SWEDESD, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Department of Global Public Health, Karolinska Institute, Stockholm, Sweden.
Front Public Health. 2024 Jan 11;11:1332738. doi: 10.3389/fpubh.2023.1332738. eCollection 2023.
A South African social innovation based on peer support for mothers was contextualized in southern Sweden. The objective of the project was to support expectant women and mothers of young children in immigrant communities to access public services that would benefit maternal and child health. This study aimed to assess how the intervention was implemented, what the contextual barriers and facilitators were, and how the implementation was perceived by those who delivered and received it.
The study used mixed methods with a convergent parallel design and followed the Medical Research Council guidance on process evaluations of complex interventions. Semi-structured interviews ( = 19) were conducted with peer supporters, client mothers, and key stakeholders involved in the intervention. The qualitative data were analyzed using content analysis. Quantitative data on peer supporters' activities were collected during contacts with client mothers and were presented descriptively.
The five peer supporters had 1,294 contacts with client mothers, of which 507 were first-time contacts. The reach was perceived as wide, and the dose of the intervention was tailored to individual needs. Barriers to implementation included community mistrust of social services, norms on gender roles and parenting, and funding challenges. The implementation was facilitated by the organization's reputation, network, experience, and third-sector affiliation. Peer supporters tended to prioritize linking clients to other services over the educational components of the intervention, sometimes doing more than what was originally planned. Implementation strategies used included building trust, using multiple outreach venues, using internal support structures, and providing practical assistance as an entry point to comprehensive psychosocial support. The personal connection between peer supporters and clients was highly valued, and the building of relationships enabled them to address sensitive topics. Peer supporters sometimes experienced a blurred line between professional and personal roles.
Peer supporters used a variety of strategies to navigate identified barriers and facilitators. Trust was central both as a contextual factor and a strategy for implementation. It is valuable to maintain a balance between flexibility and adherence to the function of peer supporters. Further research is needed to evaluate the effects of the intervention.
南非的一项基于同伴支持的社会创新在瑞典南部得到了实施。该项目的目的是支持移民社区的孕妇和幼儿母亲获得有利于母婴健康的公共服务。本研究旨在评估干预措施的实施情况、面临的障碍和促进因素，以及实施者和接受者对干预措施的看法。
本研究采用混合方法，具有收敛平行设计，并遵循医学研究委员会关于复杂干预措施的实施过程评估指南。对同伴支持者、客户母亲和参与干预的关键利益相关者进行了半结构化访谈（n=19）。使用内容分析法对定性数据进行分析。通过与客户母亲的接触收集同伴支持者活动的定量数据，并进行描述性呈现。
5 名同伴支持者与客户母亲进行了 1294 次接触，其中 507 次是首次接触。干预措施的影响范围被认为很广，干预措施的剂量根据个人需求进行了调整。实施障碍包括社区对社会服务的不信任、性别角色和育儿规范以及资金挑战。实施得到了组织声誉、网络、经验和第三部门隶属关系的促进。同伴支持者倾向于将客户与其他服务联系起来，而不是将干预措施的教育部分放在首位，有时会做超出原计划的事情。所使用的实施策略包括建立信任、利用多种外联场所、利用内部支持结构以及提供实际援助作为全面心理社会支持的切入点。同伴支持者与客户之间的个人联系受到高度重视，关系的建立使他们能够解决敏感问题。同伴支持者有时会感到自己的专业角色和个人角色之间的界限模糊。
同伴支持者使用了多种策略来应对已确定的障碍和促进因素。信任是实施的中心，既是一个背景因素，也是一种实施策略。在灵活性和遵守同伴支持者的职能之间保持平衡是很有价值的。需要进一步研究来评估干预措施的效果。
