Heidelberg, VIC, Australia
| | - Melissa L McKinlay
- Department of Mental Health, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - Catherine Brasier
- Social Work and Social Policy, School of Allied Health, Human Services and Sport, La Trobe University Melbourne, Melbourne, VIC, Australia
| | - Ron Borland
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia.,Cancer Council Victoria, Melbourne, VIC, Australia
| | - Billie Bonevski
- Flinders Health and Medical Research Institute (FHMRI), College of Medicine & Public Health, Flinders University, Bedford Park, SA, Australia
| | - Catherine Segan
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Donita E Baird
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Alyna Turner
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia.,School of Medicine, IMPACT, Institute for Innovation in Physical and Mental Health and Clinical Translation, Deakin University, Geelong, VIC, Australia
| | - Jill M Williams
- Division of Addiction Psychiatry, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
| | - Erin Forbes
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Laura Hayes
- Research, Advocacy and Policy Development, Mind Australia Limited, Heidelberg, VIC, Australia
| | - John Attia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - David Lambkin
- Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Daniel Barker
- Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Rohan Sweeney
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, VIC, Australia
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Wang Y, Chen Y, Deng H. Effectiveness of Family- and Individual-Led Peer Support for People With Serious Mental Illness: A Meta-Analysis. J Psychosoc Nurs Ment Health Serv 2021; 60:20-26. [PMID: 34432588 DOI: 10.3928/02793695-20210818-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Peer support has received increasing attention in the field of mental rehabilitation for serious mental illness (SMI), but meta-analyses are rare, especially in terms of family-led peer support. The current meta-analysis was conducted using PubMed, Embase, Cochrane, and Medline databases, and manual retrieval was performed. Randomized controlled trials of peer support interventions were included. Subgroup meta-analyses were performed separately for family-led and individual-led peer support. A total of 28 articles (five on family-led peer support and 23 on individual-led peer support) were included. For family-led peer support, there were no significant differences between intervention and control groups in family functioning or burden, and there seemed to be positive effects on use of health services, patient functioning, psychotic symptoms, rehospitalization, and duration. Individual-led peer support may have positive effects on well-being, medication adherence, finances, and loneliness; however, it seemed to be less effective in terms of self-efficacy, quality of life, recovery, hope, and activation. There were no significant differences between peer support groups and control groups in social support, functioning, psychotic symptom improvement, self-esteem, alcohol use, drug use, legal charges, building relationships, empowerment, satisfaction, and use of health care. Peer support, whether it is individualled or family-led, can be further developed for rehabilitation of individuals with SMI. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].
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Abstract
Peer specialists, or individuals with lived experience of mental health conditions who support the mental health recovery of others, often work side-by-side with traditional providers (non-peers) in the delivery of treatment groups. The present study aimed to examine group participant and peer provider experiences with peer and non-peer group co-facilitation. Data from a randomized controlled trial of Living Well, a peer and non-peer co-facilitated intervention for medical illness management for adults with serious mental illness, were utilized. A subset of Living Well participants (n = 16) and all peer facilitators (n = 3) completed qualitative interviews. Transcripts were coded and analyzed using a general inductive approach and thematic analysis. The complementary perspectives of the facilitators, teamwork between them, skillful group pacing, and peer facilitator self-disclosure contributed to a warm, respectful, and interactive group atmosphere, which created an environment conducive to social learning. Guidelines for successful co-facilitation emerging from this work are described.
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8
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Mowbray O, Campbell R, Lee M, Fatehi M, Disney L. A Systematic Review of Psychosocial-Based Outcomes in Peer-Support Services. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2021; 18:155-180. [PMID: 32893743 DOI: 10.1080/26408066.2020.1805385] [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: 06/11/2023]
Abstract
Purpose: In determining whether peer support interventions are effective, an examination of the measures used to assess outcomes is essential. Prior reviews often do not account for validly and reliability of measures used in studies, which may lead to conflicting conclusions. Method: Explicit criteria to identify articles of psychosocial based outcomes in peer support services was used. Outcome measures were categorized along broad dimensions, examined for validity and reliability and reviewed for major findings. Results: Thirteen domains of psychosocial based outcomes emerged. Most domains had at least one outcome measure that was valid and reliable. Articles that included valid and reliable outcomes suggests peer support services may be associated with multiple domains. Conclusion: From an examination of the validity and reliability of measures used to evaluate peer support services, a stronger evidence base for services is established. Future directions for both social work research and practice are identified.
