Effects of online and recovery-oriented peer support groups facilitated by Peer Support Workers in times of COVID-19: Protocol for a feasibility study of a trial.

BACKGROUND: In times of pandemics, social distancing, isolation and quarantine have precipitated depression, anxiety and substance misuse. Scientific literature suggests that patients living with mental health problems or illnesses (MHPIs) who interact with Peer Support Workers (PSWs) will not only feel the empathy and connectedness that comes from similar life experiences, but that this interaction also fosters hope in the possibility of a recovery. However, it is the effect of mental health teams or programs where there are PSWs that has been evaluated. Data will be collected for a future Randomized Controlled Trial by determining an effect size that would be specifically attributable to PSWs. OBJECTIVE: The five principal research questions are whether this online intervention will have an impact in terms of (Q1) personal-civic recovery and (Q2) clinical recovery , (Q3) how these recovery potentials can be impacted by the COVID-19 pandemic, (Q4) how the lived experience of persons in recovery can be mobilized to cope with such a situation, and (Q5) how sex and gender considerations can be taken into account for the pairing of PSWs with service users, beyond considerations based solely on psychiatric diagnoses or specific MHPIs. METHODS: Intervention: During the transitional and controlled online peer support groups, PSWs will simulate a typical unformal peer support group. They will have a personal-civic recovery focus, and they will be scripted with a fixed, predetermined duration (a series of 10 weekly 90-minute online workshops). There will be two experimental sub-groups: patients diagnosed with (1) psychotic disorders (n=10), and (2) anxiety or mood disorders (n=10), compared to a control group (n=10). Intervention Model: Parallel Assignment Allocation: Randomized Ratio: 2:1. RESULTS: Measures: Several instruments have been developed by clinicians and academics to assess clinical recovery. Based on their life narratives and to assess personal-civic recovery, measurement tools have also been developed through community-based participatory research; for instance the Recovery Assessment Scale and the Citizenship Measure questionnaires (personal-civic recovery). This pre-post research feasibility study of a trial is proposed to evaluate the outcomes on personal-civic recovery (primary outcome); and to assess its effects in terms of clinical recovery and stress- or anxiety-related responses to the COVID-19 (secondary outcomes). The COVID Stress Scales and the measures of personal-civic recovery will be repeated, along with the following measures of clinical recovery: (i) Anxiety State-Trait Anxiety Inventory Form Y6, (ii) Depression Patient Health Questionnaire, (iii) Alcohol Use Disorders Identification Test, (iv) Drug Abuse Screening Test, (v) Psychosis Screening Questionnaire, and (vi) World Health Organization Disability Assessment Schedule. Change will be compared between groups from baseline to intervention vs. control group in the study outcome measures using the Student paired sample t test. Results are expected for December 2020. CONCLUSIONS: Integrated Knowledge Translation: Study results will provide reliable evidence on a web-based intervention provided by Peer Support Workers. The investigators, with key decision makers and patient partners, will ensure knowledge translation throughout and the Massive Online Open Course (MOOC) on the Fundamentals of Recovery will be updated with the evidence and new knowledge generated by this feasibility study. CLINICALTRIAL: ClinicalTrials.gov Identifier: NCT04445324.