Facilitating Perinatal Access to Resources and Support (PeARS): a feasibility study with external pilot of a novel intervention

Background Up to 50% of women in areas of high socio-economic deprivation are at risk of developing depressive symptoms in pregnancy. Feeling well supported, can facilitate good mental health perinatally. A brief, innovative intervention to facilitate access to support and resources was developed and tested. This included one antenatal and one postnatal session, each with three evidence-based components: i) support from a non-professional peer to enable a woman to identify her needs; ii) information about local community services and signposting; and iii) development of a personalised If–Then plan to access that support. The aims were to evaluate the intervention and research methods for feasibility and acceptability for perinatal women, maternity care providers and peers, and provide preliminary effectiveness indications. Methods Pregnant women living in an area of high deprivation were recruited from community-based antenatal clinics and randomised to intervention or control condition (a booklet about local resources). Outcome measures included women’s use of community services by 34 + weeks gestation and 6 months postnatally; mental health and wellbeing measures, and plan implementation. Interviews and focus groups were conducted with women participants, providers, and peers. Data were analysed using framework analysis. Recruitment and retention of peers and participants, intervention fidelity, and acceptability of outcome measures were recorded. Results Peer facilitators could be recruited, trained, retained and provide the intervention with fidelity. One hundred twenty six women were recruited and randomised, 85% lived in the 1% most deprived UK areas. Recruitment constituted 39% of those eligible, improving to 54% after midwifery liaison. Sixty five percent were retained at 6 months postnatally. Women welcomed the intervention, and found it helpful to plan access to community services. Providers strongly supported the intervention philosophy and integrated this easily into services. The study was not powered to detect significant group differences but there were positive trends in community service use, particularly postnatally. No differences were evident in mental health and wellbeing. Conclusions This intervention was well received and easily integrated into existing services. Women living in highly deprived areas could be recruited, randomised and retained. Measures were acceptable. Peer facilitators were successfully trained and retained. Full effectiveness studies are warranted.

Development and Evaluation of Scales for Measuring Self-Efficacy and Teaching Beliefs of Students Facilitating Peer-Supported Pedagogies

Two scales measuring teaching self-efficacy and beliefs were developed from previous instruments for use with near-peer facilitators assisting with peer-supported pedagogies. Construct and face validity, measurement reliability, and factor structure were determined using a population of near-peer facilitators working in a peer-led team learning chemistry classroom at a large research-intensive postsecondary institution in the Southeast United States. Results suggest that the scales produce valid and reliable data. Teaching self-efficacy and beliefs were found to increase between pre and post administrations with small to medium effect sizes. The scales can provide a means to evaluate peer-supported pedagogies and as discussion points for faculty members training near-peer facilitators.

“We’re giving them the tools.” A qualitative study of nursing students working with Recovery College trainers to support student wellbeing

Purpose This paper aims to present a thematic analysis of student nurses’ experiences of an innovative collaboration between a mental health Recovery College and a nursing faculty, where Recovery College trainers’ expertise in co-production and peer facilitation were foregrounded. The aim of this study is to understand how nursing students experienced being peer facilitators of well-being workshops for fellow students following training with Recovery College trainers. Design/methodology/approach Thematic analysis of qualitative data from eight semi-structured interviews and a focus group with 15 participants. Findings The overarching theme that emerged was “The process of being a student Peer Facilitator”. Six themes emerged from the data: “What we brought”; “Conceptualisation”; “Adaptation”; “we’re giving them the tools”; “What we gained”; and “Development”. Practical implications Mental health nurse educators could forge collaborative relationships with Recovery College colleagues with a broader remit than service users’ “lived experience” of mental distress. Student nurses should be given opportunities to be peer facilitators and draw on their lived experience as student nurses as means of addressing their and their peers’ mental health. Originality/value Original findings were that the student experience of being a peer facilitator was different to their other experiences in education and clinical practice. They drew on their lived experience throughout and found that they learned skills to address their well-being through supporting other students to improve theirs.

Using web conferencing to engage Aboriginal and Torres Strait Islander young people in research: a feasibility study

Background While web conferencing technologies are being widely used in communication and collaboration, their uptake in conducting research field work has been relatively slow. The benefits that these technologies offer researchers for engaging with hard-to-reach populations are beginning to be recognised, however, the acceptability and feasibility of using web conferencing technology to engage Aboriginal and Torres Strait Islander young people in research is unknown. Objective This study aims to evaluate whether the use of web conferencing to engage Aboriginal and Torres Strait Islander young people in research is an acceptable and feasible alternative to conventional face-to-face methods. Methods Aboriginal and Torres Strait Islander young people aged between 18 and 24 years were recruited via emails, flyers and snowballing to participate in an Online Yarning Circle (OYC) about wellbeing conducted via web conferencing. Five young Aboriginal and Torres Strait Islander Australians were trained as peer facilitators and each conducted one or more OYCs with support from an experienced Aboriginal and Torres Strait Islander researcher. The OYCs were recorded and the researchers conducted post-OYC interviews with the facilitators. OYC recordings, facilitator interviews and researchers’ reflections about the method were analysed to assess acceptability and feasibility for use with this population. Results 11 OYCs were conducted with 21 participants. The evaluation focused on (a) acceptability of the method for participants and facilitators and (b) feasibility of data collection method and procedures for use in research. Our evaluation revealed good acceptability and feasibility of the method, with only minor challenges experienced, which were predominantly logistical in nature and related to scheduling, obtaining documentation of consent, and technical issues. These challenges were offset by the greater control over the level of engagement that was comfortable for individual participants and the greater ease with which they felt they could withdraw from participating. This shift in the traditional researcher-participant power dynamic was recognised by both participants and peer facilitators and was regarded as a support for Aboriginal and Torres Strait Islander young people’s participation in research. Conclusions The use of web conferencing to engage Aboriginal and Torres Strait Islander young people in research offers an acceptable and feasible alternative to face-to-face research methods. The benefits conferred by these technologies associated with yielding greater control and power to the research participant has broad relevance to research with marginalised populations.