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Affiliation(s)
- Orion Mowbray
- School of Social Work, University of Georgia Athens, Georgia, USA
| | - Rosalyn Campbell
- School of Social Work, University of Georgia Athens, Georgia, USA
| | - Megan Lee
- School of Social Work, University of Georgia Athens, Georgia, USA
| | - Mariam Fatehi
- School of Social Work, University of Georgia Athens, Georgia, USA
| | - Lindsey Disney
- School of Social Welfare, University at Albany, Albany, New York, USA
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9
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Japuntich SJ, Hammett PJ, Rogers ES, Fu S, Burgess DJ, El Shahawy O, Melzer AC, Noorbaloochi S, Krebs P, Sherman SE. Effectiveness of Proactive Tobacco Cessation Treatment Outreach Among Smokers With Serious Mental Illness. Nicotine Tob Res 2021; 22:1433-1438. [PMID: 31957794 DOI: 10.1093/ntr/ntaa013] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 01/17/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION People with serious mental illness (SMI) have a high smoking prevalence and low quit rates. Few cessation treatments are tested in smokers with SMI. Mental health (MH) providers are reluctant to address smoking. Proactive tobacco cessation treatment strategies reach out directly to smokers to offer counseling and medication and improve treatment utilization and quit rates. The current study is a secondary analysis of a randomized controlled trial of proactive outreach for tobacco cessation treatment in VA MH patients. AIMS AND METHODS Participants (N = 1938, 83% male, mean age 55.7) across four recruitment sites, who were current smokers and had a MH visit in the past 12 months, were identified using the electronic medical record. Participants were randomized to Intervention (telephone outreach call plus invitation to engage in MH tailored telephone counseling and assistance obtaining nicotine replacement therapy) or Control (usual care). The current study assessed outcomes in participants with SMI (N = 982). RESULTS Compared to the Control group, participants assigned to the Intervention group were more likely to engage in telephone counseling (22% vs. 3%) and use nicotine replacement therapy (51% vs. 41%). Participants in the Intervention group were more likely to be abstinent (7-day point prevalence; 18%) at 12 months than participants in the Control group (11%) but equally likely to make quit attempts. CONCLUSIONS Proactive tobacco cessation treatment is an effective strategy for tobacco users with SMI. Proactive outreach had a particularly strong effect on counseling utilization. Future randomized clinical trials examining proactive tobacco treatment approaches in SMI treatment settings are needed. IMPLICATIONS Few effective treatment models exist for smokers with SMI. Proactive tobacco cessation outreach with connections to MH tailored telephone counseling and medication promotes tobacco abstinence among smokers with SMI and is an effective treatment strategy for this underserved population.
