Men's peer support for mental health challenges: future directions for research and practice.

Peer support has a long history of helping people navigate mental health challenges and is increasingly utilized within men's mental health promotion initiatives. Despite considerable research conceptualizing and evaluating peer support in various contexts, little is known about the gendered dimensions of men's peer support and mutual help for mental health. This article provides an empirically informed commentary on men's peer support and informal help-seeking preferences to make recommendations for future directions for research and practice. Research examining men's peer support is emergent and the available evidence suggests that there is potential to conceptually align with many men's values and preferences for mental health help-seeking. Peer support offers a non-clinical, strength-based adjunct to professional support that may aid men in navigating a range of mental health challenges. Consideration must be given to the influence of gender socialization and men's diverse experiences with developing and maintaining peer relationships. It should not be assumed that authentic and supportive relationships will naturally form when men congregate together. As a growing number of interventions and programs emerge targeted at boys and men, there are important opportunities to leverage these health promotion efforts to encourage and coach men to engage in mutual help. Opportunities for research and practice are discussed to better understand and harness the health-promoting potential of peer support for men's mental health.

"A shoulder to lean on during your first year"-An exploration into a Canadian post-secondary institution's peer mentor program for varsity student athletes.

The transition period from high school to post-secondary can be particularly challenging for many, including varsity student-athletes (SAs). To better support SAs through this transitional experience, some institutions have created peer mentor programs. What is unclear, however, is the perceived value of these mentorship programs from the perspectives of multiple stakeholder positions. This paper contributes to the Scholarship of Teaching and Learning by presenting findings of a program evaluation that investigated the perceived value of a peer mentor program to its stakeholders. To accomplish this, semi-structured interviews were conducted with 30 participants to discuss SA's experiences with being a first year student, making the transition from high school to post-secondary studies, and also, to discuss their lived experiences with the peer mentor program developed for SAs. Using the findings from the inductive thematic analyses, the peer mentor program's effectiveness, areas of strengths, and areas of improvement are discussed to better align with the stakeholders' needs and experiences. Findings offer insights into a) the trials and tribulations of the first year SA experience, b) how peer mentor programs can better support SA's transition to post-secondary education, c) the benefits of conducting a program evaluation, and d) strategies to enhance the peer mentor program to better support students' needs.

Pursuing Success in a Hybrid PhD Nursing Program.

BACKGROUND: Little is known about hybrid PhD nursing students' experiences. METHOD: The purpose of this study was to describe and analyze the experiences of PhD nursing students in a hybrid program using a convergent mixed methods design. Recent nursing PhD alumni (n = 18), and current PhD students (n = 4) were recruited at a research-intensive university in the southwestern United States. RESULTS: Four metainferences were identified: (1) the facilitator of faculty as both advisors and mentors; (2) the facilitator of peers as support, motivation, and a source of advice that preceded advisors; (3) the barrier of receiving conflicting feedback from advisory and dissertation committees; and (4) the barrier of not understanding the PhD student process. CONCLUSION: Peer support is fundamental for hybrid PhD nursing student success; conflicting feedback and not understanding the process are significant barriers. Strategies are recommended to mitigate barriers to facilitate hybrid PhD nursing students' success. [J Nurs Educ. 2024;63(5):328-331.].

Heads Together Online Peer Education (HOPE): co-design of a family-led, video-based resource for families affected by paediatric acquired brain injury.

Background Many families of children with acquired brain injuries (ABI) desire opportunities to connect with peers who have shared similar experiences, but such opportunities are often unavailable. Heads Together Online Peer Education (HOPE) is a co-designed online video-based resource that provides information and early support to families following paediatric ABI. This study is part of a larger co-creation project using a community-based participatory research approach to develop and implement HOPE for families impacted by paediatric ABI in Australia. This study aimed to explore parents' and clinicians' perspectives regarding HOPE's usability, acceptability, and future implementation. Methods Parents and clinicians were recruited from a state-wide, interdisciplinary rehabilitation service. Parents were eligible to participate if their child had sustained an ABI within 2 years of recruitment. Participants accessed HOPE, completed the System Usability Scale (SUS), and participated in a semi-structured interview. Transcripts were analysed using inductive content analysis. Results Ten parents and 13 rehabilitation clinicians participated. Average SUS scores were 80.5/100 and 81.73/100, respectively. Participants were satisfied with HOPE's family-centred content and delivery. They expressed having benefited from using HOPE and offered suggestions for its optimisation. Finally, participants reflected on how HOPE could be introduced to and used by families, and its potential usefulness in educating others about paediatric ABI. Conclusions HOPE was developed through a family-led co-design process and aims to provide information and support to families in the early stages following paediatric ABI. This study's findings demonstrate HOPE's usability and acceptability from end-users' perspectives and will guide implementation.

