A Scoping Review of Interventions Delivered by Peers to Support the Resettlement Process of Refugees and Asylum Seekers

The aim of this scoping review is to conduct a systematic search of the literature as it pertains to interventions delivered by peers to refugees and asylum seekers during the resettlement process. A PRISMA-compliant scoping review based on Arskey and O'Malley's (2006) five steps was used. Four databases, Scopus, Embase, Ebsco, and ScienceDirect were searched for peer-reviewed articles published in English from 2000-2021. Studies were included if they reported on interventions, outcomes or the training received by adult peers to support refugees and asylum seekers during the resettlement process. Of an initial 632 journal articles retrieved, 14 met the inclusion criteria for this review. Most included studies were conducted in Western high-income countries, with the exception of one. Studies were heterogeneous in terms of the nationalities of peers and those receiving peer interventions; the outcomes reported on; the content of interventions, and the methodologies used. Findings suggest that peer interventions seem to be effective in addressing many of the challenges faced by refugees and asylum seekers. Community integration, acculturation and psychological distress are some of the key benefits. When such interventions are co-produced in participatory research involving refugees, asylum seekers and the civil society organisations that support this population, they are naturally culturally responsive and can therefore address issues relative to different ethnic needs during the resettlement process. This is the first scoping review to be conducted in this area and adds to what is a very limited body of research. Refugee, Asylum seeker, resettlement, scoping review

Co-developing peer interventions in health-related contexts: A case study from exercise referral

Objective: Peer support interventions can be successful in enhancing physical activity (PA) in a variety of health-related contexts. However, the evidence base remains equivocal, and ways to integrate structured peer support within the context of exercise referral schemes (ERSs) remain unexplored. In this regard, few studies consider the prospective acceptability of peer support interventions. Prior qualitative exploration can elicit insight into factors likely to influence peer intervention success, thus maximising the likelihood of developing and implementing effective peer support interventions. This study assessed the prospective acceptability of a peer support intervention for exercise referral. Design/Setting: Individual semi-structured interviews were conducted with 14 ERS clients ( n = 10) and providers ( n = 4) across two ERS sites in the North West of England, UK. Method: Interviews covered preferred demographic and personal characteristics of ERS peers and prospective peer roles. Interviews were analysed using thematic analysis. Results: A desirable ERS peer was perceived as someone who was positive and empathetic, with good interpersonal skills. ERS peers were considered to present a promising opportunity to enhance the accessibility of emotional, motivational and informational support among ERS clients while alleviating burden on ERS providers. Conclusion: Study findings have relevance to the integration of peer support in comparable ERS contexts, highlighting the value of developmental research to refine peer recruitment criteria and to facilitate ownership and support among providers across a variety of health-related contexts.

Student Intervention Against Homophobic Name-Calling: The Role of Peers, Teachers, and Inclusive Curricula

Encouraging bystander intervention is an effective strategy to prevent episodes of bullying victimization at school. Yet there remains a paucity of evidence on this behavior in situations of homophobic name-calling, a form of peer victimization aimed at mocking individuals based on their actual or perceived sexual orientation. The existing research has focused on intentionality rather than actual student intervention behaviors, and, of note, no previous studies have taken into consideration contextual factors at the classroom and school levels. The present study examined whether students’ observations of teacher and peer interventions against homophobic name-calling and perceptions of the representation of lesbian, gay, bisexual, and transgender (LGBT) issues in class are associated with student intervention behaviors against homophobic name-calling. A three-level multilevel approach was used to account for the nested nature of students’ experiences in classrooms and schools. The sample included 1,296 students (43.57% girls) recruited from 84 classrooms of 22 Italian public high schools. Preliminary analyses showed that the variability in students’ reports had more to do with which classrooms versus which schools students attend. Results from multilevel regressions indicated that students who observe teachers intervening during episodes of homophobic name-calling, and who perceive the representation of LGBT issues in class as positive, were more likely to intervene against homophobic name-calling and to observe other classmates intervene as well. Also, participants who observed other students intervening were more likely to intervene. These findings highlight the importance of the role of teachers in modeling classroom norms to encourage bystander interventions. Teachers can do so indirectly such as when providing a positive representation of LGBT issues in class, or directly when intervening to condemn episodes of homophobic name-calling. In addition, our results affirm the importance of peer influence in encouraging bystander interventions during episodes of homophobic name-calling.

Peer-to-peer health promotion interventions among African American men: a scoping review protocol

Background Health promotion efforts among African American men have been met with significant challenges and have produced limited results. Interventions that do not align with the values, perspectives, and preferences of African American men often produce less effective results. Research among African American men has provided compelling evidence that these men prefer informal networks of health support. Recent successful health promotion efforts among these men have benefited from peer-to-peer models of implementation. To date, no known scoping or systematic review of peer-to-peer health promotion interventions among African American men has been conducted. The goal of this scoping review is to understand the extent of, design, implementation, and use of peer-to-peer interventions to promote health, improve quality of life, and prevent disease among African American men. Methods A review of the literature will be performed in PubMED, EMBASE, PsycInfo, CINAHL, and Web of Science. The development of this protocol was guided by the work of Arksey and O’Malley and the PICOS statement. Reporting will be guided by the PRISMA-ScR checklist. Eligible studies include those testing the effects of a peer-to-peer health promotion intervention targeting African American men. A comparison group will not be required. For the purposes of the current review, “peers” will be limited to other African American men. An initial screening of the titles and abstracts of potentially eligible studies will be completed by two independent reviewers. The full text of records that appear to meet the eligibility criteria will be accessed and further screened. Data will then be extracted and collected using a custom Microsoft Excel spreadsheet. Extracted data will include authors’ name and publication year, target health issue(s), design of the intervention, components of the intervention, peer-led components of the intervention, peer role, length and type of training for peer leaders, intervention duration, frequency of the intervention, study design and number of participants, and main outcomes. Finally, results will be presented in table format and summarized in text format. Discussion Results will have implications for the design, implementation, and evaluation of health promotion interventions among African American men. Systematic review registration PROSPERO CRD42020198664

