Ellison Marsha Langer, Schutt Russell K, Glickman Mark E, Schultz Mark R, Chinman Matthew, Jensen Kristina, Mitchell-Miland Chantele, Smelson David, Eisen Susan
Center for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers Memorial Veterans Hospital.
Department of Sociology, University of Massachusetts.
Psychiatr Rehabil J. 2016 Sep;39(3):266-273. doi: 10.1037/prj0000221.
Patterns and predictors of engagement in peer support services were examined among 50 previously homeless veterans with co-occurring mental health conditions and substance use histories receiving services from the Veterans Health Administration supported housing program.
Veteran peer specialists were trained to deliver sessions focusing on mental health and substance use recovery to veterans for an intended 1-hr weekly contact over 9 months. Trajectories of peer engagement over the study's duration are summarized. A mixed-effects log-linear model of the rate of peer engagement is tested with three sets of covariates representing characteristics of the veterans. These sets were demographics, mental health and substance use status, and indicators of community participation and support.
Data indicate that veterans engaged with peers about once per month rather than the intended once per week. However, frequency of contacts varied greatly. The best predictor of engagement was time, with most contacts occurring within the first 6 months. No other veteran characteristic was a statistically significant predictor of engagement. Older veterans tended to have higher rates of engagement with peer supporters.
Planners of peer support services could consider yardsticks of monthly services up to 6 months. Peer support services need a flexible strategy with varying levels of intensity according to need. Peer support services will need to be tailored to better engage younger veterans. Future research should consider other sources of variation in engagement with peer support such as characteristics of the peer supporters and service content and setting. (PsycINFO Database Record
在50名曾无家可归的退伍军人中，研究他们参与同伴支持服务的模式和预测因素。这些退伍军人同时患有心理健康问题和有药物使用史，他们正在接受退伍军人健康管理局支持住房项目提供的服务。
退伍军人同伴专家接受培训，为退伍军人开展专注于心理健康和药物使用康复的课程，计划为期9个月，每周进行1小时的接触。总结了研究期间同伴参与的轨迹。使用三组代表退伍军人特征的协变量，对同伴参与率的混合效应对数线性模型进行了测试。这三组协变量分别是人口统计学特征、心理健康和药物使用状况，以及社区参与和支持指标。
数据表明，退伍军人与同伴的接触频率约为每月一次，而非计划中的每周一次。然而，接触频率差异很大。参与的最佳预测因素是时间，大多数接触发生在头6个月内。没有其他退伍军人特征是参与的统计学显著预测因素。年龄较大的退伍军人与同伴支持者的接触率往往较高。
同伴支持服务规划者可以考虑在6个月内每月提供服务的标准。同伴支持服务需要一种根据需求灵活调整强度的策略。同伴支持服务需要进行调整，以更好地让年轻退伍军人参与进来。未来的研究应考虑同伴支持参与度的其他变化来源，如同伴支持者的特征、服务内容和环境。（PsycINFO数据库记录）
