This randomized controlled non-inferiority trial explored the effectiveness of Seeking Safety (SS) delivered by peer providers compared to its delivery by licensed behavioral health clinicians. The study enrolled 291 adults with PTSD and/or substance use disorders. Data were collected at 3 and 6-months post start of treatment. With respect to long-term outcomes, at 6 months PTSD symptoms decreased by 5.1 points [95% CI (− 9.0, − 1.1)] and by 4.9 points [95% CI (− 8.6, − 1.1)] and coping skills increased by 5.5 points [95% CI (0.4, 10.6)] and by 5.6 points [95% CI (0.8, 10.4)], in the peer- and clinician-led groups, respectively. This study demonstrated non-inferiority of peer-delivered SS compared to clinician-delivered SS for reducing PTSD symptoms and similar outcomes for both groups with respect to coping skills. A confirmatory study on the effectiveness of peer-delivered trauma-specific services is warranted, especially given the potential for increasing access to such treatment in underserved rural communities.Electronic supplementary materialThe online version of this article (10.1007/s10597-019-00443-3) contains supplementary material, which is available to authorized users.

Peer providers have been associated with positive outcomes in behavioral health, but little is known about the perceived helpfulness of their services. We used a mixed-methods randomized controlled trial to compare the perceived helpfulness of seeking safety (SS) led by peer providers compared to its delivery by licensed behavioral health clinicians (including both a licensed alcohol and drug abuse counselor and licensed clinical mental health counselor). Participants (N ϭ 278) rated the helpfulness of 12 SS topics at the end of every session. A subset (n ϭ 245) of participants also rated the helpfulness of SS overall and its treatment components; 3 and 6 months following their first SS group. We also collected qualitative data to inform our understanding of the ways perceived helpfulness varied among participants in peer-led (PL) and clinician-led (CL) groups. Ratings of overall and topic-specific helpfulness were high among both groups, and while ratings were slightly higher among participants in PL groups, the difference was not significant. Participants in PL-SS rated certain treatment components significantly more helpful compared to participants in CL-SS, including the focus on learning coping skills (81.6% PL vs. 64.9% CL, p ϭ .020) and safety as a priority of treatment (81.6% PL vs. 61.5% CL, p ϭ .006). Because of the homogeneity of helpfulness ratings, the relationship between perceived helpfulness and treatment retention and outcomes could not be examined. Future research on this association is warranted.

Representation of diverse populations in health research enhances our ability to understand the factors that impact health, generalize results, implement findings, and promote social justice. The primary objective of the study was to understand the unique perspectives of frontline community health workers (CHWs) to identify actionable barriers and facilitators that may impact representation of diverse groups in health research. Focus groups with CHWs were conducted followed by thematic analysis. Results revealed five main themes: barriers/risks to research participation, facilitation of research, CHW roles, recommendations, and transparency. A novel finding was that some CHWs see themselves as both facilitators and gatekeepers. As facilitators, CHWs ensure their patient populations receive resources and benefit from being involved in research; as gatekeepers CHWs feel that they protect patient populations from experiencing further trauma, especially when engaging in research. Recognizing that in many communities there is a high reliance and trust with CHWs, can promote genuine and informed participation at all stages of research.

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Performing music in front of others can be stressful, even for experienced performers. The physiological effects of stress, namely, increases in cortisol and sympathetic nervous system activity, have been shown to have detrimental effects on cognition, particularly working memory. This study used an audition-like performance scenario to elicit a stress response in performers who differed in their degree of musical experience. We expected that participants with more musical experience would be better able to regulate their stress response, would report lower levels of anxiety, insecurity, and nervousness, and would show better working memory following the stressor, compared to participants with less musical experience. Although we did not find differences between more and less experienced performers in their sympathetic nervous system activity or their self-reported feelings of anxiety and nervousness, we did find some important differences: following the stressor, more experienced performers were less insecure, they showed better regulation of their cortisol response, and they demonstrated better working memory.