Thomson S, Michelson D, Day C
Lambeth Child and Adolescent Mental Health Services (CAMHS), South London & Maudsley NHS Foundation Trust, London, UK.
Child Care Health Dev. 2015 Jan;41(1):76-83. doi: 10.1111/cch.12132. Epub 2014 Mar 28.
Peer-led interventions are increasingly common in community health settings. Although peer-led approaches have proven benefits for service users, relatively little is known about the process and outcomes of participation for peer leaders. This study investigated experiences of parents who had participated as 'peer facilitators' in Empowering Parents, Empowering Communities (EPEC), a peer-led programme designed to improve access to evidence-based parenting support in socially disadvantaged communities.
A qualitative cross-sectional design was used. Semi-structured interviews were conducted with 14 peer facilitators and scrutinized using thematic analysis.
Peer facilitators developed their knowledge and skills through personal experience of receiving parenting support, participation in formal training and supervised practice, access to an intervention manual, and peer modelling. Peer facilitators described positive changes in their own families, confidence and social status. Transformative personal gains reinforced peer facilitators' role commitment and contributed to a cohesive 'family' identity among EPEC staff and service users. Peer facilitators' enthusiasm, openness and mutual identification with families were seen as critical to EPEC's effectiveness and sustainability. Peer facilitators also found the training emotionally and intellectually demanding. There were particular difficulties around logistical issues (e.g. finding convenient supervision times), managing psychosocial complexity and child safeguarding.
The successful delivery and sustained implementation of peer-led interventions requires careful attention to the personal qualities and support of peer leaders. Based on the findings of this study, support should include training, access to intervention manuals, regular and responsive supervision, and logistical/administrative assistance. Further research is required to elaborate and extend these findings to other peer-led programmes.
同伴主导的干预措施在社区卫生环境中越来越普遍。尽管同伴主导的方法已被证明对服务使用者有益，但对于同伴领导者参与的过程和结果却知之甚少。本研究调查了作为“同伴促进者”参与“赋能父母，赋能社区”（EPEC）项目的家长的经历，该项目是一个同伴主导的项目，旨在改善社会弱势社区中基于证据的育儿支持的可及性。
采用定性横断面设计。对14名同伴促进者进行了半结构化访谈，并使用主题分析进行审查。
同伴促进者通过接受育儿支持的个人经历、参与正式培训和监督实践、获取干预手册以及同伴示范来提升自己的知识和技能。同伴促进者描述了他们自己家庭、信心和社会地位的积极变化。个人的转变强化了同伴促进者对角色的承诺，并促成了EPEC工作人员和服务使用者之间紧密的“家庭”认同感。同伴促进者的热情、开放以及与家庭的相互认同被视为EPEC有效性和可持续性的关键。同伴促进者也发现培训在情感和智力上都要求很高。在后勤问题（如找到方便的监督时间）、处理心理社会复杂性和儿童保护方面存在特别的困难。
同伴主导的干预措施的成功实施和持续开展需要仔细关注同伴领导者的个人素质和支持。基于本研究的结果，支持应包括培训、获取干预手册、定期且及时的监督以及后勤/行政协助。需要进一步的研究来详细阐述并将这些发现扩展到其他同伴主导的项目。
