A Pilot Feasibility Randomized Controlled Trial on the Ontario Brain Injury Association Peer Support Program

Abstract

Background: The long-term consequences of traumatic brain injury can create major barriers to community integration. Peer support represents a sustainable model of support across this transition. The objective of the current study was to determine the feasibility of conducting a randomized controlled trial on the Ontario Brain Injury Association Peer Support Program and the preliminary effectiveness of the program on community integration, mood, health-related quality of life, and self-efficacy; Methods: A pilot feasibility randomized controlled trial with an embedded qualitative component was conducted. Mentees with moderate-to-severe traumatic brain injury (n = 13) were randomized to a weekly intervention or waitlist control group. Interviews were conducted with a subset of mentees and peer mentors (n = 10). Integration of the quantitative and qualitative data was completed using a joint display approach; Results: No statistically significant results were found for community integration, mood, or self-efficacy; however, changes in these outcomes were accompanied by moderate-to-large effect sizes. Within health-related quality of life, the mean pain score of the intervention group was significantly lower than that of the control group at the two-month timepoint but not at completion. Interviews revealed proximal improvements in knowledge, skills, and goals, and identified two domains related to trial acceptability: (1) environmental context and resources, and (2) reinforcement; Conclusions: Given the conceivable importance of proximal improvements in domains such as knowledge, skills, and/or goals for the attainment of more distal outcomes, modifications to the existing Peer Support Program may be warranted. The introduction of program recommendations which promote discussion around particular domains may help facilitate long-term improvements in health outcomes.

Community Support for Injured Patients: A Scoping Review and Narrative Synthesis

“…Thirteen of 25 studies concluded that shared educational or didactic material in the group was a benefit of participation (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33). Eight studies reported that they valued and appreciated the sharing of medical knowledge, either via dissemination from the group leadership or between participants within the groups (24,(26)(27)(28)(29)(30)32,34).…”

“…From a social perspective, nineteen studies reported that support group members indicated they were able to obtain guidance and coping strategies as a result of group participation (21,(23)(24)(25)(26)(28)(29)(30)(31)(32)(33)(35)(36)(37)(38)(39)(40)(41)(42), and fourteen studies reported that the groups created a sense of solidarity and group identity that members found lacking in other areas of their lives (24,26,30,(33)(34)(35)(37)(38)(39)(41)(42)(43)(44)25). Social interaction was mentioned as a positive outcome in eleven studies (22)(23)(24)26,32,33,36,38,40,42,44).…”

“…Fourteen of the studies reported that participants found emotional support and/or catharsis as a function of group membership (21,24,(26)(27)(28)(29)(31)(32)(33)(38)(39)(40)(41)(42), and fourteen studies reported that group members felt a sense of not feeling alone (22)(23)(24)28,29,31,(33)(34)(35)37,39,40,42,44) after they joined the group. Group participants in eleven studies reported a benefit to their self-esteem, empowerment, and overall quality of life (22,24,25,32,34,35,37,38,(40)(41)(42). Six studies noted that support groups gave participants a sense of hope for the future (26,32,35,37,39,42).…”

“…Group participants in eleven studies reported a benefit to their self-esteem, empowerment, and overall quality of life (22,24,25,32,34,35,37,38,(40)(41)(42). Six studies noted that support groups gave participants a sense of hope for the future (26,32,35,37,39,42). Finally, seven studies reported that participants felt a sense of altruism and being able to give back to other injury survivors as a result of group participation (25,26,28,30,35,37,39).…”

“…Finally, seven studies reported that participants felt a sense of altruism and being able to give back to other injury survivors as a result of group participation (25,26,28,30,35,37,39). On a practical level, eleven studies reported that group members found that they were able to gain assistance in navigating the health, legal, and/or social systems from their peers (23,(26)(27)(28)(29)(30)32,(40)(41)(42)45).…”