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BACKGROUND: Limited English Proficiency (LEP) Latinxs experience a longer duration of untreated depression and anxiety. LEP Latinxs have difficulty accessing mental healthcare due to insufficient Spanish-speaking behavioral/mental health clinicians to meet demand. These under-resourced healthcare systems are less likely to be the site for the implementation of innovations. Digital interventions can provide an effective option for overcoming these barriers; yet, when digital evidence-based treatments are available, uptake and engagement is often low. This manuscript presents the protocol for the SUPERA (SUpport from PEeRs to expand Access) study which will evaluate the implementation of an evidence-based, Spanish language, digital cognitive-behavioral therapy (dCBT) intervention (i.e., SilverCloud) in safety-net primary care clinics for LEP Latinx patients with depression or anxiety. METHODS: We will conduct an effectiveness-implementation hybrid trial (Type 2) design comparing engagement and clinical outcomes in two modalities of dCBT delivery (peer-supported vs. unsupported). We will also compare provider-level outreach (using a clinic patient registry) versus inreach (traditional provider referral) to compare rates of initiation, completion, and cost. Participants will be 426 LEP Latinx adults ≥18 years of age, PHQ-9 ≥ 10 or GAD-7 ≥ 8, with access to the internet via smartphone, and not currently receiving individual psychotherapy. We will collect baseline, post-intervention (8 weeks), and follow up (3 months) data. CONCLUSION: The long-term goal of this research is to aid in the implementation of digital mental health interventions that can be sustainably implemented in low-resourced settings, while reducing the reliance on professionals, overcoming workforce deficits, and increasing relevance for diverse populations.

Worldwide, parental divorce and separation rates are high. These include impactful experiences to all involved, posing risks on well-being and functioning of parents and their children, and leading to increased professional care seeking. The Dutch 'Divorce ATLAS' training aims at informing and empowering parents after divorce or separation. The intervention offers preventive support and psychoeducation in a 2-sessions group program. We aimed to assess the effectiveness of Divorce ATLAS for parents in the Dutch setting. We performed a quasi-experimental study in which we compared parents participating in Divorce ATLAS groups (n = 187) and parents on a waiting list for online support (n = 111). Outcomes included well-being of parents and their children, parental sense of competence and social support, and children's prosocial behavior. We performed regression analyses to assess differences in outcomes between intervention and control group. Additionally, we measured and reported parental knowledge and trigger to act after the intervention. As compared with routine family support of parents in the control group, the Divorce ATLAS group intervention led to increases in parents' sense of parenting incompetence (Hedges' g = 0.19), and in perceived social support (Hedges' g = 0.23). Moreover, most parents indicated that Divorce ATLAS had increased their knowledge and had triggered them to act accordingly. Hence, the increased sense of parenting incompetence in the intervention group may be due to increased participants' awareness of their parenting behaviors. In sum, Divorce ATLAS is promising for educating and supporting parents after divorce. Highlights: The high prevalence of parental divorce and its high impact on parent and child well-being and functioning call for preventive support of these families in adapting to their union dissolution. (Court-connected) educational programs for divorcing parents are available in the majority of U.S. counties. Availability and evidence regarding its effects are limited outside the U.S. This study in the Netherlands shows that the divorce education program Divorce ATLAS informs and effectively increases support as perceived by divorced or separated parents. These promising findings support wider implementation of Divorce ATLAS to educate and support parents after union dissolution. [ABSTRACT FROM AUTHOR]

As part of the evolution of the strengths-based approach in the criminological field in recent decades, various countries in the world operate peer-based programs in prisons and in the community. These programs utilize the personal knowledge and live experience of convicts and addicted people, that is, wounded healers, to promote recovery and rehabilitation processes. Studies point to the many advantages inherent in such peer work, especially for the aid providers. However, little is known about the perceived effects of professional peer work for people with a history of addiction and incarceration, as the current study suggests, the first of its kind in Israel. The respondents were 23 trained men and women with a history of traumas, addiction, and incarceration, all are formally employed in peer worker positions in various therapeutic settings, in prison and/or in the community. The findings indicate that peer work enhances the participants' social capital, and promotes their positive change and recovery process, albeit with some difficulties and challenges. The paper discusses these findings from the emerging Convict Therapy perspective and related approaches of positive criminology and desistance from crime. Specifically, our findings expand the literature on wounded healers in the criminological field and reinforce the culture of 'giving back' embodied in the role of peer supporters. [ABSTRACT FROM AUTHOR]

Repeatedly, peer support (PS) research in mental health settings has indicated the influential impact of PS on recovery outcomes, including community reintegration and overall quality of life. Despite these findings, and the bolstering of PS in UK healthcare policy, PS remains underdeveloped in UK mental health settings. This is particularly pronounced in forensic mental health settings where the development of PS has remained heavily restricted by application difficulties in secure care models. The current study aims to provide one of the first in-depth explorations of PS experiences for both service users (SUs) and peer support workers (PSWs) in UK forensic mental health services. Semi-structured interviews were conducted with 13 participants (ten SUs, three PSWs) and analyzed using thematic analysis. Four primary themes were identified detailing the experiences and challenges of forensic-based PS: Experiences of PS from SU perspective; Experiences of PS from PSW perspective; Contrasting care: Addressing the "Us and them" divide, and Further service development. Recommendations identified for progressing PS center on integration improvements, increasing the variety of peer-led interventions, and incorporating PS's "flexible" nature into traditional models of care. Further action is needed to develop and embed PS in forensic care, including guidance for the development of strategies and policy, and direction for future research. [ABSTRACT FROM AUTHOR]

AbstractBackgroundObjectiveMethods and measuresResultsConclusionsAround twenty percent of meningitis survivors experience after-effects. However, very little research on their psychological impact has been conducted. This report details a small explorative investigation into these psychological impacts.To explore the impact sequelae have on the meningitis survivors affected.Thematic analysis of one-hundred individual user’s blog posts, self-reporting one or more sequelae after a diagnosis of meningitis.Blog posters’ experiences varied greatly. Common trends in experience were mapped onto three themes. ‘Struggling to Adjust to the New Normal’ captures blog posters’ struggles in returning to their lives post-hospitalization. ‘Navigating Possibilities for Positivity’ explores how blog posters either reported positive change due to their illness experience or felt a pressure, or inability, to do so. ‘The Impact of Knowledge and Support’ overarching two sub-themes; ‘Lack of Awareness Causing Further Suffering’ and ‘Validation Leads to Narrative Shift’. These sub-themes contrast differences in experience blog posters reported, with and without knowledge, of the cause of their symptoms and support in dealing with the resulting difficulties.Consistent and structured after-care would benefit patients experiencing sequelae. Suggestions of a possible format this could take are put forward. In addition, self-regulatory models of illness perception help explain some variations in blog posters experiences, with possible intervention plans based on these models also suggested. However, limitations, including the comparatively small and highly selected sample, mean that further research is necessary to validate the findings and assess their validity, widespread applicability, and financial feasibility. [ABSTRACT FROM AUTHOR]