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Affiliation(s)
- Sandra J Japuntich
- Department of Clinical Pharmacology and Toxicology, Hennepin Healthcare, Minneapolis, MN
| | - Patrick J Hammett
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN.,Department of Medicine, University of Minnesota Medical School, Minneapolis, MN
| | - Erin S Rogers
- Department of Medicine, VA New York Harbor Healthcare System, New York, NY.,Department of Population Health, New York University School of Medicine, New York, NY
| | - Steven Fu
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN.,Department of Medicine, University of Minnesota Medical School, Minneapolis, MN
| | - Diana J Burgess
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN.,Department of Medicine, University of Minnesota Medical School, Minneapolis, MN
| | - Omar El Shahawy
- Department of Population Health, New York University School of Medicine, New York, NY
| | - Anne C Melzer
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN.,Department of Medicine, University of Minnesota Medical School, Minneapolis, MN
| | - Siamak Noorbaloochi
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN.,Department of Medicine, University of Minnesota Medical School, Minneapolis, MN
| | - Paul Krebs
- Department of Mental Health, VA San Diego Healthcare System, San Diego, CA
| | - Scott E Sherman
- Department of Medicine, VA New York Harbor Healthcare System, New York, NY.,Department of Population Health, New York University School of Medicine, New York, NY
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10
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Barnhart WR, Whalen Smith CN, Ellsworth D, Coleman E, Lorenz A, Riddle IK, Havercamp SM. Implementing Living Independent From Tobacco With Dyads of People With Disabilities and Their Caregivers: Successes and Lessons Learned. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2020; 58:241-250. [PMID: 32484885 DOI: 10.1352/1934-9556-58.3.241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 10/11/2019] [Indexed: 06/11/2023]
Abstract
People with disabilities have more health complications and higher healthcare utilization related to tobacco use than people without disabilities. Yet, they are less likely to use tobacco cessation resources. Important to meaningful and lasting health behavior change are relationships developed in the home, workplace, and community. Some people with disabilities rely on paid and unpaid caregivers. Just like people with disabilities, paid caregivers are more likely to use tobacco, creating a unique opportunity to target smoking cessation to people with disabilities and their caregivers. Living Independent From Tobacco (LIFT), an evidence-based tobacco cessation intervention, was implemented with dyads of people with disabilities (n = 5) and their caregivers (n = 7). Qualitative analyses revealed that participants valued the dyadic approach and the opportunity to learn coping skills to help with smoking cessation. Lessons for offering inclusive health promotion interventions to people with disabilities and their caregivers are discussed.
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Affiliation(s)
| | | | | | - Erica Coleman
- Erica Coleman, University of Cincinnati, University Center for Excellence in Developmental Disabilities
| | - Allison Lorenz
- Allison Lorenz, Ohio Colleges of Medicine Government Resource Center
| | - Ilka K Riddle
- Ilka K. Riddle, University of Cincinnati, University Center for Excellence in Developmental Disabilities
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Barrenger SL, Stanhope V, Miller E. Capturing the value of peer support: measuring recovery-oriented services. JOURNAL OF PUBLIC MENTAL HEALTH 2019. [DOI: 10.1108/jpmh-02-2019-0022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to examine the gap between recovery-oriented processes and clinical outcomes in peer support, an exemplar of recovery-oriented services, and offer suggestions for bridging this gap.
Design/methodology/approach
This viewpoint is a brief review of literature on peer support services and gaps in outcome measurement towards building an evidence base for recovery-oriented services.
Findings
Clinical outcomes like hospitalizations or symptoms remain a focus of research, practice and policy in recovery-oriented services and contribute to a mixed evidence base for peer support services, in which recovery-oriented outcomes like empowerment, self-efficacy and hopefulness have more evidentiary support. One approach is to identify the theoretical underpinnings of peer support services and the corresponding change mechanisms in models that would make these recovery-oriented outcomes mediators or process outcomes. A better starting point is to consider which outcomes are valued by the people who use services and develop an evaluation approach according to those stated goals. User driven measurement approaches and more participatory types of research can improve both the quality and impact of health and mental health services.
Originality/value
This viewpoint provides a brief review of peer support services and the challenges of outcome measurement in establishing an evidence base and recommends user driven measurement as a starting point in evaluation of recovery-oriented services.
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Barcelona de Mendoza V, Damio G. Evaluation of a culturally appropriate peer coaching program for smoking cessation. Public Health Nurs 2019; 35:541-550. [PMID: 30596399 DOI: 10.1111/phn.12542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 06/07/2018] [Accepted: 07/13/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the effectiveness of a peer coaching smoking cessation program in a high-risk Medicaid population. DESIGN AND SAMPLE In this manuscript, we present an evaluation of a pilot program. Participants (N = 138) were recruited out of a larger smoking cessation program administered statewide and funded by the Center for Medicare and Medicaid Services. The participant sample was diverse, with 52% self-identifying as White, 39% as Black, and 56% Latino ethnicity (any race). METHODS Motivational interviewing techniques were utilized by peer coaches in clinical and community settings to achieve smoking cessation using face-to-face, telephone, and text/email encounters over a period of 6 months. RESULTS There was a statistically significant increase in the number of participants who had quit smoking from program enrollment to discharge (5.1%-18.5%, p = 0.02). Number of peer coaching encounters predicted quitting in program participants. CONCLUSIONS This study adds to the literature that community-based smoking cessation services led by peer coaches can be effective in a diverse, high-risk population.
