Experiences of older vulnerable people with ischemic heart disease and their peer mentors: A qualitative process evaluation.

AIM: To understand the content and context of a realized peer mentor intervention, and to explore how mentors and mentees experienced the intervention. DESIGN: The study was designed as a qualitative process evaluation of a 24-week peer mentor intervention. METHODS: Semi-structured individual interviews were conducted from November 2021 to May 2022 in a purposeful sample of older vulnerable people with ischemic heart disease, referred to as mentees (n = 13), and their peer mentors (n = 12). Thematic analysis was used to analyse, categorize and interpret interview data. RESULTS: Five themes captured the content and context of the peer mentor intervention as experienced by mentors and mentees. 'Takes one to know one', stressing the importance of the mentor-mentee matching process; 'Varying demand for mentors', illustrating the difficulties in predicting who has the greatest need for mentoring; 'Varying degree of familiarity', describing the mentor-mentee relationship as a continuum from formal mentor to informal friend; 'Putting the patient first', illustrating how mentors support mentees based on their personal experiences of successful recovery while letting the mentee set the pace and goals; and 'Varying view of success', showing how intervention success is perceived differently by mentors and mentees. CONCLUSIONS: The study provides new knowledge on how and under what contextual circumstances a mentor intervention works. These findings are important for the implementation of future peer mentor interventions to achieve successful peer mentor support. IMPLICATIONS AND IMPACT: Non-attendance and drop-out from the cardiac rehabilitation program are prevalent problems among older vulnerable people with cardiovascular disease. This study describes a low-cost peer mentor intervention that can support this group of patients. REPORTING METHOD: Standards for reporting qualitative research (SRQR) guided our study. PATIENT OR PUBLIC CONTRIBUTION: A board of cardiovascular patients have contributed to the development and implementation of the intervention being evaluated.

Peer-mentor support for older vulnerable myocardial infarction patients referred to cardiac rehabilitation: single-arm feasibility study.

BACKGROUND: The positive effects of cardiac rehabilitation are well established. However, it has an inherent challenge, namely the low attendance rate among older vulnerable patients, which illustrates the need for effective interventions. Peer mentoring is a low-cost intervention that has the potential to improve cardiac rehabilitation attendance and improve physical and psychological outcomes among older patients. The aim of this study was to test the feasibility and acceptability of a peer-mentor intervention among older vulnerable myocardial infarction patients referred to cardiac rehabilitation. METHODS: The study was conducted as a single-arm feasibility study and designed as a mixed methods intervention study. Patients admitted to a university hospital in Denmark between September 2020 and December 2020 received a 24-week peer-mentor intervention. The feasibility of the intervention was evaluated based on five criteria by Orsmond and Cohn: (a) recruitment capability, (b) data-collection procedures, (c) intervention acceptability, (d) available resources, and (e) participant responses to the intervention. Data were collected through self-administrated questionnaires, closed-ended telephone interviews, semi-structured interviews, and document sheets. RESULTS: Twenty patients were offered the peer-mentor intervention. The intervention proved feasible, with a low dropout rate and high acceptability. However, the original inclusion criteria only involved vulnerable women, and this proved not to be feasible, and were therefore revised to also include vulnerable male patients. Peer mentors (n = 17) were monitored during the intervention period, and the findings indicate that their mentoring role did not cause any harm. The peer-mentor intervention showed signs of effectiveness, as a high rate of cardiac rehabilitation attendance was achieved among patients. Quality of life also increased among patients. This was the case for emotional, physical, and global quality of life measures at 24-week follow-up. CONCLUSION: The peer-mentor intervention is a feasible and acceptable intervention that holds the potential to increase both cardiac rehabilitation attendance and quality of life in older vulnerable patients. This finding paves the way for peer-mentor interventions to be tested in randomized controlled trials, with a view toward reducing inequality in cardiac rehabilitation attendance. However, some of the original study procedures were not feasible, and as such was revised. TRIAL REGISTRATION: The feasibility study was registered at ClinicalTrials.gov ( ClinicalTrials.gov identification number: NCT04507529 ), August 11, 2020.