Department of Psychiatry II, Ulm University, Ulm, Germany.
School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK.
BMC Psychiatry. 2024 Oct 11;24(1):675. doi: 10.1186/s12888-024-06081-8.
Peer support workers provide support for people experiencing mental health conditions based on their own lived experience of mental health problems. Assessing fidelity to core ingredients of peer support is vital for successful implementation and intervention delivery. Modifications to its implementation are needed when scaling up to different socio-economic settings, raising further uncertainty about fidelity. As part of a large multi-centre study on peer support called Using Peer Support In Developing Empowering Mental Health Services (UPSIDES), we developed and evaluated the psychometric properties of the UPSIDES Fidelity Scale.
We constructed the fidelity scale based on an initial item pool developed through international expert consultation and iterative feedback. Scale refinement involved site-level expert consultation and translation, resulting in a service user-rated 28-item version and a peer support worker-rated 21-item version assessing receipt, engagement, enactment, competence, communication and peer support-specific components. Both versions are available in six languages: English, German, Luganda, Kiswahili, Hebrew and Gujarati. The scale was then evaluated at six study sites across five countries, with peer support workers and their clients completing their respective ratings four and eight months after initial peer support worker contact. Psychometric evaluation included analysis of internal consistency, construct validity and criterion validity.
For the 315 participants, item statistics showed a skewed distribution of fidelity values but no restriction of range. Internal consistency was adequate (range α = 0.675 to 0.969) for total scores and all subscales in both versions. Confirmatory factor analysis indicated acceptable fit of the proposed factor structure for the service user version (χ2/df = 2.746; RMSEA = 0.084) and moderate fit for the peer support worker version (χ2/df = 3.087; RMSEA = 0.093). Both versions showed significant correlations with external criteria: number of peer support sessions; perceived recovery orientation of the intervention; and severity of illness.
The scale demonstrates good reliability, construct and criterion validity, making it a pragmatic and psychometrically acceptable measure for assessing fidelity to a manualised peer support worker intervention. Recommendations for use, along with research and practical implications, are addressed. As validated, multi-lingual tool that adapts to diverse settings this scale is uniquely positioned for global application.
ISRCTN, ISRCTN26008944. Registered on 30 October 2019.
同伴支持工作者根据自己的心理健康问题经历，为经历心理健康问题的人提供支持。评估同伴支持的核心要素的保真度对于成功实施和干预交付至关重要。在不同的社会经济环境中扩大规模时需要对其实施进行修改，这进一步增加了对保真度的不确定性。作为一项名为“使用同伴支持开发赋权心理健康服务”（UPSIDES）的大型多中心同伴支持研究的一部分，我们开发并评估了 UPSIDES 保真度量表的心理测量特性。
我们根据通过国际专家咨询和迭代反馈制定的初始项目池构建了保真度量表。通过现场层面的专家咨询和翻译对量表进行了细化，从而形成了服务使用者自评的 28 项版本和同伴支持工作者自评的 21 项版本，评估了接受、参与、实施、能力、沟通和同伴支持特定组成部分。这两个版本均有六种语言版本：英语、德语、卢干达语、斯瓦希里语、希伯来语和古吉拉特语。该量表随后在五个国家的六个研究地点进行了评估，在初始同伴支持工作者接触后四个月和八个月时，由同伴支持工作者及其客户完成各自的评分。心理测量评估包括内部一致性、结构有效性和标准有效性分析。
对于 315 名参与者，项目统计数据显示出保真度值的偏态分布，但没有范围限制。两个版本的总评分和所有子量表的内部一致性均足够（范围α=0.675 至 0.969）。验证性因子分析表明，服务使用者版本的拟议因子结构具有可接受的拟合度（χ2/df=2.746；RMSEA=0.084），同伴支持工作者版本的拟合度适中（χ2/df=3.087；RMSEA=0.093）。两个版本均与外部标准显著相关：同伴支持会议的次数、干预措施的感知康复方向以及疾病的严重程度。
该量表具有良好的可靠性、结构和标准有效性，使其成为评估手册化同伴支持工作者干预措施的一种实用且心理测量上可接受的方法。提出了使用建议以及研究和实践意义。作为一种经过验证的、多语言的工具，它可以适应不同的环境，因此该量表在全球范围内具有独特的应用地位。
ISRCTN，ISRCTN26008944。于 2019 年 10 月 30 日注册。