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Affiliation(s)
| | - Grace Damio
- Hispanic Health Council, Hartford, Connecticut
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Cocks N, Brophy L, Segan C, Stratford A, Jones S, Castle D. Psychosocial Factors Affecting Smoking Cessation Among People Living With Schizophrenia: A Lived Experience Lens. Front Psychiatry 2019; 10:565. [PMID: 31474884 PMCID: PMC6704230 DOI: 10.3389/fpsyt.2019.00565] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 07/18/2019] [Indexed: 11/13/2022] Open
Abstract
Introduction: People living with schizophrenia smoke at much higher rates than the general population, and find it more difficult to quit. To date, lived experience has received little attention from researchers. Personal recovery perspectives may generate further insights into established psychosocial barriers and enablers of smoking cessation. Methods and Results: A lived experience account is provided by one of our authors that places the current evidence in context, and highlights the role of marginalization and stigma in reinforcing smoking. Key concepts from the personal recovery paradigm, such as connectedness, hope, and empowerment are discussed. The relevance of these factors and the value of shared lived experience in challenging stigma, marginalization, and low expectations demonstrates the contribution that peer support can offer to support smoking cessation. Conclusions: Recovery-oriented approaches when integrated with existing evidence-based treatments designed to meet the needs of people living with schizophrenia have potential to improve outcomes by helping to take a more holistic approach to break down barriers and facilitate increased uptake of treatment and support. Further research to evaluate the effectiveness of integrated approaches is warranted.
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Affiliation(s)
- Nadine Cocks
- Research and Advocacy, Mind Australia Limited, Heidelberg, VIC, Australia
| | - Lisa Brophy
- Research and Advocacy, Mind Australia Limited, Heidelberg, VIC, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.,School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Bundoora, VIC, Australia
| | - Catherine Segan
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.,Quit Victoria, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Anthony Stratford
- Research and Advocacy, Mind Australia Limited, Heidelberg, VIC, Australia
| | - Simon Jones
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - David Castle
- Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia.,Department of Psychiatry, St Vincent’s Hospital Melbourne, Fitzroy, VIC, Australia
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Abstract
BACKGROUND People with a severe and persistent mental illness are far more likely to smoke than others. While a large portion would like to quit, they are less likely to make quit attempts and succeed. OBJECTIVE This study used an Randomized Controlled Trial (RCT) to test an intervention designed to increase engagement in cessation treatment, quit attempts, and quitting in smokers who did not want to quit in the next 30 days. It also compared these smokers with those who were motivated to quit in the next 30 days. METHODS Participants (N = 222), were smokers with significant mental illness receiving intensive outpatient care from Wisconsin Community Support Programs who were not interested in quitting in the next 30 days. They were randomly assigned to either an intervention group or an attention control group. The intervention, administered during four weekly sessions, included a motivational element, components designed to prepare the smoker for a quit attempt, and pre-quit nicotine patch. Additionally, 48 smokers motivated to quit in the next 30 days served as a comparison group. RESULTS Compared to control participants, smokers receiving the intervention were more likely to be abstinent at the three month follow-up (biochemically verified, intent to treat, 8.5% vs. 1.0%, respectively, p = .01). They were also more likely to accept four more quitting preparation sessions (intent to treat, 50.8% vs 29.2%, respectively, p < .001) but were not more likely to call a telephone tobacco quit line. Conclusion/Importance: Brief motivational interventions increased engagement in cessation treatment and abstinence among smokers with signification mental illness.
