Digital literacy needs for online learning among peri-urban, marginalised youth in South Africa

As online learning modes become more common, this can exacerbate educational inequalities for learners who do not have the ability to utilise these modes effectively. This has been seen in the COVID-19 crisis where there has been a shift to remote and distance learning modalities despite the limited ability for all learners to benefit equitably. In particular, digital literacy remains a fundamental barrier to benefitting from online and blended learning. This paper reports on a study that investigated the digital literacy needs and preferences of peri-urban, marginalised youth when utilising online and blended learning in South Africa and how online education platforms can be designed to better suit such groups. It is argued that for online courses to truly support marginalised groups, it needs to be ensured that these learners are digitally equipped and digitally literate in terms of accessing, utilising, and benefitting equitably from online learning. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

The Role of Social Support and Belonging in Predicting Recovery from Problem Gambling.

Research indicates a role for both social support and belonging in addiction recovery, however little is known about the role of these constructs in the recovery from problem gambling, and whether they relate to the effectiveness of mutual aid groups such as Gamblers Anonymous. The aim of this study was therefore to explore the relationship between social support and belonging, and to assess the role of demographics (including group membership of GA), social support and/or belongingness in predicting gambling addiction recovery in terms of gambling urges and quality of life. Using a cross sectional design, participants identifying as having problem gambling (n = 60) completed an online questionnaire with two independent variables (Social Support and Belonging), two dependent variables (Gambling Urges and Quality of Life) to assess gambling addiction recovery and measures of GA membership. The results showed no significant association between gender, age, ethnicity, education or employment status and gambling urges or quality of life. Membership to GA, and length of membership were significantly associated with gambling recovery indicating that being a member of GA and longer membership was associated with lower gambling urges and higher quality of life. Further, the results showed a high but not perfect correlation between social support and belonging (r(58) = .81, p = < .01). A regression analysis showed that although there was a significant correlation between social support and belongingness, they played different roles in gambling addiction recovery. Social support alone predicted higher quality of life, but not a reduction in gambling urges; belonging (along with being a member of GA) predicted a reduction in gambling urges, but not an increase in quality of life. Social support and belonging have a differential impact on aspects of gambling addiction, and should be considered as different constructs. In particular, whilst the process underpinning reduced gambling urges is membership of GA and the sense of belonging it provides its members, social support per se is a better predictor of quality of life. These findings have implications for the development of treatment for problem gamblers in the future.

Randomized trial of personalized psychological feedback from a longitudinal online survey and simultaneous evaluation of randomized stepped wedge availability of in-person peer support for hospital staff during the COVID-19 pandemic.

OBJECTIVE: We tested if automated Personalized Self-Awareness Feedback (PSAF) from an online survey or in-person Peer Resilience Champion support (PRC) reduced emotional exhaustion among hospital workers during the COVID-19 pandemic. METHOD: Among a single cohort of participating staff from one hospital organization, each intervention was evaluated against a control condition with repeated measures of emotional exhaustion at quarterly intervals for 18 months. PSAF was tested in a randomized controlled trial compared to a no-feedback condition. PRC was tested in a group-randomized stepped-wedge design, comparing individual-level emotional exhaustion before and after availability of the intervention. Main and interactive effects on emotional exhaustion were tested in a linear mixed model. RESULTS: Among 538 staff, there was a small but significant beneficial effect of PSAF over time (p = .01); the difference at individual timepoints was only significant at timepoint three (month six). The effect of PRC over time was non-significant with a trend in the opposite direction to a treatment effect (p = .06). CONCLUSIONS: In a longitudinal assessment, automated feedback about psychological characteristics buffered emotional exhaustion significantly at six months, whereas in-person peer support did not. Providing automated feedback is not resource-intensive and merits further investigation as a method of support.

Meaningful Activities and Recovery (MA&R): a co-led peer occupational therapy intervention for people with psychiatric disabilities. Results from a randomized controlled trial.