A Web-Based Peer Support Network to Help Care Partners of People With Serious Illness: Co-Design Study.

BACKGROUND: Care partners of people with serious illness experience significant challenges and unmet needs during the patient's treatment period and after their death. Learning from others with shared experiences can be valuable, but opportunities are not consistently available. OBJECTIVE: This study aims to design and prototype a regional, facilitated, and web-based peer support network to help active and bereaved care partners of persons with serious illness be better prepared to cope with the surprises that arise during serious illness and in bereavement. METHODS: An 18-member co-design team included active care partners and those in bereavement, people who had experienced serious illness, regional health care and support partners, and clinicians. It was guided by facilitators and peer network subject-matter experts. We conducted design exercises to identify the functions and specifications of a peer support network. Co-design members independently prioritized network specifications, which were incorporated into an early iteration of the web-based network. RESULTS: The team prioritized two functions: (1) connecting care partners to information and (2) facilitating emotional support. The design process generated 24 potential network specifications to support these functions. The highest priorities included providing a supportive and respectful community; connecting people to trusted resources; reducing barriers to asking for help; and providing frequently asked questions and responses. The network platform had to be simple and intuitive, provide technical support for users, protect member privacy, provide publicly available information and a private discussion forum, and be easily accessible. It was feasible to enroll members in the ConnectShareCare web-based network over a 3-month period. CONCLUSIONS: A co-design process supported the identification of critical features of a peer support network for care partners of people with serious illnesses in a rural setting, as well as initial testing and use. Further testing is underway to assess the long-term viability and impact of the network.

Parent Peer Advocacy, Mentoring, and Support in Child Protection: A Scoping Review of Programs and Services.

Objective: Parent peer advocacy, mentoring, and support programs, delivered by parents with lived child protection (CP) experience to parents receiving CP intervention, are increasingly recognized internationally as inclusive practices that promote positive outcomes, but little is known about what shared characteristics exist across these types of programs and what variations may exist in service delivery or impact. This scoping review examines 25 years (1996-2021) of empirical literature on these programs to develop a systematic mapping of existing models and practices as context for program benefits and outcome achievement. Method: Studies were selected using a systematic search process. The final sample comprised 45 publications that addressed research on 24 CP-related parent peer advocacy and support programs. Data analysis explored how programs were studied and conceptualized and examined their impact on parents, professionals, and the CP system. Results: Substantial variation in program settings, target populations, aims, advocate roles, and underlying theoretical frameworks were identified. Across program settings, existing empirical evidence on impact and outcomes also varied, though positive impacts and outcomes were evident across most settings. Conclusions: Findings from this review highlight the need to account better for parent peer advocacy and support program variations in future practice development to ensure alignment with inclusive and participatory principles and goals. Future research is also needed to address current knowledge gaps and shed light on the impact of these differences on individual, case, and system outcomes.

Peer mentoring in pharmacy programs: Recommendations for implementation based on a review of available literature.