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Affiliation(s)
- Bruce A Christiansen
- a Center for Tobacco Research and Intervention , University of Wisconsin School of Medicine and Public Health , Madison , Wisconsin , USA
| | | | - Erin TerBeek
- c Greater Milwaukee Foundation , Milwaukee , Wisconsin , USA
| | - Michael C Fiore
- a Center for Tobacco Research and Intervention , University of Wisconsin School of Medicine and Public Health , Madison , Wisconsin , USA
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15
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DeMello MM, Pinto BM, Mitchell S, Dunsiger SI, Stein K. Peer support for physical activity adoption among breast cancer survivors: Do the helped resemble the helpers? Eur J Cancer Care (Engl) 2018; 27:e12849. [PMID: 29637645 DOI: 10.1111/ecc.12849] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2018] [Indexed: 11/29/2022]
Abstract
Interventions offering peer mentoring programmes promoting moderate-to-vigorous physical activity (MVPA) have shown improvements in MVPA and well-being from baseline; however, research is limited. The purpose of this study was to compare the physical activity (PA) levels and psychosocial well-being of coaches and participants at baseline and following a 12-week intervention. Breast cancer survivors (<5 years) were recruited and randomised into either exercise (Reach-to-Recovery (RTR) + PA) or control (RTR Control). Participants in both groups were individually assigned one of the 18 available coaches who delivered either the MVPA intervention or the control condition via telephone. PA (7-Day PA Recall), psychosocial well-being, fatigue and mood were assessed at baseline and intervention completion. Seventy-six breast cancer survivors (average age = 55.62 (±9.55)) were randomised. At baseline, all participants showed significantly lower MVPA (p = .001) and well-being (p < .05) as compared to coaches. However, post-intervention showed significant improvement in PA and well-being in RTR + PA, so that they were no longer significantly different from the coaches. Post-intervention, MVPA (p < .01), quality of life (p < .05) and fatigue (p < .05) remained significantly lower in RTR Controls compared to coaches. Future interventions should consider the behavioural patterns not only of the participants, but also of those who deliver the interventions.
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Affiliation(s)
- M M DeMello
- College of Nursing, University of South Carolina, Columbia, SC, USA
| | - B M Pinto
- College of Nursing, University of South Carolina, Columbia, SC, USA
| | - S Mitchell
- College of Nursing, University of South Carolina, Columbia, SC, USA
| | - S I Dunsiger
- Centers for Behavioral and Preventive Medicine, Miriam Hospital and W. Alpert Medical School of Brown University, Providence, RI, USA
| | - K Stein
- Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA, USA
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Thomas EC, Salzer MS. Associations between the peer support relationship, service satisfaction and recovery-oriented outcomes: a correlational study. J Ment Health 2017; 27:352-358. [PMID: 29252048 DOI: 10.1080/09638237.2017.1417554] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND The working alliance between non-peer providers and mental health consumers is associated with positive outcomes. It is hypothesized that this factor, in addition to other active support elements, is also positively related to peer support service outcomes. AIMS This study evaluates correlates of the peer-to-peer relationship and its unique association with service satisfaction and recovery-oriented outcomes. METHOD Participants were 46 adults with serious mental illnesses taking part in a peer-brokered self-directed care intervention. Pearson correlation analyses examined associations among peer relationship factors, services-related variables and recovery-oriented outcomes (i.e. empowerment, recovery and quality of life). Hierarchical multiple regression analyses evaluated associations between relationship factors and outcomes over time, controlling for other possible intervention effects. RESULTS The peer relationship was not related to number of contacts. There were robust associations between the peer relationship and service satisfaction and some recovery-oriented outcomes at 24-months, but not at 12-months. These associations were not explained by other possible intervention effects. CONCLUSION This study contributes to a better understanding of the positive, unique association between the peer-to-peer relationship and outcomes, similar to what is found in non-peer-delivered interventions. Implications for program administrators and policymakers seeking to integrate peer specialists into mental health service systems are discussed.