BACKGROUND: Activity and participation are critical to health and wellbeing. Limited evidence exists on how to support people with mental illness in participating in everyday activities. AIM: To investigate the effectiveness of Meaningful Activities and Recovery (MA&R), a co-led peer occupational therapy intervention focusing on activity engagement, functioning, quality of life, and personal recovery. METHODS: In a statistician blinded, multicenter RCT including 139 participants from seven community and municipal mental health services in Denmark, participants were randomly assigned to 1) MA&R and standard mental health care or 2) standard mental health care. The MA&R intervention lasted 8 months and consisted of 11 group sessions, 11 individual sessions, and support to engage in activities. The primary outcome, activity engagement, was measured using Profile of Occupational Engagement in People with Severe Mental Illness (POES-S). Outcomes were measured at baseline and post-intervention follow-up. RESULTS: Meaningful Activities and Recovery was delivered with high fidelity and 83% completed the intervention. It did not demonstrate superiority to standard mental health care, as intention-to treat analysis revealed no significant differences between the groups in activity engagement or any of the secondary outcomes. CONCLUSION: We did not find positive effects of MA&R, possibly because of COVID-19 and related restrictions. Fidelity assessments and adherence rates suggest that MA&R is feasible and acceptable. However, future studies should focus on refining the intervention before investigating its effectiveness. TRIAL REGISTRATION: The trial was registered 24/05/2019 at ClinicalTrials.gov NCT03963245.

An exploratory cross-sectional study of the effects of ongoing relationships with accompanying patients on cancer care experience, self-efficacy, and psychological distress.

BACKGROUND: Centre hospitalier de l'Université de Montréal in Canada introduced accompanying patients (APs) into the breast cancer care trajectory. APs are patients who have been treated for breast cancer and have been integrated into the clinical team to expand the services offered to people affected by cancer. This study describes the profiles of the people who received the support and explores whether one-offs vs ongoing encounters with APs influence their experience of care, on self-efficacy in coping with cancer, and on their level of psychological distress. METHODS: An exploratory cross-sectional study was carried out among patients to compare patients who had one encounter with an AP (G1) with those who had had several encounters (G2). Five questionnaires were administered on socio-demographic characteristics, care pathway, evaluation of the support experience, self-efficacy in coping with cancer, and level of psychological distress. Logbooks, completed by the APs, determined the number of encounters. Linear regression models were used to evaluate the associations between the number of encounters, patient characteristics, care pathway, number of topics discussed, self-efficacy measures in coping with cancer, and level of psychological distress. RESULTS: Between April 2020 and December 2021, 60% of 535 patients who were offered support from an AP accepted. Of these, one hundred and twenty-four patients participated in the study. The study aimed to recruit a minimum of 70 patients with the expectation of obtaining at least 50 participants, assuming a response rate of 70%. There were no differences between G1 and G2 in terms of sociodemographic data and care pathways. Statistical differences were found between G1 and G2 for impacts on and the return to daily life (p = 0.000), the return to the work and impacts on professional life (p = 0.044), announcement of a diagnosis to family and friends (p = 0.033), and strategies for living with treatment under the best conditions (p = 0.000). Significant differences were found on the topics of cancer (p = 0.000), genetic testing (p = 0.023), therapeutic options (p = 0.000), fatigue following treatment (p = 0.005), pain and discomfort after treatment or surgery (p = 0.000), potential emotions and their management (p = 0.000) and the decision-making processes (p = 0.011). A significant relationship was found between the two groups for patients' ability to cope with cancer (p = 0.038), and their level of psychological distress at different stages of the care pathway (p = 0.024). CONCLUSIONS: This study shows differences between one-time and ongoing support for cancer patients. It highlights the potential for APs to help patients develop self-efficacy and cope with the challenges of cancer treatment.

Online peer support training to promote adolescents' emotional support skills, mental health and agency during COVID-19: Randomised controlled trial and qualitative evaluation.

