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Objective: To test the feasibility, receptivity, and preliminary effectiveness of peer support groups for emergency medicine physicians during the COVID-19 pandemic and gain a better understanding of their experiences with peer support.Methods: This pilot study used a quasi-experimental design to assess change in symptoms of distress, anxiety, depression and burn-out before and after participating in a virtual, group-based peer support intervention for a duration of 8 weeks. Pre-post change analyses were performed using two-sided, paired t tests. Feasibility was measured by attendance data to demonstrate the use of the intervention. Receptivity was measured using a global change rating and net promoter score at the end of each session and 8-week period, respectively. During the final session, qualitative data on physician experience was collected and then analyzed using conventional content analysis.Results: Twenty-four emergency medicine physicians participated in the pilot study.The attendance goal was met by 20 (24, 83%) physicians and 19 (22, 86%) physicians reported they would recommend peer support groups to a friend of colleague. Positive standardized response mean effect sizes indicated modest improvement in nine of 12 symptom measurements with marginal significance (p < 0.10) for improvement in guilt [20, Effect Size (ES) = 0.45] and depression (21, ES = 0.39). Qualitative findings revealed high overall benefit with few adverse impacts of participation. Conclusions:Results demonstrate high physician receptivity, feasibility, and benefit from participation in peer support groups. Promising signs of improvement in distress, anxiety, depression, and burn out symptoms warrant additional studies with larger sample sizes and more robust research designs to establish the evidence base for peer support in the physician population.

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Background:  The COVID-19 pandemic has placed a high psychological burden on frontline healthcare workers. Often quarantined away from their families and with little downtime to process their experiences, those on the frontlines of the pandemic are experiencing pronounced levels of distress and significantly elevated rates of burnout. Although many wellness and psychological resources are available to providers, there is low uptake and little is known about their effectiveness. In this study, we assess the impact of group-based peer support sessions on symptoms of acute distress, anxiety and depression, and provider burn out.    Methods:  An established peer support model is adapted for use with groups of frontline healthcare workers that will participate in 6 to 8 weekly group sessions using videoconferences. The study approach is a phased feasibility to research design. During the feasibility phase, we will initially test the intervention in 3 groups of 8 providers using a quasi-experimental, pre- post analysis of change. If preliminary results are positive, we will scale the intervention and progress to a more rigorous study design using a differences-in-differences approach to assess change over time between exposure and non-exposure groups. Outcomes will be measured at baseline, intervention completion, and 3- and 6- month follow ups. During the feasibility phase we will assess intervention fidelity and conduct qualitative analysis to assess the effects of the pandemic on work, family and social life.     Results:  This is a work in progress. At present we have recruited 28 emergency medicine physicians and residents with a target start date of August 1, 2020.    Potential Impact:  We anticipate the results of this study will provide evidence in support of a recent call for “the use of non-clinical mental health support, such as social or peer support” from the American College of Emergency Physicians in conjunction with 42 leading professional organizations in medicine. In addition, results may lead to advocacy for improved policies that mitigate against “fear of resultant loss of licensure, loss of income, or other career setbacks” for seeking mental health support.