Effects of Online and Recovery-oriented Peer Support Groups Facilitated by Peer Support Workers in Times of COVID-19

NCT04445324 | Unknown DMC

• 1 other identifier: 2021-2281
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

In times of pandemics, social distancing, isolation and quarantine exacerbate depression and anxiety as confined people are detached from their loved ones, deprived of personal liberties, and devoid of purpose owing to altered routine and livelihood (1,2). Those with pre-existing mental health problems or illnesses (MHPIs) might suffer from limiting interpersonal interactions that are central to their self-management, as well as reduced access to helpful but "non-essential" (often cancelled) psychiatric services (3). In response to this situation, this feasibility study of a trial consists of offering a transitional measure of online peer support for people suffering from (a) psychotic disorders or (b) anxiety and mood disorders, and to determine an effect size to this Peer Support Workers-delivered intervention in terms of both personal-civic recovery and clinical recovery (4). Peer Support Workers (PSWs) are persons with first-hand lived experience of MHPIs, and who are further along in their own recovery journey. As recommended by recovery-oriented best practices guidelines (5,6), upon training and certification they can provide supportive services when hired to fill such a paid specialty position directly in, or in conjunction with, current psychiatric services. Indeed, recovery focuses on how individuals can have more active control over their lives (agency). It is characterized by a search for the person's strengths and capacities, satisfying and meaningful social roles, and mobilizing formal and informal support systems. Peer support has thus become one predominant concept in the recovery paradigm and PSWs are specialized in peer support. Yet, not much is known about the efficacy of PSWs from a consumer's perspective of personal-civic recovery. The five principal research questions are whether this online intervention will have an impact in terms of (Q1) personal-civic recovery potential and (Q2) clinical recovery potential, (Q3) how these potentials can be impacted by the COVID-19 pandemic, (Q4) how the lived experience of people in recovery can be mobilized to cope with such a situation, and (Q5) how sex and gender considerations can be taken into account for the pairing of PSWs with service users, beyond considerations based solely on psychiatric diagnoses or specific MHPIs.

Conditions

Psychotic Disorders; Anxiety Depression

Outcome Measures

Primary Outcomes (3)

• Assessment of patients' current status : recovery (personal recovery)

  Recovery Assesment Scale (RAS). This is a 24-item questionnaire with 5-point Likert scales (1-2-3-4-5). Higher scores are positively correlated with higher levels of recovery. Minimum score = 24 : maximum score = 120.

  14 weeks

• Assessment of patients' current status : citizenship (personal recovery)

  Participating patients will fill out the Citizenship Measure (CM). This is a 23-item questionnaire with 5-point Likert scales (1-2-3-4-5). Higher scores are positively correlated with higher levels of citizenship. Minimum score = 23 : maximum score = 115.

  14 weeks

• Assessment of patients' current status : COVID-19 Stress Scales

  Participating with 5-point Likert scales (0-1-2-3-4). Higher scores are positively correlated with higher levels of COVID-related levels of stress. Minimum score = 0 : maximum score = 144.

  14 weeks

Secondary Outcomes (6)

• Assessment of patients' current status : anxiety (clinical recovery)

  14 weeks

• Assessment of patients' current status : depression (clinical recovery)

  14 weeks

• Assessment of patients' current status : alcohol dependence (clinical recovery)

  14 weeks

• Assessment of patients' current status : drug dependence (clinical recovery)

  14 weeks

• Assessment of patients' current status : psychosis (clinical recovery)

  14 weeks

Study Arms (2)

Transitional Online Peer Support Group (n=20)

EXPERIMENTAL

Trained Peer Support Workers (PSWs) from the Quebec Association of PSWs will organize and facilitate two series (one per condition) of 10 co-learning recovery workshops in a manner to simulate a typical peer support group. The difference of these transitional peer support groups to real community-based peer support groups is that (A) they will be facilitated by trained PSW, (B) they will have a personal-civic recovery focus, and (C) they will have a fixed, predetermined duration (10 weekly 60 to 90-minute online workshops). Typical Peer support groups bring together people who have similar concerns so they can explore solutions to overcome shared challenges and feel supported by others with similar experiences and who may better understand each other's situation. Peer support groups should ideally be independent from mental health and social services, although some services may facilitate and encourage the creation of (transitional) peer support groups, as is the case here. (WHO)