Adolescents often look to their peers for emotional support, so it is critical that they are prepared to take on a supportive role, especially during a health crisis. Using a randomised controlled trial (ISRCTN99248812, 28/05/2020), we tested the short-term efficacy of an online training programme to equip young people with skills to support to their peers' mental wellbeing during the COVID-19 pandemic. In June 2020, one-hundred UK adolescents (aged 16-18) recruited through social media were randomly allocated (1:1) to immediate 5-day peer support training or a wait-list, via an independently generated allocation sequence. Primary outcomes were indicators of ability to help others (motivation, perceived skills, frequency of help provided, compassion to others and connectedness to peers). Secondary outcomes included emotional symptoms, mental wellbeing, and indicators of agency (civic engagement and self-efficacy). We also collected qualitative reports of participants' experience. Assessments were completed at baseline and 1 week post randomisation (primary endpoint), and up to 4 weeks post randomisation (training group only). The training increased support-giving skills, frequency of providing support, compassion and peer connectedness (medium-large-effect sizes), but not motivation to provide support, 1 week post randomisation, compared to controls. Gains in the training group were maintained 4 weeks post randomisation. Training also improved adolescents' mental health and agency, and qualitative reports revealed further positive outcomes including increased self-care and empowerment. Leveraging digital platforms that are familiar to young people, peer support training has the potential to enable adolescents to support their own and their peers' mental wellbeing during a health crisis.

Students' mental health issues in Europe and other countries

This chapter describes and analyzes how different countries dealt with children and youth with mental health issues before and during the COVID-19 pandemic beginning in March 2020. The pandemic and measures worldwide to control the spread of the virus COVID-19, such as lockdowns, closures of schools and preschools, social distancing rules, restrictions of movement, contact limits, and quarantine, changed the daily life of millions of people, especially children and youth. The countries include: Germany, Greece, Portugal, Tanzania/Vietnam, and the Netherlands. The chapter also analyzes how fear of infection and death, high uncertainty, and the containment measures that were implemented on affected children and youth with mental health issues. Students with disabilities and students from disadvantaged backgrounds were particularly affected by school closures. Mental health systems in the various countries coped in different ways, also depending on how they operated before the pandemic. Developing prevention programs, building resiliency, peer support, online support measures, and raising awareness of mental health all seem to be useful strategies to address mental health problems in children and youth. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Qualitative Study of Certified Peer Specialists' Experiences Delivering Peer Support Services During the COVID-19 Pandemic.

OBJECTIVE: The purpose of this qualitative study was to examine the experiences of certified peer specialists (CPSs) in delivering telehealth services during the COVID-19 pandemic. METHODS: Fourteen semistructured interviews with CPSs were conducted from August to November 2020. Data were analyzed by using thematic analysis. RESULTS: Helpful support from employers during the transition to telehealth included clear communication and access to training on telehealth technologies. Main barriers and facilitators were related to interpersonal relationships and logistical factors. CPSs reported that telehealth allowed them to continue to support the peers they serve but that the quality of interactions was not as good as with in-person services. Logistical challenges included inadequate equipment and Internet access. CONCLUSIONS: To support CPSs in delivering telehealth, employers can engage them in open and transparent communication about guidelines for service delivery, provide training and equipment, and allow them the flexibility to tailor service delivery modalities to the peers they serve.

Trauma-informed dance/movement therapy in the age of telehealth

The COVID-19 pandemic precipitated an unprecedented shift from in-person therapy to telehealth. Dance/movement therapists, along with other somatic and creative arts therapists faced unique challenges in adapting their work under such unexpected conditions. Much of the inspiration and clinical insight for this chapter comes from therapists who persevered and developed effective therapeutic approaches during the pandemic. Drawing on their own discoveries, dialogues with colleagues, and insights from a series of dance/movement therapy (DMT) peer support groups, the authors introduce telehealth concepts relevant to DMT, emphasizing the importance of a trauma-informed approach. The chapter presents a collection of vignettes to explore both challenges and possibilities of dance/movement teletherapy. Telehealth poses unique considerations for DMT. It necessitates adjustments from in-person work, and is not always a viable option. However, DMT has a great deal to offer to the range of possibilities for serving clients in rich and meaningful ways as remote therapy continues to develop. Working through a trauma-informed lens allows therapists to work more safely and effectively in the context of telehealth with clients whether they have a known trauma history. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Accessibility and Financial Barriers in the Utilization of Alternative to Discipline Programs in the United States