BACKGROUND: Stress experienced by pharmacy students is on the rise and is negatively impacting student success. Pharmacy accreditation standards encourage schools to promote student success and well-being. Peer to peer student support is a largely under-investigated strategy to address this. The objective of this manuscript is to conduct a literature review on the development of peer mentoring programs for pharmacy students and describe best practices for successful implementation into pharmacy programs. METHODS: This literature review identified studies using major databases, including PubMed, Embase, International Pharmaceutical Abstracts, and Education Resources Information Center. Search terms included [(peer mentor*) AND pharmacy]. Any study that involved peer assessment, peer tutoring, or peer learning within a course, faculty mentors only, non-pharmacy students, and/or did not implement a mentor-mentee relationship, was excluded. RESULTS: Three studies met the criteria for inclusion. Mentorship programs varied with regard to duration, mentor recruitment, participant incentives, and overall structure. Various methods of analyses were employed. Despite major differences between the included studies, three themes were identified regarding development of peer mentoring programs: participation, support, and pairing. Active engagement led to higher perceived benefit and both mentors and mentees found the programs beneficial, agreed to recommend the programs to others, and provided positive feedback. IMPLICATIONS: Successful mentoring programs should aim to incorporate the following characteristics to some degree: mandatory participation by mentor and mentee as well as support for mentors with training and faculty oversight. Peer mentoring programs have a positive impact on participants. More studies are needed to assess the effects of peer mentoring in pharmacy programs. This is the first known review of peer mentoring within pharmacy programs and identifies a gap in knowledge in this area. There is a paucity of data surrounding peer mentoring in pharmacy and its potential value as a tool to improve student well-being.

[L'Atelier créa: a therapeutic mediation group for neonatal parents]. / L'Atelier créa : un groupe thérapeutique à médiation pour les parents en néonatalogie.

The parents of a baby hospitalized in a neonatal unit are confronted with the trauma of premature birth. L'Atelier créa, a creatively-mediated peer group, was designed to give them a space in which to meet and share their experiences. It's a time for talking, imagining and dreaming about the baby. This group is also a form of passage, taking the place of ritual, allowing access to the parent-baby triad, in this sometimes so inhospitable universe.

Assessing the perceived value of a user-led educational intervention to support recovery in a Swedish psychiatric organization: A qualitative case study.

INTRODUCTION: Many people with mental health issues recover and re-establish their identity and find hope and meaning in life, irrespective of symptom burden. Recovery can be supported through learning and education, aiming at strengthening self-management and coping skills. Such education offered by peers with lived experience is rare and scarcely reported. The aim was to assess the perceived value of an educational intervention, called the Patient School (PS), organized within a psychiatry organization by employed patient peers with lived experience. METHODS: A qualitative case study based on interviews with people with mental health issues (n = 8), peer-organizers (n = 4) and healthcare professionals (n = 4), and documents such as schedules and educational materials were used. First, the interviews were transcribed and analyzed using inductive conventional content analysis. Second, the findings were synthesized into a programme theory, illustrated in a logic model. RESULTS: The perceived value of the PS was related to the willingness of peer-organizers to share their own experiences, a sense of belonging, sharing with like-minded and new knowledge, practical skills, roles and attitudes acquired. These experiences were empowering, decreased stigma and reassured user participants that one's identity is not defined by mental health issues. This increased self-confidence paves the way for increased self-management and creates a potential for a more efficient use of healthcare services. CONCLUSION: We conclude that this PS, organized within a psychiatry organization by salaried peers, achieved the same positive results as those reported in the literature and showed the value of having peer-organizers being part of the staff. PATIENT OR PUBLIC CONTRIBUTION: This research was performed in a partnership between academic researchers and persons with user experience of psychiatric services, engaged in the educational intervention in the focus of the study. The research plan was co-designed, and the analysis of the data collected was performed in collaboration. The participation of the co-researchers with user experience gave the project team access to the study site, provided the team with insights into to study context and contributed with an understanding promoting the interpretation of the findings.

The effectiveness of interprofessional peer-led teaching and learning for therapeutic radiography students and Speech and Language Therapy students.