There has been much interest in how to develop a sense of belonging to an academic institution over the last twenty years, given the evidence that this improves student retention, satisfaction and attainment. Fostering a sense of belonging involves both psychological and sociological aspects; students need to feel like they belong and are valued by their institution, and this is developed through interactions with staff and peers. Research carried out since 2020 into belonging online has focused primarily on course-based teaching initiatives. This article will describe our 18-month pilot on a fully online qualification developing a greater sense of belonging for our students based on qualification-wide online events and their impact on student engagement and sense of belonging. Qualification-wide events are events that are open to all students on a qualification or programme, such as a law degree, as compared to events which are only available to students on a specific course. It will highlight some of the barriers students perceive to building online community, including a lack of confidence, and discuss the students' views that the responsibility for developing community lies with the university. [ABSTRACT FROM AUTHOR]

Succeeding at university can be a complex matter, and the barriers are manifold for students with disabilities (SwDs). Accommodations are available for those with needs, but these alone do not meet the political goals of inclusive educations. Student ambassadors act as experienced representatives on campuses, supporting others and gaining individual benefits themselves. Approaches building on SwDs' experiences and capacities can be a means to overcome the complex barriers often faced throughout education. This scoping review aimed to map research on student ambassador interventions for SwDs in higher education and identify the interventions' key concepts. The result will inform an ambassador intervention in higher education. Six electronic databases were searched for peer-reviewed articles of any design published between 2010 and December 2020. Six studies met the inclusion criteria. A thematic synthesis resulted in three key concepts: peer guidance and supportive relationships; building strategies and transferable skills; and advocating for change. However, no program utilises exclusively students with disabilities in ambassador roles. The results indicate a lack of research as well as awareness on the unexplored potential of actively involving SwDs in ambassador roles. [ABSTRACT FROM AUTHOR]

Correctional work includes dealing with numerous stressors that compromise mental health. Yet, correctional scholars have dedicated limited attention to assessing the mental health support available to correctional officers at work. Therefore, we explore how officers view mental health programs, especially the Employee Assistant Program (EAP) and the Critical Incident Stress Management Program (CISM). Our findings derive from 44 semi-structured interviews with officers from 15 federal correctional institutions in Canada. Most participants found the mental health programs available at their institutions "helpful." However, they still regretted some of the program's characteristics, providing insights into alterations that can increase the effectiveness of the mental health support provided to prison staff. Such alterations comprise changing the mental health approach within correctional services from reactive to proactive and expanding the availability of professionals specialized in correctional mental health within the existing programs. [ABSTRACT FROM AUTHOR]

To address Young Carers' (YCs) needs for space and opportunities to reflect and exchange, a guided peer-support programme, the "Get-togethers", was developed in collaboration with YC in Switzerland in 2018. In order to evaluate if the Get-togethers were able to meet their originally set goals of (1) strengthening support among YCs, (2) promoting their life skills, (3) strengthening their social network and (4) promoting the inclusion and participation of YCs, participants of the Get-togethers were asked to complete a short questionnaire about their participation in and experiences with the Get-togethers. We also analysed the standard documentation of 17 Get-togethers held between May 2021 and September 2023. Overall, the Get-togethers were rated positively in almost all areas of the survey and the documentation, indicating that the four originally set objectives of the Get-togethers were (at least largely) achieved. The Get-togethers covered a large part of the needs of YCs, such as emotional support and opportunities to relax and exchange with people in a similar situation, yet they largely failed to reach minor YCs and male YCs. Further support programmes should be developed to address the different needs of different groups of YCs. [ABSTRACT FROM AUTHOR]

Copyright of Psycho-Oncologie is the property of PiscoMed Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The underserved population—i.e., individuals who identify themselves as non-female, non-heterosexual, or non-White—have long faced inequities when accessing traditional clinic-based mental health services. Individuals from the underserved population tend to use and benefit from these services less than their better-served counterparts (i.e., those who identify themselves as female, heterosexual, and White). This study investigates whether similar inequities exist within the context of mobile apps specifically designed to provide self-support and peer-support. To this end, we conduct an empirical analysis using longitudinal user-level data collected from a mental health mobile app (MHMA). Our results indicate that: (i) in contrast to the traditional clinic-based mental health services, in a MHMA setting, users from the underserved population engage with the app services and derive similar benefits as much as their better-served counterparts; and (ii) there is a positive relationship between app usage frequency and the mental condition of app users. Our post-hoc analysis uncovers that the MHMA promotes equitable usage and benefit for users: (i) from the underserved population via self-management functions that enable self-support; and (ii) from the better-served population via online community functions that facilitate peer-support. These findings suggest that MHMAs have the potential to achieve equity through both user engagement and the benefits derived from such engagement. We conclude by discussing the implications for mobile app firms, policymakers, and organizations in their efforts to achieve mental health equity for the underserved population. [ABSTRACT FROM AUTHOR]

Purpose: Peer-support groups for stroke survivors are often organized and facilitated by health authorities and disability related organizations within rehabilitation programs. However, the benefits of peer-led, peer-support groups have not yet been evaluated. The purpose of this study was to explore participants' experiences in a community-based, peer-led, peer-support group for stroke survivors. Materials and Methods: Semi-structured interviews were conducted and analyzed following constructivist grounded theory with 11 participants who attended a peer-led, peer-support group for people with stroke. The data were also complemented with one quantitative rating question regarding their experience attending the group. Results: Three themes were identified. Meeting unmet needs after stroke captured how the group was created by stroke survivors to address life in the community post-stroke. Buddies helping buddies highlighted that stroke recovery is a shared process at the group, where members help and encourage each other to contribute what they can. Creating authentic friendships revealed how people experienced social connection and developed relationships in the peer-led, peer-support group. Conclusions: Peer-led, peer-support groups may provide opportunities for stroke survivors to connect with like-minded people in their community to have fun while exploring their abilities. [ABSTRACT FROM AUTHOR]

Peer support groups have become widely utilized among those in recovery from problematic substance use. Yet, these peer-based programs vary and research examining their effectiveness has yielded mixed results. Relatively less is known about the impacts of arts-based peer recovery programs. Some research suggests that theatre may offer a powerful tool to address biopsychosocial changes among individuals in recovery. To explore the role of arts-based peer support programs, we draw on qualitative interviews with performers in two arts-based recovery programs. Our findings suggest that arts-based peer recovery programs may aid individuals in recovery in four main ways. Performing allowed participants to build relationships with others in recovery, channel experiences creatively while challenging stigma, foster confidence and recovery-identity formation, aiding participants in working through emotional impacts of prior substance use. These findings support emerging scholarship examining the role of performance in challenging stereotypes about substance use to aid those in recovery. [ABSTRACT FROM AUTHOR]

Abstract Background Psychosocial support is a crucial component of adequate rare disease care, but to date psychosocial support needs of this patient population are insufficiently met. Within Q.RARE.LI, we strive to evaluate the effectiveness of a structured, transdiagnostic, and location-independent psychosocial support intervention in routine care of patients with rare autoimmune liver diseases in five countries and prepare its implementation. Methods Within an effectiveness-implementation hybrid trial, we aim to a) investigate the effectiveness of the intervention in routine care in five diverse healthcare systems and b) assess implementation outcomes, examine and prepare the implementation context, and develop country-specific implementation strategies. To assess effectiveness, we will include N = 240 patients with rare autoimmune liver diseases. Within a two-armed randomized controlled trial (allocation ratio 1:1), we will compare structured and peer-delivered psychosocial support in addition to care-as-usual (CAU) with CAU alone. Outcomes will be assessed via electronic database entry prior to intervention, directly after, and at a three-month follow-up. Our primary effectiveness outcome will be mental health-related quality of life at post-assessment. Secondary outcomes include depression and anxiety severity, perceived social support, helplessness, and disease acceptance. Implementation outcomes will be assessed within a mixed-methods process evaluation. In a quantitative cross-sectional survey, we will examine perceived acceptability and feasibility in patients, peer-counselors, and healthcare providers involved in delivery of the intervention. In qualitative focus groups, we will analyze the implementation context and determine barriers and facilitators for implementation with different stakeholders (patients and/or representatives, peer-counselors, healthcare providers, health insurers). Based on these results, we will derive country-specific implementation strategies and develop a concrete implementation plan for each country. Discussion The intervention is expected to help patients adjust to their disease and improve their mental quality of life. The transdiagnostic and location-independent program has the potential to reach patients for psychosocial support who are usually hard to reach. By preparing the implementation in five countries, the project can help to make low-threshold psychosocial support available to many patients with rare diseases and improve comprehensive healthcare for an often neglected group. Trial registration ISRCTN15030282