Nurses are facing increased mental health issues, substance use, and even suicide since the novel coronavirus pandemicarrived in the United States. Nurses with substance use disorder (SUD) may enroll in alternative-to-discipline (ATD)programs to retain their license during initial treatment with the goal to return to practice, but this process is not withoutchallenges. For example, previous analyses have shown that the time surrounding disciplinary/regulatory process regardingsubstance use disorder (SUD) by either employers or licensure boards was a trigger for nurses who died by suicide. Internetsearches are a common approach to find information on health-related topics. This limited critical review sought toreplicate and evaluate a simple internet search that a nurse seeking information on their state ATD program may complete.Google searches for information on ATD programs were completed on the 50 continental states and Washington, DCbetween April and September 2022. States with ATD programs were evaluated for evidence-based components andbarriers to accessing program information. Publicly available ATD program information ranged from requirements forcontact information to obtain details to websites that outline the entire program, including associated costs. While ATDprograms offer a significant improvement over traditional disciplinary responses to nurse substance use, a significantbarrier is program cost, which can often exclude participation. In this article, we discuss the detailed results of our criticalreview and offer implications for practice that include opportunities for research and a national database to track ATDprogram components and target outcomes to support return to practice for nurses with SUDs © 2023, Online Journal of Issues in Nursing.All Rights Reserved.

Promoting Employees' Mental Health in the Post-COVID New Normal: Using a Peer Support Model

It is evident that stress and mental health conditions can negatively affect employees' job performance and productivity, work engagement, communication, physical capability, and daily functioning. Employer organizations have implemented several innovative methods to improve in-person and virtual workplace mental health promotion programs. In 2019, the US Centers for Disease Control and Prevention published a guideline on Mental Health in the Workplace. However, there is limited research on using a peer support model in organizations as an alternative and complementary approach to promote employee psychological well-being. The history and principles of a peer support model will be introduced and implied as an effective resource to employees. An overview of the evidence-based practice in a peer support program in mental health promotion will be provided. Finally, ethical principles, legal issues, and best practices of the peer support program will be presented, especially in a virtual format and in a social media platform. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Use of the Revised Second Victim Experience and Support Tool to Examine Second Victim Experiences of Respiratory Therapists.

BACKGROUND: Respiratory therapists (RTs) work alongside allied health staff, nurses, and physicians during stressful and traumatic events that can be associated with emotional and physiological implications known as second victim (SV) experiences (SVEs). This study aimed to evaluate SVEs of RTs, including both positive and negative implications. METHODS: RTs within a large academic health care organization across Minnesota, Wisconsin, Florida, and Arizona were asked to participate in an anonymous survey that included the validated Second Victim Experience and Support Tool-Revised to assess SVEs as well as desired support services. RESULTS: Of the RTs invited to participate, 30.8% (171/555) completed the survey. Of the 171 survey respondents, 91.2% (156) reported that they had been part of a stressful or traumatic work-related event as an RT, student, or department support staff member. Emotional or physiologic implications experienced by respondents as SVs included anxiety 39.1% (61/156), reliving of the event 36.5% (57/156), sleeplessness 32.1% (50/156), and guilt 28.2% (44/156). Following a stressful clinical event, 14.8% (22/149) experienced psychological distress, 14.2% (21/148) experienced physical distress, 17.7% (26/147) indicated lack of institutional support, and 15.6% (23/147) indicated turnover intentions. Enhanced resilience and growth were reported by 9.5% (14/147). Clinical and non-clinical events were reported as possible triggers for SVEs. Nearly half of respondents 49.4% (77/156) indicated feeling like an SV due to events related to COVID-19. Peer support was the highest ranked form of desired support following an SVE by 57.7% (90/156). CONCLUSIONS: RTs are involved in stressful or traumatic clinical events, resulting in psychological/physical distress and turnover intentions. The COVID-19 pandemic has had a significant impact on RTs' SVEs, highlighting the importance of addressing the SV phenomenon among this population.

The long-term effects of Kerala Diabetes Prevention Program on diabetes incidence and cardiometabolic risk: a study protocol.