BACKGROUND: Therapeutic Radiographers (RT) and Speech and Language Therapists (SLT) work closely together in caring for people with head and neck cancer and need a strong understanding of each others' roles. Peer teaching has been shown to be one of the most effective methods of teaching; however, no studies to date, have involved RT and SLT students. This research aims to establish the effectiveness and perceptions of peer-led teaching between undergraduate RT and SLT students in Ulster University. METHODS: Twenty SLT students and 14 RT students participated. Knowledge tests were taken online before the peer-led teaching session (T1), after the session (T2) and 3 months later (T3). Students' perceptions of the experience were collected at the end of the session. Wilcoxon signed-rank tests were used to analyse the impact of the intervention on knowledge scores. Qualitative content analysis was used for open text response data. RESULTS: RT students' own professional knowledge score at T2 was statistically significantly higher than the score at T1; the score at T3 was not deemed to be statistically significantly higher. RT students' SLT knowledge score at T2 and T3 was found to be statistically significantly higher than the score at T1. SLT students' own professional knowledge score was not statistically significantly higher at T2 or T3 than T1. They did have a statistically significantly higher score at T2 on the RT test, but score at T3 was not deemed to be statistically significantly higher. The majority of students across both professions agreed or strongly agreed that the peer-led teaching experience had a positive impact on their learning. CONCLUSION: This investigation highlights the benefits of an interprofessional peer-led teaching intervention for RT and SLT students and the findings add to the evidence of more objective study of knowledge gain as a result of interprofessional peer teaching.

Informal peer support for rural doctors.

INTRODUCTION: Practising medicine exposes physicians to emotionally difficult situations, which can be devastating, and for which they might be unprepared. Informal peer support has been recognised as helpful, although this phenomenon is understudied. Hence, it is important to develop a better understanding of the features of helpful informal peer support from the experiences of physicians who have successfully moved through such difficult events. This could lead to new and potentially more effective ways to support struggling physicians. METHODS: Rural Canadian generalist physicians were interviewed. Using a hermeneutic phenomenological approach, data analysis was oriented towards understanding features of helpful informal peer support and the meanings that participants derived from the experience. RESULTS: Eleven rural generalist physicians took part. Peer support prompted the processing of difficult emotional experiences, which initially seemed insurmountable and career-ending. Participants overcame feelings of emotional distress after even brief encounters of informal peer support. Most participants described the support they received as vitally important. After the peer support encounter, practitioners no longer thought of leaving medical practice and felt more able to handle such difficulties moving forward. CONCLUSIONS: Informal peer support enabled recipients to move through an emotionally difficult experience. Empathy, shared vulnerability and connection were the part of the peer support encounter. In addition, the support offered benefits which are known to help physicians not only process emotionally difficult events but also to acquire 'post-traumatic growth'. Practitioners, healthcare leaders and medical educators all have roles to play in enabling the conditions for informal peer support to flourish. INTRODUCTION: La pratique de la médecine expose les médecins à des situations émotionnellement difficiles, qui peuvent être dévastatrices, et auxquelles ils ne sont pas préparés. Le soutien informel par les pairs a été reconnu comme utile, même si ce phénomène est peu étudié. Il est donc important de mieux comprendre les caractéristiques du soutien informel par les pairs à partir des expériences de médecins qui ont réussi à traverser des événements aussi difficiles. Cela pourrait conduire à de nouvelles façons, potentiellement plus efficaces, de soutenir les médecins en difficulté. MTHODES: Onze médecins généralistes canadiens ruraux ont été interrogés. En utilisant une approche phénoménologique herméneutique, l'analyse des données a été orientée vers la compréhension des caractéristiques du soutien informel utile par les pairs et des significations que les participants ont tirées de l'expérience. RSULTATS: Le soutien des pairs a incité à vivre des expériences émotionnelles difficiles, qui semblaient au départ insurmontables et mettant fin à une carrière. Les participants ont surmonté leurs sentiments de détresse émotionnelle après même de brèves rencontres de soutien informel par leurs pairs. La plupart des participants ont décrit le soutien qu'ils ont reçu comme étant d'une importance vitale. Après la rencontre de soutien par les pairs, les praticiens ne pensaient plus à quitter la pratique médicale et SE sentaient plus capables de faire face à de telles difficultés à l'avenir. CONCLUSION: Le soutien informel par les pairs a permis aux bénéficiaires de traverser une expérience émotionnellement difficile. L'empathie, la vulnérabilité partagée et la connexion faisaient partie de la rencontre de soutien par les pairs. En outre, le soutien a offert des avantages connus pour aider les médecins non-seulement à gérer des événements émotionnellement difficiles, mais également à acquérir une 'croissance post-traumatique'. Les praticiens, les dirigeants des soins de santé et les enseignants en médecine ont tous un rôle à jouer pour permettre aux conditions propices au soutien informel par les pairs de s'épanouir.

