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同行连线:一项针对长期患病成年人的同伴指导的实用可行性随机对照试验。

PEER CONNECT: a pragmatic feasibility randomised controlled trial of peer coaching for adults with long-term conditions.

机构信息

Torbay and South Devon NHS Foundation Trust, Torquay, UK

Peninsula Medical School, University of Plymouth, Plymouth, UK.

出版信息

BMJ Open. 2024 Aug 19;14(8):e087020. doi: 10.1136/bmjopen-2024-087020.

Abstract

OBJECTIVE

To test the feasibility of a targeted peer coaching intervention on the health and well-being of people with long-term health conditions and low activation attending outpatient clinics at a UK National Health Service (NHS) Trust.

DESIGN

Randomised controlled feasibility trial, with embedded qualitative study.

SETTING

An NHS integrated health and care organisation in the South West of England, UK, with significant areas of deprivation.

PARTICIPANTS

Patients (over 18 year of age) of the Trust's rheumatology, pain or multiple sclerosis services, with a Patient Activation Measure score at level 1 or 2.

INTERVENTION

Up to 14 sessions of peer coaching delivered in a stepped-down model delivered over 6 months.

MAIN OUTCOMES

Primary feasibility outcomes were recruitment, retention, intervention adherence and peer, coach and staff experience.Secondary outcomes included psychological well-being, resource use, long-term condition management and disease-specific measures.

RESULTS

97 potential coaches were contacted directly. 27 (27.8%) were screened and of those 21 (77.8%) were eligible and recruited into the study. For a range of reasons, only five (23.8%) progressed through training and on to deliver peer coaching. 747 potential peers were invited to take part and 19 (2.5%) were screened. Of those screened, seven (36.8%) were eligible, recruited and randomised, all white females with median age of 50 years (range: 24-82 years). One peer in the intervention group withdrew prior to receiving the intervention, the remaining four received coaching. Peers and coaches reported a range of benefits related to their health and well-being.

CONCLUSION

Coach recruitment, training and study procedures were feasible and acceptable. Due to low peer recruitment numbers, it was decided not to progress to a definitive trial. Further research is required to explore how to engage with and recruit people reporting low levels of activation and the acceptability and effectiveness of peer coaching for this group.

TRIAL REGISTRATION NUMBER

ISRCTN12623577.

摘要

目的

测试针对英国国民保健制度(NHS)信托机构门诊就诊的长期健康状况不佳和低激活人群的健康和福祉的目标同行指导干预的可行性。

设计

随机对照可行性试验,嵌入定性研究。

地点

英国西南部的 NHS 综合健康和护理组织,该地区贫困程度较高。

参与者

该信托机构的风湿病、疼痛或多发性硬化症服务的患者(18 岁以上),其患者激活测量得分处于 1 级或 2 级。

干预措施

在 6 个月内,以逐步降低的模式提供最多 14 次同行指导。

主要结果

主要可行性结果为招募、保留、干预依从性以及同行、教练和工作人员的经验。次要结果包括心理健康、资源利用、长期疾病管理和特定疾病的措施。

结果

直接联系了 97 名潜在教练。27 人(27.8%)进行了筛选,其中 21 人(77.8%)符合条件并被招募参加研究。由于各种原因,只有 5 人(23.8%)通过培训并开始提供同行指导。邀请了 747 名潜在同伴参加,并对 19 人(2.5%)进行了筛选。在筛选出的人员中,有 7 人(36.8%)符合条件、被招募并随机分配,均为白人女性,中位年龄为 50 岁(范围:24-82 岁)。干预组的一名同伴在接受干预前退出,其余 4 人接受了指导。同伴和教练报告了与他们的健康和福祉相关的一系列好处。

结论

教练的招募、培训和研究程序是可行和可接受的。由于同伴招募人数较少,决定不进行确定性试验。需要进一步研究如何吸引和招募报告低激活水平的人群,以及同行指导对这一人群的可接受性和有效性。

试验注册号

ISRCTN85430006。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2414/11337699/264ac88dfc30/bmjopen-14-8-g001.jpg

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