INTRODUCTION: India currently has more than 74.2 million people with Type 2 Diabetes Mellitus (T2DM). This is predicted to increase to 124.9 million by 2045. In combination with controlling blood glucose levels among those with T2DM, preventing the onset of diabetes among those at high risk of developing it is essential. Although many diabetes prevention interventions have been implemented in resource-limited settings in recent years, there is limited evidence about their long-term effectiveness, cost-effectiveness, and sustainability. Moreover, evidence on the impact of a diabetes prevention program on cardiovascular risk over time is limited. OBJECTIVES: The overall aim of this study is to evaluate the long-term cardiometabolic effects of the Kerala Diabetes Prevention Program (K-DPP). Specific aims are 1) to measure the long-term effectiveness of K-DPP on diabetes incidence and cardiometabolic risk after nine years from participant recruitment; 2) to assess retinal microvasculature, microalbuminuria, and ECG abnormalities and their association with cardiometabolic risk factors over nine years of the intervention; 3) to evaluate the long-term cost-effectiveness and return on investment of the K-DPP; and 4) to assess the sustainability of community engagement, peer-support, and other related community activities after nine years. METHODS: The nine-year follow-up study aims to reach all 1007 study participants (500 intervention and 507 control) from 60 randomized polling areas recruited to the original trial. Data are being collected in two phases. In phase 1 (Survey), we are admintsering a structured questionnaire, undertake physical measurements, and collect blood and urine samples for biochemical analysis. In phase II, we are inviting participants to undergo retinal imaging, body composition measurements, and ECG. All data collection is being conducted by trained Nurses. The primary outcome is the incidence of T2DM. Secondary outcomes include behavioral, psychosocial, clinical, biochemical, and retinal vasculature measures. Data analysis strategies include a comparison of outcome indicators with baseline, and follow-up measurements conducted at 12 and 24 months. Analysis of the long-term cost-effectiveness of the intervention is planned. DISCUSSION: Findings from this follow-up study will contribute to improved policy and practice regarding the long-term effects of lifestyle interventions for diabetes prevention in India and other resource-limited settings. TRIAL REGISTRATION: Australia and New Zealand Clinical Trials Registry-(updated from the original trial)ACTRN12611000262909; India: CTRI/2021/10/037191.

The evolution of community peer support values: Reflections from three UK mental health project teams

Objective: To explore emergent values for community-based peer support in three projects and use of peer research methodology. Background: Peer support refers to the support people with shared lived experiences provide to each other. Its roots are in the civil rights movement, providing alternatives to clinical treatments. This method of support is delivered in different settings, with varying degrees of structure. In this paper, it includes shared experience of mental health issues. Methods: We reviewed interview data from two evaluations and one development project - mental health (n = 69), women-only (n = 40), and maternal mental health (n = 24), respectively. Each project used peer research methods. Peer support values from each project were compared, along with reflections from mostly peer researchers who worked on them (n = 11). Results: Six peer support values emerged and were found to be identifiable and applicable in different contexts. Decisions on facilitation and leadership varied across projects and generated some concerns over professionalisation, including non-peer leadership. Frameworks were viewed as broadly useful, but peer support is heterogenous, and peer researchers were concerned about over-rigid application of guidance. Discussion: We propose caution applying frameworks for peer support. Values must remain flexible and peer-led, evolving in new contexts such as COVID-19. Evaluators have a responsibility to consider any potentially negative consequences of their work and mitigate them. This means ensuring research outputs are useful to the peer support community, and knowledge production is based upon methodologies, such as peer research, that complement and are consistent with the values of peer support itself. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Social support, self-efficacy and academic satisfaction of university students during the COVID-19 lockdown

This work aimed to analyze the relationships between the students perceived institutional support, teachers' support, peers' support, and their academic satisfaction, mediated by their self-efficacy in information and comunication technologies (ICT). Participants were 157 students who were studying from first to fourth year in different disciplines of the Valencia University. Structural equation models with latent factors were tested. A final model had satisfactory fit indices to the observed data. It is worth highlighting the strong direct effect of the teaching staff support on student' academic satisfaction, with less weight, although significant, being the effect of institutional support. In conclusion, teacher's figure is of paramount importance for student's academic satisfaction. © 2023 Servicio de Publicaciones de la Universidad de Navarra. All rights reserved.