'Getting addicted to it and losing a lot of money it's just like a hole.' A grounded theory model of how social determinants shape adolescents' choices to not gamble.

BACKGROUND: Gambling abstinence when underage lowers the risk of harmful gambling in later life. However, little research has examined why many young people refrain from gambling, even though this knowledge can inform protective strategies and lower risk factors to reduce underage gambling and subsequent harm. This study draws on the lived experience of adolescent non-gamblers to explore how social determinants while growing up have shaped their reasons and choices to not gamble. METHODS: Fourteen Australian non-gamblers, aged 12-17 years, participated in an in-depth individual interview (4 girls, 3 boys) or online community (4 girls, 3 boys). Questions in each condition differed, but both explored participants' gambling-related experiences while growing up, including exposure, attitudes and behaviours of parents and peers, advertising, simulated gambling and motivations for not gambling. The analysis used adaptive grounded theory methods. RESULTS: The grounded theory model identifies several reasons for not gambling, including not being interested, being below the legal gambling age, discouragement from parent and peers, concern about gambling addiction and harm, not wanting to risk money on a low chance of winning, and moral objections. These reasons were underpinned by several social determinants, including individual, parental, peer and environmental factors that can interact to deter young people from underage gambling. Key protective factors were parental role modelling and guidance, friendship groups who avoided gambling, critical thinking, rational gambling beliefs, financial literacy and having other hobbies and interests. CONCLUSIONS: Choices to not gamble emanated from multiple layers of influence, implying that multi-layered interventions, aligned with a public health response, are needed to deter underage gambling. At the environmental level, better age-gating for monetary and simulated gambling, countering cultural pressures, and less exposure to promotional gambling messages, may assist young people to resist these influences. Interventions that support parents to provide appropriate role modelling and guidance for their children are also important. Youth education could include cautionary tales from people with lived experience of gambling harm, and education to increase young people's financial literacy, ability to recognise marketing tactics, awareness of the risks and harms of gambling, and how to resist peer and other normalising gambling influences.

Ethnic Racial Identity Development and Self-Esteem among Native American Adolescents: The Mediating Role of Peer Belonging.

While ethnic racial identity (ERI) development is associated with a variety of psychological well-being outcomes, the mechanisms through which this association operates is yet to be fully explained. During adolescence, social belonging is a developmentally salient process that can play a key role in how ERI impacts well-being. We sought to explore the mediating role of belonging to peer networks in the association between ERI and self-esteem among Native American adolescents. In this cross-sectional, mediational study, we used survey data from 317 Native American students attending a reservation high school (46.9% female; M age =16). Students' levels of ERI development were measured by combining items from two scales pertaining to ethnic identity development and racial identity. We employed a structural equation modeling approach to explore the mediating role of peer belonging in the association between ERI and self-esteem. Results suggest that our 4-item index of peer belonging was an acceptable measure of this construct. Further, the significant indirect effect of peer belonging explains a notable portion (ß=.22, p ≤ .05) of the total effects of ERI on self- esteem (ß=.54, p ≤ .05). This finding suggests that higher levels of ERI achievement contribute to higher levels of peer belongingness, which in turn lead to improved self-esteem among students. Implications for research and practice are discussed.

Transformative Peer Connections: Early Experiences From the ASCO Palliative Care Community of Practice.

The integration of palliative care into routine oncology practice is the standard of care by most leading cancer organizations. Palliative medicine helps to deliver higher quality of care at a lower cost. However, there are barriers to implementing palliative oncology at many institutions for myriad reasons. In this article, we discuss an innovative strategy that ASCO implemented called the Communities of Practice (CoP). We share our experiences as the Palliative Care CoP and how our group seeks to develop processes and structures to collectively promote systemic change and enhance palliative care delivery for people with cancer. Our Palliative Care CoP engages with senior leaders, administrators, and those in power to achieve a shared vision of delivering holistic health care for people with serious illness. We continue to evolve to meet our members' growing needs by addressing eight main domains: (1) increasing palliative care education and resources; (2) creating opportunities for global palliative care research; (3) providing peer mentorship and community building; (4) engaging with patient advocates; (5) supporting and developing interdisciplinary teams; (6) assisting with professional development and identity formation, especially for trainees and early career faculty; (7) extending our outreach through social media; and (8) enhancing the clinical practice of palliative oncology. The ASCO CoP has been a vital forum to realize ASCO's mission of conquering cancer and advancing the Art and Science of Cancer Care: From Comfort to Cure.