ALDinHE is launching its new mentoring scheme and mentorship recognition to acknowledge, promote and recognise the importance of mentoring for LD as a field that does not offer an official route into the profession. This Professional Development session introduced the mentoring scheme, explaining how to get involved, what support mentors and mentees can receive from ALDinHE and what benefits both sides can get from mentoring or being mentored. If you’re new to LD or keen to develop more experience in a specific area with the help of a mentor, the mentoring scheme will offer you a brilliant framework to broaden your expertise. If you’re an experienced Learning Developer or have specific expertise you could share, find out how you could become recognised as a Certified Mentor (CeM) in LD by ALDinHE.

Background: Mental health acute crisis episodes are associated with high inpatient costs. Self-management interventions may reduce readmission by enabling individuals to manage their condition. Delivery of such interventions by Peer Support Workers (PSWs) may be cost-effective. CORE, a randomized control trial of a PSW self-management intervention compared to usual care, found a significant reduction in admissions to acute mental healthcare for participants receiving the intervention. This paper aims to evaluate the cost-effectiveness of the intervention over 12 months from a mental health service perspective. Analysis methods of increasing complexity were used to account for data missingness and distribution. Methods: Participants were recruited from six crisis resolution teams in England from 12 March 2014 to 3 July 2015 (trial registration ISRCTN: 01027104). Resource use was collected from patient records at baseline and 12 months. The EQ-5D-3L was collected at baseline and 4 and 18 months, and linear interpolation was used to calculate 12-month values for quality-adjusted life-years (QALYs). The primary analysis of adjusted mean incremental costs and QALYs for complete cases are calculated separately using OLS regression. Secondly, a complete-case non-parametric two-stage bootstrap (TSB) was performed. The impacts of missing data and skewed cost data were explored using multiple imputation using chained equations and general linear models, respectively. Results: Four hundred and forty-one participants were recruited to CORE; 221 randomized to the PSW intervention and 220 to usual care plus workbook. The probability that the PSW intervention was cost-effective compared with the workbook plus usual care control at 12 months varied with the method used, and ranged from 57% to 96% at a cost-effectiveness threshold of £20,000 per QALY gained. Discussion: There was a minimum 57% chance that the intervention was cost-effective compared to the control using 12-month costs and QALYs. The probability varied by 40% when methods were employed to account for the relationship between costs and QALYs, but which restricted the sample to those who provided both complete cost and utility data. Caution should therefore be applied when selecting methods for the evaluation of healthcare interventions that aim to increase precision but may introduce bias if missing data are heavily unbalanced between costs and outcomes. [ABSTRACT FROM AUTHOR]

This article presents a community-led kaupapa Māori research project involving Whakatōhea and neighbouring rohe (areas). This project arose from a moemoeā (dream or vision) of Tawhai, a stroke survivor who wanted to help fellow stroke survivors. We began with a survey of stroke survivors, community members and service providers in Ōpōtiki and surrounding areas, investigating community knowledge of stroke, barriers and facilitators to recovery, and the availability and appropriateness of health services for stroke survivors in the area. The ultimate aim was to facilitate Māori stroke survivors and whānau (family) to support recent stroke survivors, and find funding to allow sustainable employment of stroke survivors in this capacity. Survey results depicted an isolated community with very poor knowledge of stroke and little access to stroke services. However, they also revealed a community that is determined to look after their own, improve outcomes, and has the support of local health and social service providers. Community-based discussions on the survey results resulted in a vision for He Whare Oranga Tonutanga – a place where Māori stroke survivors and whānau could come to contribute what they can and take what they need. Māori stroke survivors could be employed to provide mentoring and run the centre. [ABSTRACT FROM AUTHOR]

Emergency Department Peer Navigator Programs (EDPN) have been shown to increase the prescribing of medications for opioid use disorder (MOUD) and improve linkage to addiction care. However, what is not known is whether it can improve overall clinical outcomes and healthcare utilization in patients with OUD. This is a single-center, IRB approved, retrospective cohort study using patients with OUD enrolled in our peer navigator program from 11/7/19 to 2/16/21. On an annual basis, we determined MOUD clinic follow-up rates and clinical outcomes in those patients who utilized our EDPN program. Finally, we also looked at the social determinants of health factors (e.g., race, status of medical insurance, lack of housing, access to phone and/or internet, employment, etc.) that impact our patients clinical outcomes. ED and inpatient provider notes were reviewed to determine causes of ED visits and hospitalizations one year before and after enrollment into the program. The clinical outcomes of interest were number of ED visits from all-causes, number of ED visits from opioid-related causes, number of hospitalizations from all-causes, and number of hospitalizations from opioid-related causes one year after enrollment into our EDPN program, subsequent urine drug screens, and mortality. Demographic and socioeconomic factors (age, gender, race, employment, housing, insurance status, access to phone) were also analyzed to determine if any were independently associated with clinical outcomes. Death and cardiac arrests were noted. Clinical outcomes data were described using descriptive statistics and compared using t -tests. 149 patients with OUD were included in our study. 39.6% had an opioid-related chief complaint at their index ED visit; 51.0% had any recorded history of MOUD and 46.3% had history of buprenorphine use. 31.5% had buprenorphine given in the ED with individual doses ranging from 2 to 16 mg and 46.3% were provided with a buprenorphine prescription. The average number of ED visits 1-year pre vs post enrollment, respectively, for all-causes was 3.09 vs 2.20 (p < 0.01); for opioid related complications 1.80 vs 0.72 (p < 0. 01). The average number of hospitalizations 1-year pre and post enrollment, respectively, for all-causes was 0.83 vs 0.60 (p = 0.05); for opioid related complications 0.39 vs 0.09 (p < 0.01). ED visits from all-causes decreased in 90 (60.40%) patients, had no change in 28 (18.79%) patients, and increased in 31 (20.81%) patients (p < 0.01). ED visits from opioid-related complications decreased in 92 (61.74%) patients, had no change in 40 (26.85%) patients, and increased in 17 (11.41%) (p < 0.01). Hospitalizations from all causes decreased in 45 (30.20%) patients, had no change in 75 patients (50.34%), and increased in 29 (19.46%) patients (p < 0.01). Lastly, hospitalizations from opioid-related complications decreased in 31 (20.81%) patients, had no change in 113 (75.84%) patients, and increased in 5 (3.36%) patients (p < 0.01). There were no socioeconomic factors that had a statistically significant association with clinical outcomes. Two patients (1.2%) died within 1 year after study enrollment. Our study found that there was an association between implementation of an EDPN program and decreases in ED visits and hospitalizations from both all-causes as well as from opioid-related complications for patients with opioid use disorder. [ABSTRACT FROM AUTHOR]

Abstract Introduction Interventions that support patients to handle the emotional and medical aspects of a long‐term health condition is important. One way is to use peer‐support groups, to help patients solving problems, increasing their knowledge and making decisions. Aim was to investigate the impact on shared decision‐making, empowerment and coping after participation in group‐learning sessions for patients with long‐term conditions (N = 42). Design An intervention following a health education programme based on group‐learning sessions was established. Eight different programmes were held in five different departments at a regional county hospital in Sweden. Methods Questionnaires were analysed using paired‐sample t‐test. Results Results showed that patients might have better opportunities to be more active during their patient encounter after attending the group learning sessions. Interventions directed to patient activation may be one key in future healthcare management, especially concerning long‐term conditions. Empowering patients is central in healthcare, and using different approaches is important.