"Something to look forward to" - experiences of older adults taking part in a peer support group

The political response to Wales' ageing population has been to strive to make Wales the best place in the world to grow older (Older People's Commissioner for Wales, 2019). Third sector interventions to improve the wellbeing of older adults have been recognised by the Welsh Government as "pivotal" (Welsh Assembly Government, 2008). Many studies have been carried out to evaluate the effectiveness of such interventions, but there is little in-depth understanding of people's experiences of participation. The aim of this study was to describe the experience of taking part in a peer support group for older adults from the perspective of its participants. Using descriptive phenomenology, the study avoided evaluation and instead gave voice to the older adults who participated in a peer support group taking place in a retirement housing scheme in South Wales. The study had a longitudinal design with three interview phases over a 15-month period. The first phase of interviews took place whilst the group was led by professional facilitators. The second phase took place six months later when the group was led by a volunteer peer leader. The final interviews were conducted six months thereafter during the first lockdown period of the COVID-19 pandemic. Six members of the group volunteered to participate in this study of whom three became peer leaders. Sixteen one-to-one interviews of between 45 and 60 minutes were conducted over 15 months. The data gathered was analysed to identify themes using Giorgi's method for descriptive phenomenological analysis (Giorgi, 1997). The overarching theme identified was of experiences of wellbeing. The findings suggest that wellbeing includes feelings of positive emotion such as enjoyment, amusement, feelings of being in control, being valued and pride. Wellbeing included feelings of belonging and encompassed the development of relationships with other group members and external facilitators. Participants described attending the group as providing opportunities to learn from one another,share experiences of bereavement and provide empathetic support. Findings indicated that participation in the group generated feelings of wellbeing from participants' perceptions that it was a meaningful experience with purpose. It was described as "something to look forward to" and an opportunity to "bring the outside in." The contribution to new knowledge made by this study arises from findings about the experience of the older adult peer leaders. These experiences have not been explored in other studies. The peer leaders' experiences of wellbeing were broader than those of the group members. They included feelings of engagement and achievement arising from their participation in meaningful activities. These findings can be used to inform policies which seek to improve the wellbeing of older adults. This is a strategic objective of the Welsh Government's Ageing Well policy (Welsh Government, 2020). Welsh Government policy also seeks to realign the negative perceptions held of older adults. Including older adults in opportunities for social participation such as leading peer support groups in a voluntary capacity contributes to this realignment and accords with Ageing Well policy. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Understanding peer support: a qualitative interview study of doctors one year after seeking support.

BACKGROUND: Doctors' health is of importance for the quality and development of health care and to doctors themselves. As doctors are hesitant to seek medical treatment, peer support services, with an alleged lower threshold for seeking help, is provided in many countries. Peer support services may be the first place to which doctors turn when they search for support and advice relating to their own health and private or professional well-being. This paper explores how doctors perceive the peer support service and how it can meet their needs. MATERIALS AND METHODS: Twelve doctors were interviewed a year after attending a peer support service which is accessible to all doctors in Norway. The qualitative, semi-structured interviews took place by on-line video meetings or over the phone (due to the COVID-19 pandemic) during 2020 and were audiotaped. Analysis was data-driven, and systematic text condensation was used as strategy for the qualitative analysis. The empirical material was further interpreted with the use of theories of organizational culture by Edgar Schein. RESULTS: The doctors sought peer support due to a range of different needs including both occupational and personal challenges. They attended peer support to engage in dialogue with a fellow doctor outside of the workplace, some were in search of a combination of dialogue and mental health care. The doctors wanted peer support to have a different quality from that of a regular doctor/patient appointment. The doctors expressed they needed and got psychological safety and an open conversation in a flexible and informal setting. Some of these qualities are related to the formal structure of the service, whereas others are based on the way the service is practised. CONCLUSIONS: Peer support seems to provide psychological safety through its flexible, informal, and confidential characteristics. The service thus offers doctors in need of support a valued and suitable space that is clearly distinct from a doctor/patient relationship. The doctors' needs are met to a high extent by the peer-support service, through such conditions that the doctors experience as beneficial.

Faculty-Wide Peer-Support Program During the COVID-19 Pandemic: Design and Preliminary Results.

