Healthy Parent Carers programme: mixed methods process evaluation and refinement of a health promotion intervention
Jenny LloydGretchen BjornstadAleksandra BorekBeth Cuffe-FullerMary FredlundAnnabel McDonaldMark TarrantVashti BerryKath WilkinsonSiobhán MitchellAnnette GillettStuart LoganChristopher Morris
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Parent carers of children with special educational needs or disability are at risk of poorer mental and physical health. In response to these needs, we codeveloped the 'Healthy Parent Carers' (HPC) programme. This study examined the views and experiences of participants in the HPC feasibility trial to inform programme refinement.HPC is a peer-led group-based intervention (supported by online materials) for primary carers of disabled children, encouraging behaviours linked with health and well-being. It was delivered by two lead and six assistant peer facilitators in six community sites (one lead and one assistant per group) in South West England over six or 12 sessions. Control participants had online materials only. The trial involved 47 intervention and 45 control parent carers (97% female and 97% white) and eight facilitators (one male).A preplanned mixed methods process evaluation using questionnaires and checklists (during and after the intervention), qualitative interviews with participants after intervention (n=18) and a focus group with facilitators after trial.HPC was highly acceptable to participants and facilitators and experiences were very positive. Participants reported that the programme increased awareness of what parent carers could and could not change and their self-efficacy to engage in health-promoting behaviours. The intended mechanisms of action (social identification and peer support) matched participants' expectations and experiences. Control participants found the online-only programme flexible but isolating, as there were no opportunities to share ideas and problem solve with peers, the key function of the programme. Areas for improvement were identified for programme content, facilitator training and delivery.HPC was acceptable, well received and offers considerable potential to improve the health of parent carers. Under the pandemic, the challenge going forward is how best to maintain reach and fidelity to function while delivering a more virtual programme.ISRCTN151144652.Keywords:
Peer Support
Background: A range of evidence for the effectiveness of one-to-one peer support in mental health services is emerging. Levels of engagement with peer support vary with limited studies showing few individual participant characteristics predicting engagement. Implementation factors that might predict engagement have not been considered. Methods: Data were analysed from the intervention arm of the ENRICH trial of one-to-one peer support for discharge from acute psychiatric inpatient care. Two outcomes were considered: (1) a measure of ‘engaged with peer worker’; (2) number of face-to-face contacts with peer worker post-discharge. Two sets of independent variables were analysed against each outcome: (1) pre-randomisation participant characteristics; (2) implementation factors measured pre-discharge. Analyses used logistic and zero-inflated negative binomial regression models according to outcome structure. Results: Data were analysed for 265 participants randomised to peer support who had a known peer worker. Non-heterosexual participants had increased odds of engaging with peer support compared to heterosexual participants, OR = 4.38 (95% CI: 1.13, 16.9, p = .032). Longer duration of first contact with peer worker ( OR = 1.03, 95% CI: 1.00, 1.04, p < .001) and more relationship building activities in the first contact ( OR = 1.4, 95% CI: 1.13, 1.85, p = .004) were associated with greater odds of engaging with peer support. Analysis of number of contacts post-discharge showed consistent findings. Conclusions: Implementation of peer support should include a focus on relationship building in the first session of peer support. The potential for peer support to break down barriers to accessing mental health services experienced by people from marginalised communities warrants further investigation.
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Adolescents with chronic renal failure face unique problems often best understood by peers with the same condition. An adolescent peer support group can be a valuable tool to foster peer relationships and enhance self-esteem. Moreover, nurses can learn to be effective group leaders.
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ABSTRACT A qualitative research offers insights into social, emotional and experimental phenomena. Unlike quantitative study, no structured questionnaire is involved in the data collection. Instead, series of semi-structured or unstructured interviews are conducted. Interview is one of the commonest methods of data collection used in qualitative study. It can be in the form of in-depth interview or focus group discussion (FGD). The moderator plays a crucial role in ensuring the success of the interviews conducted and the quality of information gained. This paper gives an overview on the two most common methods of data collection used in qualitative research: In-depth interviews and focus group discussion. Keywords: Interviews, Qualitative research, In-depth, Focus Group Discussion
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Peer research has been recognized as an important strategy. As with other qualitative approaches, one issue that is often raised is how do we judge the quality of such methods? This paper argues that one of the ways we can do this is by comparing the data collected through participatory methods with that collected with other research strategies within the same research context. This was done through a qualitative study which investigated student's attitudes towards ethnicity and politics in two secondary schools in Kenya. A research design was developed using focus-group discussions where half of the focus groups were led by an adult researcher and the other half by a student researcher. The paper will compare the data collected from these two kinds of focus groups using the framework method in order to illustrate that peer research produces high-quality data comparable to that collected using other means. Moreover, the paper will use reflections from the process to show that one other way that we can judge the quality of peer research is through the benefits that accrue not only to the peer researchers such as skills development but also to the adult researchers, for example greater reflexivity.
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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.
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Abstract 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.
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To describe the development of a peer support intervention and test an enhanced version compared to a standard protocol.Participants (N = 36 females) were assigned to an Enhanced Peer Support (PS) vs Standard weight loss group for 4 months. The PS component consisted of skills training and practice between sessions using social networking.The PS group perceived significantly more peer support and experienced higher levels of social interaction. When meeting frequency decreased, the PS group showed an increase in overall types of support from group members.Findings suggest that an intervention targeting peer support skills results in greater feelings of peer support.
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This article describes a Chronic Illness Peer Support (ChIPS) programme designed to assist young people in their adjustment to life with a chronic medical condition. The ChIPS programme takes a non-categorical approach to participation, recognizing that young people with different medical conditions experience many similar concerns. Support groups are facilitated by a health professional and peer co-leader. Groups meet weekly for 8 weeks and typically include between six and eight young people. Young people can choose to remain involved in broader social, educational and recreational activities following completion of the 8-week programme. We discuss nine psychosocial mechanisms by which peer support groups such as ChIPS might act to improve resilience and well-being among participants. We also discuss some theoretical risks in running support groups for chronically ill young people, which emphasize the importance of training and support of group leaders, including the peer co-leaders. The article concludes with a personal testimony by a ChIPS participant that was prepared for the 2003 Australian and New Zealand Adolescent Health Conference.
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Abstract Mediators benefit from both formal and informal training. One method of informal training that can be conducted by any local group is a peer support group. This article describes the formation, operation, and benefits of a mediators' peer support group. It recounts examples and concludes that such a group provides personal and professional development to its members.
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