BackgroundMental health acute crisis episodes are associated with high inpatient costs. Self-management interventions may reduce readmission by enabling individuals to manage their condition. Delivery of such interventions by Peer Support Workers (PSWs) may be cost-effective. CORE, a randomized control trial of a PSW self-management intervention compared to usual care, found a significant reduction in admissions to acute mental healthcare for participants receiving the intervention. This paper aims to evaluate the cost-effectiveness of the intervention over 12 months from a mental health service perspective. Analysis methods of increasing complexity were used to account for data missingness and distribution.MethodsParticipants were recruited from six crisis resolution teams in England from 12 March 2014 to 3 July 2015 (trial registration ISRCTN: 01027104). Resource use was collected from patient records at baseline and 12 months. The EQ-5D-3L was collected at baseline and 4 and 18 months, and linear interpolation was used to calculate 12-month values for quality-adjusted life-years (QALYs). The primary analysis of adjusted mean incremental costs and QALYs for complete cases are calculated separately using OLS regression. Secondly, a complete-case non-parametric two-stage bootstrap (TSB) was performed. The impacts of missing data and skewed cost data were explored using multiple imputation using chained equations and general linear models, respectively.ResultsFour hundred and forty-one participants were recruited to CORE; 221 randomized to the PSW intervention and 220 to usual care plus workbook. The probability that the PSW intervention was cost-effective compared with the workbook plus usual care control at 12 months varied with the method used, and ranged from 57% to 96% at a cost-effectiveness threshold of £20,000 per QALY gained.DiscussionThere was a minimum 57% chance that the intervention was cost-effective compared to the control using 12-month costs and QALYs. The probability varied by 40% when methods were employed to account for the relationship between costs and QALYs, but which restricted the sample to those who provided both complete cost and utility data. Caution should therefore be applied when selecting methods for the evaluation of healthcare interventions that aim to increase precision but may introduce bias if missing data are heavily unbalanced between costs and outcomes.

Background: Psychosocial support is a crucial component of adequate rare disease care, but to date psychosocial support needs of this patient population are insufficiently met. Within Q.RARE.LI, we strive to evaluate the effectiveness of a structured, transdiagnostic, and location-independent psychosocial support intervention in routine care of patients with rare autoimmune liver diseases in five countries and prepare its implementation. Methods: Within an effectiveness-implementation hybrid trial, we aim to a) investigate the effectiveness of the intervention in routine care in five diverse healthcare systems and b) assess implementation outcomes, examine and prepare the implementation context, and develop country-specific implementation strategies. To assess effectiveness, we will include N = 240 patients with rare autoimmune liver diseases. Within a two-armed randomized controlled trial (allocation ratio 1:1), we will compare structured and peer-delivered psychosocial support in addition to care-as-usual (CAU) with CAU alone. Outcomes will be assessed via electronic database entry prior to intervention, directly after, and at a three-month follow-up. Our primary effectiveness outcome will be mental health-related quality of life at post-assessment. Secondary outcomes include depression and anxiety severity, perceived social support, helplessness, and disease acceptance. Implementation outcomes will be assessed within a mixed-methods process evaluation. In a quantitative cross-sectional survey, we will examine perceived acceptability and feasibility in patients, peer-counselors, and healthcare providers involved in delivery of the intervention. In qualitative focus groups, we will analyze the implementation context and determine barriers and facilitators for implementation with different stakeholders (patients and/or representatives, peer-counselors, healthcare providers, health insurers). Based on these results, we will derive country-specific implementation strategies and develop a concrete implementation plan for each country. Discussion: The intervention is expected to help patients adjust to their disease and improve their mental quality of life. The transdiagnostic and location-independent program has the potential to reach patients for psychosocial support who are usually hard to reach. By preparing the implementation in five countries, the project can help to make low-threshold psychosocial support available to many patients with rare diseases and improve comprehensive healthcare for an often neglected group. Trial registration: ISRCTN15030282 [ABSTRACT FROM AUTHOR]

Abstract Background Depressive and anxiety disorders share major risk factors and can often be effectively prevented or treated with similar interventions. However, less than half of young people with mental health problems seek professional help and hence innovative approaches to support this group are needed. To this end Coping with Anxiety and Depression shows promise. The aim of this paper was to evaluate the implementation of Coping with Anxiety and Depression for young people aged 15–25 years showing symptoms of anxiety and/or depression in a Danish community setting. Methods The programme was implemented in 39 Danish municipalities. To evaluate the implementation of the programme, we collected quantitative and qualitative data simultaneously and subsequently we triangulated it in the data analysis. The qualitative data collection comprised semi-structured interviews in seven case municipalities. In each municipality we conducted interviews with a local municipality coordinator of the program, a group interview with two voluntary instructors facilitating the program and a group interview with two to seven participants in the programme. In total, seven local coordinators, 14 voluntary instructors and 23 participants (8 men and 15 women) were interviewed. We also carried out a baseline and post-intervention survey. Interview data was coded via an inductive and deductive analysis approach. Survey data was analysed via descriptive statistics in the statistical software programme STATA 16. Results The evaluation showed that the implementation of the programme is feasible, and that most participants (83%) were satisfied with the programme to a high/very high extent. In total, 84% of the participants strongly agreed/agreed that it was advantageous that instructors themselves had experience with anxiety and depression. Qualitative data showed that the participants were very positive about the group format. It also showed that recruitment and retention of participants and especially young instructors were challenging but doable. Thus our findings suggest that the programme can be implemented in a way that is perceived as useful and satisfying to young people. Conclusions Coping with Anxiety and Depression constitutes a feasible peer-to-peer, group-based community programme that is well-received by its target group. Recruitment and retention of participants and instructors is challenging but doable.