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Affiliation(s)
- Elizabeth C Thomas
- a Department of Rehabilitation Sciences, College of Public Health , Temple University , Philadelphia , PA , USA
| | - Mark S Salzer
- a Department of Rehabilitation Sciences, College of Public Health , Temple University , Philadelphia , PA , USA
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Abstract
Mental health service users (MHSUs) have elevated rates of cardiometabolic disturbance. Improvements occur with physical activity (PA) programs. We report the development and evaluation of three innovative peer-developed and peer-led PA programs: 1) walking; 2) fitness; and 3) yoga. Qualitative evaluation with 33 MHSUs in British Columbia, Canada, occurred. These programs yielded improvements for participants, highlighted by powerful narratives of health improvement, and improved social connections. The feasibility and acceptability of innovative peer-developed and peer-led programs were shown. Analyses revealed concepts related to engagement and change. Relating core categories, we theorize effective engagement of MHSUs requires accessibility on three levels (geographic, cost, and program flexibility) and health behavior change occurs within co-constituent relationships (to self, to peers, and to the wider community). This study highlights the benefits of peer involvement in developing and implementing PA programs and provides a theoretical framework of understanding engagement and behavior change in health programs for MHSUs.
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Pagano A, Tajima B, Guydish J. Barriers and Facilitators to Tobacco Cessation in a Nationwide Sample of Addiction Treatment Programs. J Subst Abuse Treat 2016; 67:22-9. [PMID: 27296658 DOI: 10.1016/j.jsat.2016.04.004] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Revised: 04/12/2016] [Accepted: 04/27/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Smoking rates among addiction treatment clients are 3-4 times higher than those of the general population. Recent studies indicate that ceasing tobacco use during treatment may improve recovery outcomes. Across the United States, publicly funded addiction treatment programs vary widely in terms of their tobacco policies and tobacco cessation services offered to clients. METHODS The study reported here is the qualitative component of a larger study. Twenty-four programs were recruited from a random sample of publicly funded programs participating in the NIDA Clinical Trials Network. Semi-structured interviews were administered by phone to program directors. ATLAS.ti software was used to facilitate thematic analysis of interview transcripts. FINDINGS While all directors expressed interest in helping clients to quit smoking, they cited numerous barriers to implementing tobacco policies and services. These included smoking culture, client resistance, lack of resources, staff smoking, and environmental barriers. Directors also cited several factors that they believed would support tobacco cessation. These included financial support, enhanced leadership, and state mandates against smoking in addiction treatment programs. CONCLUSION Addiction treatment programs are beginning to place more emphasis on tobacco cessation during treatment. However, furthering this goal requires substantial infrastructural and cultural change. These qualitative study findings may help to inform Single State Agencies (SSAs) to support publicly funded addiction treatment programs in their tobacco cessation efforts. In order to maximize effectiveness, state-level policies regarding tobacco cessation during treatment should be informed by ongoing dialogue between service providers and SSAs.
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Affiliation(s)
- Anna Pagano
- Prevention Research Center, Pacific Institute for Research and Evaluation (PIRE), Oakland, CA, 94612.
| | - Barbara Tajima
- Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, 94118
| | - Joseph Guydish
- Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, 94118
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The Experience of Peer Mentors in an Intervention to Promote Smoking Cessation in Persons with Psychiatric Illness. Community Ment Health J 2016; 52:416-23. [PMID: 26602772 PMCID: PMC6207946 DOI: 10.1007/s10597-015-9967-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 11/08/2015] [Indexed: 10/22/2022]
Abstract
Peer support is an important component of services for persons with psychiatric illness but the experience of peer mentors is not well understood. This study explored the experiences of peer mentors, all former smokers and persons with psychiatric illness, who provided smoking cessation counseling as part of a 6 month professionally-led intervention. Data was obtained from 383 contact log entries and in-depth interviews with eight peer mentors. Qualitative analysis indicated that mentor roles were unexpectedly varied beyond the focus on smoking cessation. Of the two aspects of "peer-ness," shared smoking history was more prominent, while the shared experience of psychiatric illness was sometimes overlooked. Peer mentors experienced multiple challenges trying to help participants to change their smoking behaviors. Nonetheless, they described their experience as personally rewarding. Future interventions may be improved by anticipating peer mentor role complexity and the inherent tension between providing person-centered support and promoting behavior change.
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