Decentralised same day test and treatment of hepatitis C levering existing peer support networks among men who inject drugs: feasibility and effectiveness.

BACKGROUND: Prevalence of hepatitis C virus (HCV) infection among people who inject drugs in the state of Manipur, India, is 43%; however, access to care is poor. We piloted a Community-led and comprehensive hepatitis care model that included same-day HCV treatment at drug treatment centres. METHODS: Screening was conducted through venipuncture samples collected by community peer PWID, using HCV antibody (HCV Ab) rapid screening and hepatitis B virus (HBV) surface antigen (HBsAg) rapid diagnostic tests. Reactive HCV Ab samples were tested for HCV RNA using near point-of-care Truenat® HCV on Truelab® Quattro. Eligible HCV RNA-positive participants were treated on the same day using direct-acting antivirals and followed for sustained virologic response (SVR). HBsAg-negative participants received rapid HBV vaccination regimen while those positive for HBsAg were tested for DNA and referred for treatment. RESULTS: Between November 2021 and August 2022, 643 individuals were approached and 503 consented and were screened. All screened were males with history of injection drug use, and a median age of 27 years (IQR 23-32). Of the 241 (47.9%) HCV Ab reactive all underwent RNA testing and 156 (64.7%) were RNA detectable. Of those with viraemia, 155 (99.4%) were initiated on treatment with 153 (98.1%) on same day, with 2 (1.2%) HBsAg positive and waiting for HBV DNA results. Among those 153, median time from HCV Ab screening to treatment was 6 h 38 min (IQR 5 h 42 min-8 h 23 min). In total 155 (100%) completed HCV treatment, of those 148 (95.5%) completed SVR testing and 130 (87.8%) achieved SVR12. 27 (5%) participants were HBsAg-positive, 3 (11.1%) were also living with HCV viraemia; 443 (97.6%) were eligible for vaccination and 436 (98.4%) received all 3 vaccine doses. CONCLUSION: Community-led hepatitis care incorporating same day "test and treat" for HCV was feasible and effective. HBV screening identified a large proportion who were unvaccinated. Peer support extended resulted in ensuring compliance to care and treatment cascade and completing all the three doses of HBV vaccination. As the screening, diagnostics infrastructure and vaccine are available in most countries with national viral hepatitis programs also in place, our model can be adapted or replicated to progress towards global elimination targets.

Peer-led stay interviews to connect employees and develop retention strategies.

ABSTRACT: Stay interviews can strengthen employee engagement and increase retention. This quality improvement project aimed to determine nurses' motivations for staying on their current unit by conducting peer-led stay interviews. Participants responded positively to the stay interview process.

How peer relationships affect academic achievement among junior high school students: The chain mediating roles of learning motivation and learning engagement.

BACKGROUND: Despite the recognition of the impact of peer relationships, learning motivation, and learning engagement on academic achievement, there is still a gap in understanding the specific mechanisms through which peer relationships impact academic achievement via learning motivation and learning engagement. METHODS: This study aims to investigate how peer relationships affect junior high school students' academic achievement through the chain mediating roles of learning motivation and learning engagement, employing the self-system model of motivational development as the theoretical framework. In January 2024, 717 participants were selected from two middle schools in eastern China (mean age = 13.49 years, SD = 0.5). The data analysis in this study was performed using the structural equation model (SEM) in AMOS 24.0 and SPSS 24.0. RESULTS: The results showed that peer relationships were directly and significantly related to junior high school students' academic achievement, and that peer relationships were indirectly and positively related to junior high school students' academic achievement via learning motivation and learning engagement respectively. The results also revealed a significant indirect and positive relationship between peer relationships and junior high school students' academic achievement, mediated by the sequential mediating roles of learning motivation and learning engagement. Moreover, the path "peer relationship→learning motivation→academic achievement" has the strongest indirect effect. CONCLUSION: For junior high school students to achieve academic success, the appropriate interventions should be implemented to improve peer relationships, learning motivation, and learning engagement.