Copyright of E-Beratungsjournal is the property of E-beratungsjournal.net and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To identify how peer support interventions, for self-management of chronic pain, support basic psychological needs from a self-determination theory (SDT) perspective, using a systematic review.Methods: Ten databases were searched for studies reporting qualitative research about peer interactions in pain management interventions. 'Best fit' framework synthesis methodology was applied to identify strategies that support the satisfaction of competence, autonomy and motivation. These were matched to definitions of strategies provided by standardised taxonomies.Results: 18 studies were selected for inclusion. The synthesis resulted in a conceptual model, identifying 12 peer strategies that support psychological needs for self-management of chronic pain; 10 overlapped with existing taxonomies.Conclusion: This was the first known attempt to synthesise evidence about peer support strategies for people living with pain, using SDT as an a priori framework. The model demonstrates commonality between the motivation-promoting processes of peer support and those of other behaviour change interventions and identifies additional unique strategies provided by peers. This systematic classification of peer support strategies provides a means for future study of the efficacy and comprehensiveness of peer interventions.Practice Implications: The model could assist healthcare professionals and support groups to optimise the potential of peer processes. [ABSTRACT FROM AUTHOR]

Background: Informal care for people with dementia not only affects the well-being of the primary caregiver but also changes their roles and interactions with the social environment. New online interventions might facilitate access to social support. Recently, an online social support platform, Inlife, was developed in the Netherlands and aims to enhance social support and positive interactions in informal support networks. Objective: This study aimed to evaluate the effectiveness of Inlife for caregivers of people with dementia. Methods: A randomized controlled trial with 96 caregivers of people with dementia was performed. Participants were randomly assigned to the Inlife intervention or the waiting list control group. After 16 weeks of Inlife use, the waiting list control group could start using Inlife. Effects were evaluated at baseline (T0), 8 weeks (T1), and 16 weeks (T2). The 16-week follow-up assessment (T2) served as the primary endpoint to evaluate the results for the primary and secondary outcome variables evaluated with online self-report questionnaires. The primary outcomes included feelings of caregiver competence and perceived social support. The secondary outcomes included received support, feelings of loneliness, psychological complaints (eg, anxiety, stress), and quality of life. Results: No significant improvements were demonstrated for the intervention group (n=48) relative to the control group (n=48) for the primary outcomes (feeling of carer competence: b=-0.057, 95% CI -0.715 to 0.602, P=.87; perceived social support: b=-15.877, 95% CI -78.284 to 46.530, P=.62) or any secondary outcome. This contrasts with our qualitative findings showing the potential of Inlife to facilitate the care process in daily life. Adherence was not optimal for all Inlife users. Additional per-protocol and sensitivity analyses also revealed no beneficial results for high active Inlife users or specific subgroups. Inlife users were more active when part of a larger network. Conclusions: Researchers should be modest regarding the effectiveness of online caregiver interventions in terms of quantitative measures of well-being and quality of life. Nevertheless, online tools have the potential to facilitate the caregiver process in daily life. Lessons learned include the importance of harnessing the power of human interaction in eHealth, making use of the user's social capital, and the need to develop research methods that can identify benefits in daily life that are ecologically valid for caregivers. [ABSTRACT FROM AUTHOR]

Youth-led peer-support initiatives appear well placed to dismantle conventional binaries of youth-adult, as they hold promise as models able to perceive youth outside the role of service recipients. Drawing on ethnographic research at an Australian youth program that included interviews with young people, young and adult volunteers, and staff, this paper investigates the role young people play in determining, creating, and applying change processes for their peers. Through the mechanisms of "cultivating relatability," "establishing a culture of support," and "role-modeling alternative pathways," new possibilities and hope were created. At the core of peer-support efforts was an attempt to increase social integration and a commitment to notions of equality and respect as well as the eradication of unequal power relations between adults and young people. The dual phenomenon of being both the recipient of peer support and facilitators of change processes for others has novel implications for youth programs that work with young people to enhance processes of empowerment and agency and promote positive youth outcomes. Such an approach to working with young people as engaged partners, which gives them a voice and, in particular, asserts the rights of young people to be involved in transforming and recreating their situations, creates opportunities that may both extend the reach and deepen the impact of youth services. [ABSTRACT FROM AUTHOR]

Introduction: Interventions that support patients to handle the emotional and medical aspects of a long‐term health condition is important. One way is to use peer‐support groups, to help patients solving problems, increasing their knowledge and making decisions. Aim: was to investigate the impact on shared decision‐making, empowerment and coping after participation in group‐learning sessions for patients with long‐term conditions (N = 42). Design: An intervention following a health education programme based on group‐learning sessions was established. Eight different programmes were held in five different departments at a regional county hospital in Sweden. Methods: Questionnaires were analysed using paired‐sample t‐test. Results: Results showed that patients might have better opportunities to be more active during their patient encounter after attending the group learning sessions. Interventions directed to patient activation may be one key in future healthcare management, especially concerning long‐term conditions. Empowering patients is central in healthcare, and using different approaches is important. [ABSTRACT FROM AUTHOR]

Abstract Background The aim of this study was to illuminate participants’ experiences with transfer in (1) Illness Management and Recovery (IMR); and (2) two programs based on peer support: Turning Points, and Learn to Tackle Anxiety and Depression (LTAD); and whether peer support within these programs influenced the process of transfer beyond the interventional context. Furthermore, we investigated participants’ experiences with a community-based intervention [Individual Placement and Support (IPS)] to explore perspectives on mechanisms that may eliminate challenges in the transfer process. Methods The study was based on semi-structured interviews with participants with mental illness, from four different psychosocial interventions with and without peer support and across interventional settings. The material partly consists of secondary analyses of existing data sets of anonymised, transcribed interviews investigating participants' experience from two psychosocial interventions: Illness Management and Recovery (n = 15), and Individual Placement and Support (n = 12). Additionally, we conducted semi-structured interviews with persons who had participated in one of two peer-led programs: Turning Points and Learn How to Tackle Anxiety and Depression (n = 12). The analysis was guided by a hermeneutic-phenomenological approach to illuminate transfer processes and was based on the template method described by Nigel King. Results Applying a transfer perspective on rehabilitation interventions identified everyday life situations where capacities learned during the interventions were utilized and conditions were highlighted that promoted or hindered transfer. Experiential knowledge and peer-exchange made transferal pathways between the interventional context and everyday life. Illness intrusiveness and uncertainty, together with environmental obstacles, generated transferal gaps. Individualized support could partly address these gaps. Conclusion Findings from this qualitative study illuminate how peer-support in group-based rehabilitation interventions increased social functioning and developed better self-care strategies that can be transferred to daily life. Interventions situated in mental health settings, e.g. outpatient clinics, had limited impact on participation in broader community life. Advancing rehabilitation services in mental health may benefit from tailoring services to address illness fluctuation and combining group sessions with individualized support together with acknowledging and overcoming environmental obstacles.

Abstract Background Currently 21% of the German population is older than 65 years. Above this age, the risk of suffering from chronic disease and mental disorders increases rapidly. Therefore, physical inactivity is one of the most important public health concerns among older people. To address this issue, we have conceptualised and evaluated a simple and low-threshold intervention, which requires only minimal demand on the participants, targeting older people with inadequate activity levels. The aim of the POWER Study is to investigate whether volunteer-supported outdoor-walking improves physical function and quality of life in older people. Methods/design In a randomised, controlled interventional superiority-trial, individuals older than 65 years of age living in the community or nursing homes will be randomised into two groups. The study will be conducted in two study centres with assessments at baseline, 6 and 12 months. The intervention group will participate in a supported physical activity intervention for 6 months. An assigned volunteer will visit them three times a week for an outdoor walk between 30 and 50 min, or equivalent indoor activity. Persons in the control group will be invited to two lectures covering topics related to health. Primary endpoint is the physical function measured by the Short Physical Performance Battery (SPPB) at baseline, after 6 and 12 months. Secondary and safety endpoints will be quality of life (EQ. 5D), fear of falling (Falls Efficacy Scale), physical activity (activity diary), cognitive executive function (clock drawing test), falls requiring medical attention, hospitalisation and death. Primary analysis will be carried out by intention to treat. Discussion We expect the intervention to improve the overall health status of the participants in a wide range of health-related outcomes. If effectiveness can be shown, the intervention will close an important gap in current services for older people. We will disseminate our experiences and results in the form of informational documents (training manual) to allow municipalities and health care organisations to implement a similar intervention. Trial registration The trial was registered on 31 Aug 2018; German Clinical Trials Register (www.germanctr.de), Deutsches Register Klinischer Studien: DRKS00015188 .