Behavioral: Transitional Online Peer Support Group (n=20); Other: Control Group (pharmacotherapy and/or psychotherapy, n=10)

Control Group (pharmacotherapy and/or psychotherapy N=10)

ACTIVE COMPARATOR

When individuals show up at the Emergency Department (T1) of the Montreal Mental Health University Institute, they are evaluated by the Evaluation and Liaison Module during their hospital stay when they are hospitalized. A diagnostic is established or confirmed by psychiatrists on the ward, and coded according to the World Health Organisation International Classification of Disease (ICD-10). According to these diagnoses, after discharge (T2) they are referred to a specialized outpatient clinic for an appointment (T3). Whether for (a) psychotic disorders or for (b) anxiety and mood disorders, pharmacotherapy or psychotherapy, or a combination of both, are then offered in accordance with guidelines of the Royal College of Physicians and Surgeons of Canada.

Other: Control Group (pharmacotherapy and/or psychotherapy, n=10)

Interventions

Transitional Online Peer Support Group (n=20) BEHAVIORAL

Trained Peer Support Workers (PSWs) from the Quebec Association of PSWs will organize and facilitate two series (one per condition) of 10 co-learning recovery workshops in a manner to simulate a typical peer support group. The difference of these transitional peer support groups to real community-based peer support groups is that (A) they will be facilitated by trained PSW, (B) they will have a personal-civic recovery focus, and (C) they will have a fixed, predetermined duration (10 weekly 60 to 90-minute online workshops). Typical Peer support groups bring together people who have similar concerns so they can explore solutions to overcome shared challenges and feel supported by others with similar experiences and who may better understand each other's situation. Peer support groups should ideally be independent from mental health and social services, although some services may facilitate and encourage the creation of (transitional) peer support groups, as is the case here. (WHO)

Transitional Online Peer Support Group (n=20)

Control Group (pharmacotherapy and/or psychotherapy, n=10) OTHER

When individuals show up at the Emergency Department (T1) of the Montreal Mental Health University Institute, they are evaluated by the Evaluation and Liaison Module during their hospital stay when they are hospitalized. A diagnostic is established or confirmed by psychiatrists on the ward, and coded according to the World Health Organisation International Classification of Disease (ICD-10). According to these diagnoses, after discharge (T2) they are referred to a specialized outpatient clinic for an appointment (T3). Whether for (a) psychotic disorders or for (b) anxiety and mood disorders, pharmacotherapy or psychotherapy, or a combination of both, are then offered in accordance with guidelines of the Royal College of Physicians and Surgeons of Canada.

Control Group (pharmacotherapy and/or psychotherapy N=10); Transitional Online Peer Support Group (n=20)

Eligibility Criteria

• Age: 18 Years+
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients diagnosed with (1) schizophrenia and psychotic disorders (ICD F20-F29), or
• Patients diagnosed with (2) anxiety or mood disorders (ICD F30-F49)

You may not qualify if:

• Active suicidal intentions
• Marked cognitive impairment
• No access to an electronic device with a webcam and microphone

Sponsors & Collaborators

• Centre de Recherche de l'Institut Universitaire en santé Mentale de Montréal: lead
• Yale University: collaborator

Study Sites (1)

CR-IUSMM

Montreal, Quebec, H1N 3M5, Canada

Location

Related Publications (1)

• Pelletier JF, Houle J, Goulet MH, Juster RP, Giguere CE, Bordet J, Henault I, Lesage A, De Benedictis L, Denis F, Ng R. Online and Recovery-Oriented Support Groups Facilitated by Peer Support Workers in Times of COVID-19: Protocol for a Feasibility Pre-Post Study. JMIR Res Protoc. 2020 Dec 18;9(12):e22500. doi: 10.2196/22500.