A redesigned training and staff support programme to enhance job retention in employees with moderate-severe depression

Purpose Closing the treatment gap in depression is vital to prevent people from losing their jobs. Delivering group-based interventions at work could reach more employees than delivering 1:1 interventions in a clinical setting. This study aims to redesign a Treatment Programme to make it more acceptable and accessible for employees with depression. Design/methodology/approach A mixed-methods exploratory sequential design with a high level of stakeholder consultation was used to redesign an interdisciplinary Work-focussed Relational Group CBT Treatment Programme for moderate-severe depression. Qualitative data from focus groups and quantitative data from a small feasibility study were integrated to develop the new Training (and Staff Support) Programme (TSSP), which was fully specified and manualised in line with the Template for Intervention Description and Replication (TIDieR) for future delivery. Findings Focus groups identified a need for improved acceptability and accessibility of the tertiary preventative Work-focussed Relational Group CBT Treatment Programme. This programme was, therefore, simplified for delivery by peer facilitators at the worksite as an intervention for all employees rather than an indicated/targeted intervention for only those with symptoms/risk of depression. The TSSP comprised a compulsory trauma-informed educational/experiential workshop over four days plus optional open-ended, peer-led base groups set up and run by volunteer peer facilitators. Research limitations/implications The focus groups comprised a convenience sample who knew the researchers as a colleague or therapist, so there is a risk of selection or relationship bias. They were not involved in the data analysis which undermines the element of co-production and increases the risk of analytic or confirmation bias. Practical implications Delivering the new intervention in a group format will require peer facilitators to acquire skills in co-facilitation using a structured-directive leadership style and an awareness of the potential side effects of group-based interventions. Social implications The worksite TSSP provides a democratic learning space and empowers employees to stay at work by self-managing their symptoms and by challenging the interpersonal dynamics and organisational structures that might precipitate and perpetuate depression. Originality/value This intervention is fully specified and manualised with an explicit programme theory, unlike most universal worksite-based CBT programmes.

Using Web Conferencing to Engage Aboriginal and Torres Strait Islander Young People in Research: A Feasibility Study

Background: While web conferencing technologies are being widely used in communication and collaboration, their uptake in conducting research field work has been relatively slow. The benefits that these technologies offer researchers for engaging with hard-to-reach populations are beginning to be recognised, however, the acceptability and feasibility of using web conferencing technology to engage Aboriginal and Torres Strait Islander young people in research is unknown.Objective: This study aims to evaluate whether the use of web conferencing to engage Aboriginal and Torres Strait Islander young people in research is an acceptable and feasible alternative to conventional face-to-face methods. Methods: Aboriginal and Torres Strait Islander young people aged between 18-24 years were recruited via emails, flyers and snowballing to participate in an Online Yarning Circle (OYC) about wellbeing conducted via web conferencing. Five young Aboriginal and Torres Strait Islander Australians were trained as peer facilitators and each conducted one or more OYCs with support from an experienced Aboriginal and Torres Strait Islander researcher. The OYCs were recorded and the researchers conducted post-OYC interviews with the facilitators. OYC recordings, facilitator interviews and researchers’ reflections about the method were analysed to assess acceptability and feasibility for use with this population. Results: 11 OYCs were conducted with 21 participants. The evaluation focused on (a) acceptability of the method for participants and facilitators and (b) feasibility of data collection method and procedures for use in research. Our evaluation revealed good acceptability and feasibility of the method, with only minor challenges experienced, which were predominantly logistical in nature and related to scheduling, obtaining documentation of consent, and technical issues. These challenges were offset by the greater control over the level of engagement that was comfortable for individual participants and the greater ease with which they felt they could withdraw from participating. This shift in the traditional researcher-participant power dynamic was recognised by both participants and peer facilitators and was regarded as a support for Aboriginal and Torres Strait Islander young people’s participation in research.Conclusions: The use of web conferencing to engage Aboriginal and Torres Strait Islander young people in research offers an acceptable and feasible alternative to face-to-face research methods. The benefits conferred by these technologies associated with yielding greater control and power to the research participant has broad relevance to research with marginalised populations.

The impact of a peer-facilitated discussion initiative on international students’ learning experience in the context of internationalisation at home

Fostering skills development is one of the tenets of education. For a long time, the traditional binary teacher-student interaction was used as the sole approach to teaching and learning but it is now overwhelmingly regarded as insufficient. The present paper reports on an initiative based on the principles of peer learning. The discussion groups and one-to-one sessions in languages, facilitated by native speakers (NS) who are international students in the institution, were set-up to enable language learners to develop their oral skills. While the advantages of the activity for language learners are clear, it is not as easy to determine the benefits for the NS peer-facilitators. The study presents findings from questionnaires and interviews conducted with some of these NS peer-facilitators and discuss the reported impact of the initiative on these students. While personal growth and development of intercultural awareness feature strongly in the data analysis, an enhanced language learning experience and an influential factor in some participants’ educational and career paths are also revealed. These findings are explained with reference to relevant developments in the study abroad, volunteering and peer learning literature. We will conclude that the initiative is a positive tool for international students’ integration into the host institution and offers a novel way for them to socialise and engage in their new learning environment.