Background: Depressive and anxiety disorders share major risk factors and can often be effectively prevented or treated with similar interventions. However, less than half of young people with mental health problems seek professional help and hence innovative approaches to support this group are needed. To this end Coping with Anxiety and Depression shows promise. The aim of this paper was to evaluate the implementation of Coping with Anxiety and Depression for young people aged 15–25 years showing symptoms of anxiety and/or depression in a Danish community setting. Methods: The programme was implemented in 39 Danish municipalities. To evaluate the implementation of the programme, we collected quantitative and qualitative data simultaneously and subsequently we triangulated it in the data analysis. The qualitative data collection comprised semi-structured interviews in seven case municipalities. In each municipality we conducted interviews with a local municipality coordinator of the program, a group interview with two voluntary instructors facilitating the program and a group interview with two to seven participants in the programme. In total, seven local coordinators, 14 voluntary instructors and 23 participants (8 men and 15 women) were interviewed. We also carried out a baseline and post-intervention survey. Interview data was coded via an inductive and deductive analysis approach. Survey data was analysed via descriptive statistics in the statistical software programme STATA 16. Results: The evaluation showed that the implementation of the programme is feasible, and that most participants (83%) were satisfied with the programme to a high/very high extent. In total, 84% of the participants strongly agreed/agreed that it was advantageous that instructors themselves had experience with anxiety and depression. Qualitative data showed that the participants were very positive about the group format. It also showed that recruitment and retention of participants and especially young instructors were challenging but doable. Thus our findings suggest that the programme can be implemented in a way that is perceived as useful and satisfying to young people. Conclusions: Coping with Anxiety and Depression constitutes a feasible peer-to-peer, group-based community programme that is well-received by its target group. Recruitment and retention of participants and instructors is challenging but doable. [ABSTRACT FROM AUTHOR]

Abstract Background Peer-led support models have gained increasing popularity in suicide prevention. While previous reviews show positive effects of peer-led support for people with mental health problems and those bereaved by suicide, little is known about the types of lived experience peer support programs in suicide prevention and whether these are effective in improving the health and wellbeing of people at risk of suicide. The aim of this paper is to provide an overview of peer support programs that aim to reduce suicidality and are led by people with lived experience of suicide. Method We conducted a systematic scoping review, involving a search of three academic (Medline, PsycINFO, Embase) and selected grey literature databases (Google Scholar, WHO Clinical Trials Registry) for publications between 2000 and 2019. We also contacted suicide prevention experts and relevant internet sites to identify peer support programs that exist but have not been evaluated. The screening of records followed a systematic two-stage process in alignment with PRISMA guidelines. Results We identified 8 records accounting for 7 programs focussed on peer-led support programs in suicide prevention. These programs employed a range of different designs and included a variety of settings (schools, communities, rural and online). Only 3 of the 7 programs contained data on effectiveness. With the small number of eligible programs the findings from this review are limited and must be interpreted with caution. Conclusions Despite the increased focus of policymakers on the importance of peer support programs in suicide prevention, our scoping review confirms an evidence gap in research knowledge regarding program design, implementation, and effectiveness. More rigour is required in reporting peer-led support initiatives to clarify the underlying definition of peer support and lived experience and to enhance our understanding of the types of current peer support programs available to those experiencing suicidality. Further, we need formal and high-quality evaluations of peer support suicide prevention programs led by people with lived experience to better understand their effectiveness on participant health across different settings and delivery modalities and to allow for comprehensive systematic reviews and meta-analysis in future.

Purpose of Review: A gap exists between PrEP interest and PrEP uptake in key populations (KP) for HIV prevention that may be ascribed to PrEP delivery services not being acceptable. This review summarizes novel platforms for HIV prevention outside of the traditional health facilities environment. Recent Findings: Mobile health clinics provide highly acceptable integrated, KP-focused services at convenient locations with the potential of high PrEP uptake. Telemedicine and health apps decongest health systems and allow for personal agency and informed decision-making on personal health. Pharmacy-led PrEP delivery provides de-medicalized, confidential PrEP services at extended hours in community locations, from trusted medical professionals. Peer-supported delivery encourages continued PrEP use. Summary: Community-based, differentiated and de-medicalized PrEP delivery can address uptake and continued use barriers in key populations. Future research should assess scalability, cost-effectiveness and sustainability of these PrEP delivery platforms, as well as focus on ways to simplify PrEP provision. [ABSTRACT FROM AUTHOR]

Information and communication technology (ICT)-based reading interventions have potential to help children with reading difficulties, especially those in resource-constrained environments who otherwise might not have access to support. This pilot study aimed to describe the impact of an online, partner-supported reading intervention designed for South African children with reading difficulties. Objectives were to qualitatively describe participants' experience of the intervention, and quantitatively evaluate changes in reading accuracy, rate, comprehension and receptive vocabulary after intervention. Two studies were conducted: (1) A retrospective analysis using data from intervention in mainstream Cape Town schools with peers as reading partners; (2) A prospective study in a Cape Town school with special needs educational provision where speech-language therapists served as reading partners. Both studies used matched participant, pre/post intervention designs. A total of 40 children in grades 3 to 6 participated. In each study the intervention group (n = 20) received intervention 3 times per week (30 minutes per session) for 10 weeks, while the control group (n = 20) continued with regular school activities. Participants enjoyed the ICT-based intervention, valued the role of the reading partners, believed they had made literacy gains, and reported positive attitudinal and behavioural changes related to reading. Retrospective analysis revealed no statistically significant differences between intervention and control groups. The prospective study found a statistically significant difference between the intervention and control groups' gains on one measure of reading rate, but no significant difference in reading accuracy, vocabulary or reading comprehension gains. The study provides a preliminary description of one ICT-based reading intervention. Although an intervention effect could not be demonstrated, the changes noted in reading rate together with qualitative findings suggest a need for further research. [ABSTRACT FROM AUTHOR]

To raise awareness that families with a mentally ill parent face special challenges and the correct handling of it, need to be considered more in health care. The simple question "how are you as a parent and your children?" is often not asked but this question is important so as not to endanger the healing process, to identify the need for assistance and to break the potential vicious circle for children. Awareness of the problem in the psychiatry of adults can support the care of affected persons and their children. [ABSTRACT FROM AUTHOR]