Voluntary sector interventions to address loneliness and mental health in older people: taking account of emotional, psychological and social wellbeing

Aims: (1) To explore the relationship between loneliness and mental health in older people accessing interventions delivered through the voluntary sector. (2) To understand how these interventions can take account of mental health, discussing the relative strengths of a number of different one-to-one and group-based interventions. Methods: Qualitative case study of Age Better in Sheffield (ABiS), an initiative to address loneliness and isolation among older people (aged above 50). 37 beneficiaries of voluntary sector interventions participated in the study: 17 had accessed a one-to-one intervention and 20 had accessed group-based activities. Results: One-to-one therapeutic interventions are beneficial when loneliness is associated with low psychological and emotional wellbeing stemming from trauma and other complex pre-existing issues that have left individuals unable to build social relationships and networks. One-to-one peer-to-peer interventions are beneficial for individuals whose loneliness is linked to low psychological and emotional wellbeing but for whom their issues are less complex. Group-based interventions are beneficial when loneliness is linked to social wellbeing and individuals want to build social networks and relationships and contribute to their community. Participants should be supported to access other forms of support if the benefits of the initial intervention are to be sustained. Conclusions: There is an interconnected relationship between loneliness and the emotional, psychological and social components of mental health that should be taken into account in the design of interventions. A range of one-to-one and group-based interventions are necessary to meet the varying needs and circumstances of older people experiencing loneliness. Public health commissioners should invest in an ecosystem of voluntary organisations providing different types of loneliness intervention if the epidemic of loneliness is to be addressed.

Effectiveness of Peer Support Interventions for Adolescents and Young Adults Living with HIV Globally

Background: Adolescents and young adults living with HIV (AYALHIV, ages 10-24) have poorer outcomes in care compared to other age groups. The global Treat All strategy aims to extend antiretroviral therapy (ART) to all individuals living with HIV. Efforts to improve outcomes in the AYALHIV population are essential to successfully achieving viral suppression and improving the long-term health outcomes of young people, and ultimately to ending the HIV pandemic. Peer support interventions are increasingly implemented by care programs, and are broadly favored by AYALHIV. This systematic review will evaluate the current evidence for quantitative effects of peer support interventions on AYALHIV treatment outcomes. Methods: We searched MEDLINE, Embase, Global Health, CINAHL Complete, Cochrane, and Scopus databases for papers published between 1994 and October 2019, in all languages and regions. Studies of the effect of peer support interventions for AYALHIV on measures of adherence or retention in care were included. Solely qualitative studies and those without a comparator or control were excluded. Three researchers screened the papers independently, and those meeting criteria were included. Abstracted variables included study characteristics, participant population, peer intervention characteristics, and outcomes. Results: The current evidence base for the effect of peer interventions for AYALHIV is very limited. Included studies were of small sample size, and primarily consisted of observational cohort studies with imperfect comparators. In initial analyses we find that studies of peer interventions have had mixed findings regarding the effect of such interventions on adherence to ART. By contrast, studies have consistently reported a favorable effect of peer interventions on increased retention in care among AYALHIV. Conclusion/Implications: Rigorous studies of interventions to improve outcomes among AYALHIV are urgently needed. Further analyses in this review will examine differences according to study population, design, or intervention characteristics, which may underlie variable effects identified.

Addressing financial strain through a peer-to-peer intervention in primary care

Background Financial strain is a key social determinant of health. As primary care organizations begin to explore ways to address social determinants, peer-to-peer interventions hold promise. Objective Our objective was to evaluate a peer-to-peer intervention focussed on financial empowerment delivered in primary care, in partnership with a social enterprise. Methods This intervention was hosted by a large primary care organization in Toronto, Canada. Participants were recruited within the organization and from local services. We organized three separate groups who met over 10 weekly in-person, facilitated sessions: millennials (age 19–29) no longer in school, precariously employed adults (age 30–55) and older adults near retirement (age 55–64). We applied principles of adult education and peer-to-peer learning. We administered surveys at intake, at exit and at 3 months after the intervention, and conducted three focus groups. Results Fifty-nine people took part. At 3 months, participants had sustained higher rates of optimism about their financial situation (54% improved from baseline), their degree of control (55% improved) and stress around finances (50% improved). In focus groups, participants reported greater understanding of their finances, that they were not alone in struggling with finances, and that it was useful to meet with others. One group continued to meet for several months after the intervention. Conclusions In this study, a peer-to-peer intervention helped address a key social determinant of health, likely through reducing stigma, providing group support and creating a space to discuss solutions. Primary care can host these interventions and help engage potential participants.