The effectiveness and sustainability of peer support interventions for persons living with HIV: a realist synthesis.

BACKGROUND: Peer support is an important supplement to medical resources for persons living with HIV (PLHIV). However, previous studies have shown mixed results about intervention effects. It is necessary to explain the mechanism of peer support interventions' effectiveness and sustainability to help design more valid peer support interventions. OBJECTIVE: To identify and explain the mechanisms that drive the effectiveness and maintain the sustainability of peer support interventions. METHODS: A preliminary theoretical framework was developed through a scoping review of the grey literature and international project frameworks in five professional websites. We then refined the framework by systematically searching evidence in databases including PubMed, EMBASE, Web of Science, ProQuest, CINAHL, CNKI and Wanfang. Qualitative methods were used to generate codes and themes relating to the studies' context, mechanisms and outcomes. We checked chains of inference (connections) across extracted data and themes through an iterative process. RESULTS: A total of 6345 articles were identified, and 52 articles were retained for final synthesis. The refined theoretical framework presents five areas of peer support, including informational support, instrumental support, emotional support, affiliational support and appraisal support; five types of outcomes that peer support can improve for PLHIV, including physiological outcomes, psychological outcomes, behavioural outcomes, cognitive outcomes and social outcomes; the effectiveness mechanism coding system from peer volunteers and the relationship between peer volunteers and PLHIV; and the sustainability mechanism coding system in terms of peer volunteers, PLHIV and study context. CONCLUSIONS: Given that peer support has huge potential human resources, that is, all the qualified PLHIV, irreplaceable advantages in dealing with barriers to HIV-related discrimination and potential comprehensive benefits for PLHIV, it is necessary to develop and organise more peer support projects for PLHIV. Our study highlights that the expansion of peer support projects should be based on their effectiveness and sustainability. PROSPERO REGISTRATION NUMBER: CRD42022339079.

Psychometric properties of measurement tools of active aging: A systematic review.

BACKGROUND: Active aging has become a global goal under the current aging situation. Accurate and reproducible assessment tools are prerequisites to robust and reliable results for prevalence evaluation, associated factor exploration, and intervention effect assessment. However, there remains no systematic review to summarize all active aging assessment tools and report their psychometric properties. OBJECTIVE: To identify and assess the psychometric properties of patient-reported outcome measures of active aging in older adults. DESIGN: Systematic review of measurement properties using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) methodology. METHODS: Eight databases (PubMed, EMBASE, CINAHL, Web of Science, Cochrane library, ProQuest Dissertations and Theses, CNKI, and Wanfang) were searched from January 2002 to February 2022. Studies that aim to validate patient-reported outcome measures of active aging in older adults aged 60 and over and report one or more psychometric properties were eligible for this systematic review. Methodological quality was assessed using the COSMIN Risk of Bias Checklist. We used the COSMIN criteria to summarize and rate the psychometric properties of each patient-reported outcome measure. A modified Grading, Recommendations, Assessment, Development, and Evaluation system was used to assess the certainty of evidence. RESULTS: Twenty studies reported on the psychometric properties of 18 identified patient-reported outcome measures. Of the 20 included studies, seven explored more than five psychometric properties. Limited information was retrieved on cross-cultural validity/measurement invariance, reliability, criterion validity, hypothesis testing for construct validity, measurement error, and responsiveness. High-quality evidence on psychometric properties was provided for the Active Aging Scale and individual-level Active Aging Index. CONCLUSIONS: The findings from the included studies highlighted that the Active Aging Scale and individual-level Active Aging Index are strongly recommended to evaluate active aging in research and clinics based on the specific aims of assessment and the response burden for participants. Future studies should also develop or translate more active aging individual-level assessment tools and pay attention to the evaluation of psychometric properties. REGISTRATION: PROSPERO (CRD42021287395).