A series of online practice development discussions were held during the Covid-19 pandemic by the Art Therapy and Learning Disability Professional Support Group of the British Association of Art Therapists (formerly known as the Special Interest Group). (1) To capture the experiences of art therapists living through and working with this population during the global pandemic; (2) To describe the barriers and facilitators for online art therapy with people with a learning disability. An anonymised, hand-written record was made during six 60-minute Zoom sessions. The data was transferred to an Excel database. Reflexive thematic analysis was conducted. The resultant themes and thematic map are shared in this paper. The themes are: (A) The pandemic as leveller. (B) The joy and jeopardy of working online. (C) Art after the eclipse. (D) The function of the professional support group. (E) Insight and understanding to meet client diversity. Stimulated by the national restrictions imposed due to the pandemic, art therapy practice changed at an unprecedented pace. Online art therapy for people with a learning disability may provide a viable alternative to face-to-face art therapy. The BAAT Professional Support Group provides an important peer-network for art therapists and could become a practice-based research hub. Further research is needed to develop best-practice online art therapy; this must include experts by experience as co-researchers. Additional training will be needed for art therapists to practice safely and confidently online. In 2020, the coronavirus made many people across the world sick, some people died. In the UK, our government asked us to stay at home to help to stop the virus spreading. Lots of things changed very suddenly – activities, hobbies and therapy were stopped. This meant that people with a learning disability were not able to keep coming to their art therapy sessions. Art therapists across the UK met on the internet, using a video-chat, to talk about what changes they had made in their clinical practice, whether they were able to keep therapy going during the pandemic and how they felt about the changes. We wanted to understand: (1) Art therapists' experiences during the pandemic. (2) What's helped and what's gotten in the way when art therapists have worked online with people with a learning disability. This piece of research uses a qualitative research procedure called 'thematic analysis' to make sense of different people's views. Thematic analysis is a systematic way of organising and interpreting large volumes of information, called 'data'. In this research, the data is people's words, which were written down live during the six video-chat meetings. Using thematic analysis helps us to find patterns in the data where people have a similar or different view. These patterns are called: 'themes'. The themes gave us a concise record of a broad range of people's views. We found five key themes: (A) The pandemic as leveller. (B) The joy and jeopardy of working online. (C) Art after the eclipse. (D) The function of the professional support group. (E) Insight and understanding to meet client diversity. Online art therapy might help some people with a learning disability, but we need more research and training. Art therapists value peer-support. Our peer-support group could help to develop more robust research projects. [ABSTRACT FROM AUTHOR]

• Peer-support after lower limb loss is well-received by most patients in the U.S. • Receiving peer-support may have both psychological and physical benefits. • Main reasons for peer-support: companionship, altruism, and gaining information. • Main barriers to accessing peer support is scheduling conflicts. • Social distancing during COVID-19 significantly affected access to peer-support. To examine participants' experiences with peer-support after lower limb loss (LLL) and the associations between the peer-support experience (perceived benefits and barriers) and mobility outcomes. Quantitative and qualitative descriptive study with a cross-sectional design. National survey (distributed to 169 peer-support groups in 44 states in the US). The survey was completed by 82 individuals with a major lower limb amputation (53% female, 54% over 55 years of age; N=82). A 32-item survey to examine respondents' experiences in peer-support activities. Prosthetic mobility was measured using the Prosthetic Limb Users Survey of Mobility (PLUS-M). Two out of 3 respondents received some forms of peer-support after amputation. Among them 75% reported peer-support having a positive effect on their outlook on life, and 78% reported that information gained from peer-support was helpful. Companionship, altruistic acts, and gaining information on how to cope with amputation were the top themes of why respondents enjoyed the peer-support experience. Nearly all (94%) respondents would recommend peer-support to other people with LLL. Individuals who received peer-support exhibited a trend of greater mobility (55th vs 36th percentile on PLUS-M; P =.055). Individuals with LLL reported generally positive experiences regarding their engagement in peer-support activities. Peer-support groups are viewed as a helpful source for both information and emotional support, potentially benefiting functional and psychological recovery after amputation. Individuals who have received peer-support also exhibited greater mobility. [Display omitted] [ABSTRACT FROM AUTHOR]

Abstract Background Hepatitis C Virus (HCV) infection is endemic in prison populations, and HCV management in prisons is suboptimal. Incarceration is a public health opportunity to target this cohort. Community peer support increases HCV screening and treatment uptake. Prison peer workers have the potential to support the engagement of prisoners with health services and reduce stigma. This study’s primary aim is to evaluate peer-supported screening as a model of active HCV case finding with a secondary aim to describe the HCV cascade among those infected including linkage to care and treatment outcomes. Methods An observational study was conducted in a medium-security Irish male prison housing 538 inmates, using a risk-based questionnaire, medical records, peer-supported screening, laboratory-based HCV serology tests and mobile elastography. Results A prison peer-supported screening initiative engaged large numbers of prisoners in HCV screening (n = 419). The mean age of participants was 32.8 years, 92% were Irish and 33% had a history of injecting drug use. Multiple risk factors for HCV acquisition were identified including needle sharing (16%). On serological testing, 87 (21%) were HCV Ab +ve and 50 (12%) were HCV RNA +ve of whom 80% were fibroscaned (25% showing evidence of liver disease). Eighty-six percent of those with active infection were linked with HCV care, with 33% undergoing or completing treatment. There was a high concordance with HCV disclosure at committal and serological testing (96% for HCV Ab +ve and 89% for HCV Ab −ve). Conclusion Peer-supported screening is an effective active HCV case-finding model to find and link prisoners with untreated active HCV infection to HCV care.

A survey was conducted to document the perspectives of stakeholders in Quebec (Canada) on seven strategies that could promote social inclusion of people with intellectual disability through sports and physical activities. These strategies are associated with Unified Sports, awareness raising, training to coaches, supports through a companion, a peer or a resource person, and involvement in another role. A total of 229 individuals completed the survey. Their openness and desire to be involved was generally high for all seven strategies. Two strategies came out as most frequently prioritized: providing training to coaches and reinforcing awareness raising activities. [ABSTRACT FROM AUTHOR]

Introduction Oncologic patients with schizophrenia have a higher mortality, which could be explained by a delayed diagnosis and a poor quality of the oncologic treatment (1). Some of the potential reasons are related with patient’s psychopathology, stigma, and barriers in access to medical care. An structured support during the oncologic treatment has been proposed to solve the difficulties that patients with schizophrenia can experience when handling with an oncologic process. (2). Objectives To illustrate two approaches for cancer accompaniment in patients with schizophrenia. Methods We present two case-report and literature research of the topic. Results Case A. A 49 y.o. woman diagnosed with a schizoaffective disorder. In the last years she had difficulties to manage her selfcare, so her mental health providers linked her to an individualized community nurse, who later played a crucial role in helping the patient during the diagnosis and treatment of a breast cancer. Case B. A 37 y.o. man diagnosed with schizophrenia, who was very integrated in a peer-support organization. After being diagnosed with a Lymphoma, he continued participating in all the group activities (theatre, collaborative radio, painting) until his decease. Sharing the process with other patients not only improved his quality of life but also helped the group to manage the grief. Conclusions - Individualized support with a mental health nurse could enhance the communication between the oncologist and mental health providers, improve the symptoms management, and allow psychological support. - Peer-support can prevent social isolation, improve the quality of life and the management of the oncologic treatment. Disclosure No significant relationships.