Evaluation of lived experience Peer Support intervention for mental health service consumers in Primary Care (PS-PC): study protocol for a stepped-wedge cluster randomised controlled trial.

BACKGROUND: The demand for mental health services in Australia is substantial and has grown beyond the capacity of the current workforce. As a result, it is currently difficult for many to access secondary healthcare providers. Within the secondary healthcare sector, however, peer workers who have lived experience of managing mental health conditions have been increasingly employed to intentionally use their journey of recovery in supporting others living with mental health conditions and their communities. Currently, the presence of peer workers in primary care has been limited, despite the potential benefits of providing supports in conjunction with GPs and secondary healthcare providers. METHODS: This stepped-wedge cluster randomised controlled trial (RCT) aims to evaluate a lived experience peer support intervention for accessing mental health care in primary care (PS-PC). Four medical practices across Australia will be randomly allocated to switch from control to intervention, until all practices are delivering the PS-PC intervention. The study will enrol 66 patients at each practice (total sample size of 264). Over a period of 3-4 months, 12 h of practical and emotional support provided by lived experience peer workers will be available to participants. Scale-based questionnaires will inform intervention efficacy in terms of mental health outcomes (e.g., self-efficacy) and other health outcomes (e.g., healthcare-related costs) over four time points. Other perspectives will be explored through scales completed by approximately 150 family members or carers (carer burden) and 16 peer workers (self-efficacy) pre- and post-intervention, and 20 medical practice staff members (attitudes toward peer workers) at the end of each study site's involvement in the intervention. Interviews (n = 60) and six focus groups held toward the end of each study site's involvement will further explore the views of participants, family members or carers, peer workers, and practice staff to better understand the efficacy and acceptability of the intervention. DISCUSSION: This mixed-methods, multi-centre, stepped-wedge controlled study will be the first to evaluate the implementation of peer workers in the primary care mental health care sector. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12623001189617. Registered on 17 November 2023, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=386715.

Preventing postnatal depression in new mothers using telephone peer support: protocol for the DAISY (Depression and AnxIety peer Support studY) multi-centre randomised controlled trial.

INTRODUCTION: Postnatal depression affects up to one in six new mothers in Australia each year, with significant impacts on the woman and her family. Prevention strategies can be complicated by a woman's reluctance to seek professional help. Peer support is a promising but inadequately tested early intervention. Very few trials have reported on the efficacy of peer support in the perinatal period and no study has been undertaken in Australia. We will explore if proactive telephone-based peer (mother-to-mother) support, provided to women identified as being at high risk of postnatal depression, impacts on clinically significant depressive symptomatology at 6 months postpartum. METHODS AND ANALYSIS: This is a protocol for a single-blinded, multi-centre, randomised controlled trial conducted in Melbourne, Australia. Eligible women will be recruited from either the postnatal units of two maternity hospitals, or around 4 weeks postpartum at maternal and child health centres within two metropolitan council areas. A total of 1060 (530/group) women will be recruited and randomly allocated (1:1 ratio) to either-usual care, to receive the standard community postpartum services available to them, or the intervention group, to receive proactive telephone-based support from a peer volunteer for 6 months, in addition to standard community services. PRIMARY OUTCOME: clinically significant depressive symptomatology at 6 months postpartum as measured using the Edinburgh Postnatal Depression Scale. SECONDARY OUTCOMES: symptoms of anxiety and/or stress, health-related quality of life, loneliness, perception of partner support, self-rated parenting, child health and development, infant feeding and health service use. The cost-effectiveness of the intervention relative to standard care will also be assessed. ETHICS AND DISSEMINATION: Ethics approval has been obtained from La Trobe University, St. Vincent's Hospital, the Royal Women's Hospital, Northern Health, Victorian Department of Health and Human Services and Victorian Department of Education and Training. Written informed consent will be obtained from all participants before randomisation. Trial results will be disseminated through peer-reviewed publications, conference presentations and a higher degree thesis. TRIAL REGISTRATION NUMBER: ACTRN12619000684123; Australian New Zealand Clinical Trials Registry.