The effects of peer support on empowerment, self-efficacy, and internalized stigma: A narrative synthesis and meta-analysis.

Abstract

Peer support is sometimes formalized and offered as an intervention in mental health services and organizations. Evidence suggests that empowerment, self-efficacy, and internalized stigma are theoretically linked and implicated in the change processes involved in peer support. This review aimed to synthesize quantitative evidence published in the English language from trials that introduced any type of peer support intervention on the outcomes of empowerment, self-efficacy, and internalized stigma for those in receipt of peer support. Literature searches were conducted between November 2016 and April 2017 on CENTRAL, CINAHL, Clinicaltrials.gov, EMBASE, MEDLINE, PsycINFO, and Web of Science databases. Study quality was appraised. Results were integrated first through narrative synthesis.Where data was available, effect sizes were calculated and meta-analyses conducted when there were at least four randomized trials with similar characteristics. Twenty-three studies met inclusion criteria and could be separated into three broad categories: peer-led group interventions, one-to-one peer support, and peer-run services. Most were moderate to weak in quality. Meta-analyses were conducted for group interventions only. Results suggested that peer-facilitated time-limited group interventions can result in small but significant improvements in empowerment and self-efficacy compared with treatment as usual.Evidence was inconclusive for one-to-one peer support, peer-run services, and for internalized stigma. Areas for future research include: equivalence trials of group interventions with nonpeer facilitators, developing peer-led group interventions specific to the needs of people with particular mental health difficulties, high-quality research on one-to-one peer support and peer-run services, and research to understand the essential components and change mechanisms involved in peer support.

The effectiveness of one-to-one peer support in mental health services: a systematic review and meta-analysis

“…However, both reviews combined studies of individual and group-based peer supportnoting substantial heterogeneity in both intervention and trial populationand in both reviews authors cautioned that the majority of trials were of low to moderate quality and that reporting bias in particular might explain these results. More focused reviews have considered peer support for people experiencing depression [9], and for those experiencing psychosis [10]. The former considered only group interventions, while the latter combined group, one-to-one and servicelevel modalities of peer support, and found no evidence of effectiveness of one-to-one peer support.…”

“For them and for me”: a qualitative exploration of peer befrienders’ experiences supporting people with aphasia in the SUPERB feasibility trial

“…There is currently limited evidence for effective psychological interventions for this group, particularly interventions aimed at preventing people from developing depression as they adjust to living with the stroke and aphasia [12]. One potential intervention is peer-befriending, which may benefit the wellbeing of both befriender and befriendee [13][14][15]. The current paper investigates the experiences of people with post-stroke aphasia working as peer-befrienders.…”

Text message reminders and peer education increase HIV and Syphilis testing among female sex workers: a pilot quasi-experimental study in Uganda

“…Peer education may have improved knowledge of the benefits of periodic syphilis and HIV testing, while text messages acted to remind and reinforce information received during peer education. The resultant empowerment and self-efficacy may explain the increase in testing uptake that we observed [ 46 ]. Public health programs that combine both mHealth and peer education interventions may be more desirable for promoting regular syphilis and HIV testing among FSW.…”