Background: The aim of this study was to illuminate participants' experiences with transfer in (1) Illness Management and Recovery (IMR); and (2) two programs based on peer support: Turning Points, and Learn to Tackle Anxiety and Depression (LTAD); and whether peer support within these programs influenced the process of transfer beyond the interventional context. Furthermore, we investigated participants' experiences with a community-based intervention [Individual Placement and Support (IPS)] to explore perspectives on mechanisms that may eliminate challenges in the transfer process. Methods: The study was based on semi-structured interviews with participants with mental illness, from four different psychosocial interventions with and without peer support and across interventional settings. The material partly consists of secondary analyses of existing data sets of anonymised, transcribed interviews investigating participants' experience from two psychosocial interventions: Illness Management and Recovery (n = 15), and Individual Placement and Support (n = 12). Additionally, we conducted semi-structured interviews with persons who had participated in one of two peer-led programs: Turning Points and Learn How to Tackle Anxiety and Depression (n = 12). The analysis was guided by a hermeneutic-phenomenological approach to illuminate transfer processes and was based on the template method described by Nigel King. Results: Applying a transfer perspective on rehabilitation interventions identified everyday life situations where capacities learned during the interventions were utilized and conditions were highlighted that promoted or hindered transfer. Experiential knowledge and peer-exchange made transferal pathways between the interventional context and everyday life. Illness intrusiveness and uncertainty, together with environmental obstacles, generated transferal gaps. Individualized support could partly address these gaps. Conclusion: Findings from this qualitative study illuminate how peer-support in group-based rehabilitation interventions increased social functioning and developed better self-care strategies that can be transferred to daily life. Interventions situated in mental health settings, e.g. outpatient clinics, had limited impact on participation in broader community life. Advancing rehabilitation services in mental health may benefit from tailoring services to address illness fluctuation and combining group sessions with individualized support together with acknowledging and overcoming environmental obstacles. [ABSTRACT FROM AUTHOR]

Background: Breast cancer (BC) is the most prevalent cancer diagnosis among women worldwide. Several randomized controlled trials and systematic reviews have shown the benefits of exercise before, during, and after cancer treatment to manage side effects related to cancer and its therapies. However, these are poorly implemented across the disease-span, specifically, during the preoperative setting. Methods: Patients diagnosed with BC and participating in a randomized controlled trial on the effects of a prehabilitation program based on Nordic walking, muscle strengthening, and therapeutic education were invited to participate in this qualitative substudy. Two groups of eight patients each were recorded, transcript and analyzed using a specialized software (Atlas-Ti ® , version 24). Results: During the axial codification phase, 22 unique codes and 6 main themes were identified related to their experience with the program, namely, (1) information received prior to participating; (2) motivation to participate; (3) barriers; (4) facilitators; (5) perceived degree of support from healthcare workers as well as peers; and (6) satisfaction with the characteristics of the prehabilitation program. Conclusions: Patients interviewed showed great interest in prehabilitation as a way to prepare both physically and mentally for surgery. In order to implement these interventions, healthcare systems need to acknowledge barriers and facilitators as well as the need for these programs to be supervised and monitored to avoid adverse events.

This paper reports preliminary evidence of the impacts of Australia's first residential peer-support service for people at risk of suicide. Aim: This paper reports preliminary evidence of the impacts of Australia's first residential peer-support service for people at risk of suicide. Methods: Psychological distress was measured preintervention, postintervention, and after 3 months and analyzed using paired t tests. Interviews were held postintervention and were analyzed using thematic analysis. Results: Psychological distress significantly improved from preintervention to postintervention ( n = 16, d = 1.77) and at follow-up ( n = 5, d = 10) indicated that participants experienced improvements in mental well-being and feelings of connectedness, respite, and confidence to engage with other services. The peer-support workers were key. Some participants felt that the location was too remote, too little information was given, and a longer stay would have been preferable. n = 10) indicated that participants experienced improvements in mental well-being and feelings of connectedness, respite, and confidence to engage with other services. The peer-support workers were key. Some participants felt that the location was too remote, too little information was given, and a longer stay would have been preferable. Limitations: These findings indicate that residential peer-support services potentially offer a valuable alternative to conventional inpatient treatment for people at risk of suicide.Conclusions: These findings indicate that residential peer-support services potentially offer a valuable alternative to conventional inpatient treatment for people at risk of suicide.

Background: In the innovative seminar “Peer-support and Patient Competence”, which was conceived as a face to face course, we teach various concepts of patient competence and invite patients to report about their illness experience and peer-group activities. Method: Implementation of a face to face course into a virtual format via video conference.Result: Despite concerns regarding the sensitive topic and technical challenges, the conversion of the seminar with interactive character, which was originally designed in a face-to-face format, into a virtual one was successful. Both lecturers and participants experienced the seminar as satisfactory.Conclusion: In times of Covid-19, this virtual course experience can encourage colleagues to restructure their face to face seminars into innovative and virtual teaching formats.

Abstract Background The Parent Infant Feeding Initiative (PIFI) was a factorial, randomised controlled trial that aimed to prolong exclusive breastfeeding by targeting expecting fathers. One of the intervention strategies evaluated was a father-focused breastfeeding class facilitated by a male peer facilitator. The aim of this mixed-methods descriptive study was to 1) evaluate the feedback provided from participants of the class and 2) explore the motivations and experiences of volunteer male peer facilitators trained to deliver the class. Methods Father-focused breastfeeding antenatal (FFAB) classes were conducted in six Western Australian hospitals between August 2015 and December 2016. Following each peer facilitated FFAB class, expecting father participants completed an evaluation form to assess their satisfaction with the format, facilitation and content, in addition to whether their expectations and confidence to manage breastfeeding problems had changed. Feedback to open-ended questions was analysed using content analysis to identify learnings and suggestions for improvements. At the completion of PIFI, individual telephone interviews were undertaken with 14 peer facilitators to gain insight into their motivations for volunteering and experiences of conducting the classes. Transcripts from interviews were analysed using Braun and Clarke’s six phases for thematic analysis. Results Participant evaluation forms were completed by 678 of the 697 father participants (98%). Overall satisfaction with class format, facilitation and content was high with 90% or more of fathers either strongly agreeing or agreeing with each positively-phrased evaluation item. Class participants enjoyed interacting with other fathers, appreciated validation of their role, were not always aware of the importance of breastfeeding or potential difficulties, valued the anticipatory guidance around what to expect in the early weeks of parenting and appreciated learning practical breastfeeding support strategies. Peer facilitators indicated they felt well prepared and supported to conduct FFAB classes. Analysis of interview transcripts revealed common experiences of the peer facilitators incorporating four themes: ‘Highlights of being a facilitator’, ‘Challenges’, ‘Mourning the project completion’ and ‘Satisfaction with training and support’. Conclusion Father-focused breastfeeding classes supported by volunteer male peer facilitators are a feasible and acceptable way of engaging fathers as breastfeeding supporters. Trial registration ACTRN12614000605695. Registered 6 June 2014.

Abstract Background To evaluate the feasibility, acceptability and effectiveness of implementing a peer-based, multi-component mental health program in the Australian coal mining industry. Methods The multicomponent program included MATES in mining (a peer-based mental health and suicide prevention program) and supervisor training. Eight Australian coal mines participated in the research, with four mines receiving the mental health program. Primary outcome variables including mental health stigma, help-seeking behaviour and perception of the workplace commitment to mental health were measured prior to program implementation, and then again 10 months following using a paper based survey. Process evaluation of the mental health program was measured using a pre-test/post-test survey. Results MATES in mining 1275 miners participated in the MATES general awareness and connector training. Participants were more confident that they could identify a workmate experiencing mental ill-health; help a workmate, family member or themselves identify where to get support and were more willing to start a conversation with a workmate about their mental health. Supervisor training 117 supervisors completed the supervisor training and were subsequently more confident that they could: identify someone experiencing mental ill-health in the workplace; identify and recommend support services to a person experiencing mental ill-health; and have an effective conversation about performance issues that may be due to mental ill-health. Conclusions Our findings show evidence to support the use of peer-based mental health programs in the mining industry, and for male-dominated industry more broadly.