BACKGROUND: Physicians experience higher rates of burnout relative to the general population. Concerns of confidentiality, stigma, and professional identities as health care providers act as barriers to seeking and receiving appropriate support. In the context of the COVID-19 pandemic, factors that contribute to burnout and barriers to seeking support have been amplified, elevating the overall risks of mental distress and burnout for physicians. OBJECTIVE: This paper aimed to describe the rapid development and implementation of a peer support program within a health care organization located in London, Ontario, Canada. METHODS: A peer support program leveraging existing infrastructures within the health care organization was developed and launched in April 2020. The "Peers for Peers" program drew from the work of Shapiro and Galowitz in identifying key components within hospital settings that contributed to burnout. The program design was derived from a combination of the peer support frameworks from the Airline Pilot Assistance Program and the Canadian Patient Safety Institute. RESULTS: Data gathered over 2 waves of peer leadership training and program evaluations highlighted a diversity of topics covered through the peer support program. Further, enrollment continued to increase in size and scope over the 2 waves of program deployments into 2023. CONCLUSIONS: Findings suggest that the peer support program is acceptable to physicians and can be easily and feasibly implemented within a health care organization. The structured program development and implementation can be adopted by other organizations in support of emerging needs and challenges.

Increasing the Repertoire for Depression Care: Methods and Challenges of a Randomized Controlled Trial of Peer Support for Vulnerable Older Adults.

OBJECTIVE: Low-income White and older adults of color face barriers to depression care. Our purpose is to describe the methods and challenges encountered during the implementation of a randomized controlled trial to test the effectiveness of a peer support depression care intervention for low-income White and older adults of color during the COVID-19 pandemic. METHODS: Peer Enhanced Depression Care (Peers) is an 8-week community-based intervention that uses peer mentors who are trained and supervised to provide social support and self-care skills to depressed older adults. The effectiveness of the intervention in reducing depression will be evaluated by following a sample of older adults recruited in the community over a 12-month period. Target enrollment is 160 older adults. We hypothesize that participants randomized to the Peer Enhanced Depression Care intervention will experience greater decrease in depressive symptoms compared to participants randomized to the social interaction control. We provide lessons learned regarding the recruitment of BIPOC and White low-income older adults and peer mentors during the COVID-19 pandemic. RESULTS: Recruitment challenges occurred in primary care clinics that were unable to accommodate recruitment efforts during the pandemic. This led to focused outreach to community-based organizations serving older adults. Challenges to participant recruitment have included barriers related to stigma, distrust, as well as unfamiliarity with research. Peer mentor recruitment was facilitated by existing government-supported resources. CONCLUSIONS: This study will provide knowledge regarding the effectiveness, mechanism, and processes of delivering an informal psychosocial intervention such as peer support to a vulnerable older adult population.

Accompanying patients in clinical oncology teams: Reported activities and perceived effects.

INTRODUCTION: Since 2018, four establishments in Quebec, Canada, have decided to implement the PAROLE-Onco programme, which introduced accompanying patients (APs) in healthcare teams to improve the experience of cancer patients. APs are patient advisors who have had a cancer treatment experience and who conduct consultations to complement the service offered by providing emotional, informational and educational support to patients undergoing treatments (e.g., radiotherapy, chemotherapy, surgery), mostly for breast cancer. We aimed to explore the evolution of APs' perspectives regarding their activities within the clinical oncology teams as well as the perceived effects of their intervention with patients, the clinical team and themselves. METHODS: A qualitative study based on semistructured interviews and focus groups was conducted with APs at the beginning of their intervention (T1) and 2 years afterwards (T2). The themes discussed were APs' activities and the perceived effects of their interventions on themselves, on the patients and on the clinical team. RESULTS: In total, 20 APs were interviewed. In T2, APs' activities shifted from listening and sharing experiences to empowering patients by helping them become partners in their care and felt generally more integrated into the clinical team. APs help patients feel understood and supported, alleviate stress and become partners in the care they receive. They also alleviate the clinical team's workload by offering a complementary service through emotional support, which, according to them, helps patients feel calmer and more prepared for their appointments with healthcare professionals. They communicate additional information about their patients' health journey, which makes the appointment more efficient for healthcare professionals. When APs accompany patients, they feel as if they can make a difference in patients' lives. Their activities are perceived by some as an opportunity to give back but also as a way of giving meaning to their own experience, in turn serving as a learning experience. CONCLUSION: By mobilizing their experiential knowledge, APs provide emotional, informational, cognitive and navigational support, which allows patients to be more empowered in their care and which complements professionals' scientific knowledge, thereby helping to refine their sensitivity to the patients' experiences. PATIENT OR PUBLIC CONTRIBUTION: Two patient-researchers have contributed to the study design, the conduct of the study, the data analysis and interpretation, as well as in the preparation and writing of this manuscript.