  PMID: 33259326 DERIVED

Related Links

• 1 . Hawryluck, L., Gold, W. L., Robinson, S., Pogorski, S., Galea, S., \& Styra, R. (2004). SARS control and psychological effects of quarantine, Toronto, Canada. Emerging infectious diseases, 10(7), 1206-1212.
• 2\. Jeong, H., Yim, H. W., Song, Y. J., Ki, M., Min, J. A., Cho, J., \& Chae, J. H. (2016). Mental health status of people isolated due to Middle East Respiratory Syndrome. Epidemiology and health, 38, e2016048.
• 3\. Venkatesh Ashwin, Edirappuli Shantal. (2020) Social distancing in covid-19: what are the mental health implications? BMJ 2020; 369 :m1379
• 4\. Pelletier JF, Corbière M, Lecomte T, Briand C, Corrigan P, Davidson L, Rowe M. (2015) Citizenship and recovery: two intertwined concepts for civic-recovery. BMC Psychiatry. 2015;15(37):1-7.
• 5\. van Vugt M, Kroon H, Delespaul P, Mulder C. (2012). Consumer-Providers in Assertive Community Treatment Programs: Associations With Client Outcomes. Psychiatr Serv. 2012;63(5):477-81.
• 6\. Mental Health Commission of Canada. (2015). Guidelines for Recovery-Oriented Practice
• 7\. Corrigan PW, Salzer M, Ralph RO, Sangster Y, Keck L. Examining the Factor Structure of the Recovery Assessment Scale. Schizophr Bull. 2004;30(4):1035-41.
• 8\. Rowe M, Clayton A, Benedict P, Bellamy C, Antunes K, Miller R, Pelletier, JF al. Going to the Source: Creating a Citizenship Outcome Measure by Community-Based Participatory Research Methods. Psychiatr Serv. 2012;63(5):445-50.
• 9\. Taylor, S., Landry, C. A., Paluszek, M. M., Fergus, T. A., McKay, D., \& Asmundson, G. (2020). Development and initial validation of the COVID Stress Scales. Journal of anxiety disorders, 72, 102232.
• 10\. Peer support groups by and for people with lived experience. WHO QualityRights guidance module. Geneva: World Health Organization; 2019.
• 11\. Yardley S, Teunissen P, Dornan T. Experiential learning: transforming theory into practice. Med Teach. 2012;34(2):161-164.
• 12\. Christens, B. D. Toward relational empowerment. American Journal of Community Psychology. 2012;50(1-2):114-28.
• STAI-Y-short: Marteau TM, Bekker H. The development of a six-item short form of the state scale of the Spielberger State - Trait Anxiety Inventory (STAI). British Journal of Clinical Psychology. 1992;31:301-306.
• PHQ-9: Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine. 2001;16:606-13.
• AUDIT: Babor et al. The AUDIT guidelines for use in primary care. 2nd ed. World Health Organization. 2001.
• DAST-10: Lam, L. P., Leung, W. C., Ip, P., Chow, C. B., Chan, M. F., Ng, J. W. Y., … Chin, R. K. H. Validation of the Drug Abuse Screening Test (DAST-10): A study on illicit drug use among Chinese pregnant women. Scientific Reports. 2015;5, 11420.
• PSQ: Bebbington PE, Nayani T. The Psychosis Screening Questionnaire. International Journal of Methods in Psychiatric Research. 1995;5: 11-19.
• WHODAS : Federici S, Bracalenti M, Meloni F, Luciano JV. World Health Organization disability assessment schedule 2.0: An international systematic review. Disabil Rehabil. 2017;39(23):2347-2380.

MeSH Terms

Conditions

Psychotic Disorders

Interventions

Control Groups

Condition Hierarchy (Ancestors)

Schizophrenia Spectrum and Other Psychotic Disorders; Mental Disorders

Intervention Hierarchy (Ancestors)

Epidemiologic Research Design; Epidemiologic Methods; Investigative Techniques; Research Design; Methods

Study Officials

• Jean-Francois Pelletier, PhD

  Research Centre - Montreal Mental Health University Institute

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: CARE PROVIDER, INVESTIGATOR
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor, Dpt of Psychiatry and Addictologye, University of Montreal

Study Record Dates

• First Submitted: June 22, 2020
• First Posted: June 24, 2020
• Study Start: August 25, 2020
• Primary Completion: August 25, 2020
• Study Completion: December 1, 2020
• Last Updated: November 23, 2020

Record last verified: 2020-10

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)