Challenges in the Ethical Review of Peer Support Interventions

Simmons, David; Bunn, Christopher; Nakwagala, Frederick Nelson; Safford, Monika M.; Ayala, Guadalupe X.; Riddell, Michaela A; Graffy, Jonathan; Fisher, Edwin B.

doi:10.1370/afm.1803

Cited by 7 publications

(5 citation statements)

References 33 publications

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“…Organizations may facilitate peer support through their values, actions, and oversight [ 119 ] and through a robust supervision system with available educational access, which could be the adequate path for creating a positive and risk-free environment for PSWs throughout their complex workloads [ 126 ]. On the other hand, ethics committees play essential roles in the inclusion of PSWs in applied research studies by avoiding repetition of the work of other trusted agencies and considering the ethical validity of consent procedures for peer support interventions [ 127 ].…”

Section: Resultsmentioning

confidence: 99%

Peer Support in Mental Health: Literature Review

Shalaby¹,

Agyapong²

2020

JMIR Ment Health

257

164

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Background A growing gap has emerged between people with mental illness and health care professionals, which in recent years has been successfully closed through the adoption of peer support services (PSSs). Peer support in mental health has been variously defined in the literature and is simply known as the help and support that people with lived experience of mental illness or a learning disability can give to one another. Although PSSs date back to several centuries, it is only in the last few decades that these services have formally evolved, grown, and become an integral part of the health care system. Debates around peer support in mental health have been raised frequently in the literature. Although many authors have emphasized the utmost importance of incorporating peer support into the health care system to instill hope; to improve engagement, quality of life, self-confidence, and integrity; and to reduce the burden on the health care system, other studies suggest that there are neutral effects from integrating PSSs into health care systems, with a probable waste of resources. Objective In this general review, we aimed to examine the literature, exploring the evolution, growth, types, function, generating tools, evaluation, challenges, and the effect of PSSs in the field of mental health and addiction. In addition, we aimed to describe PSSs in different, nonexhaustive contexts, as shown in the literature, that aims to draw attention to the proposed values of PSSs in such fields. Methods The review was conducted through a general search of the literature on MEDLINE, Google Scholar, EMBASE, Scopus, Chemical Abstracts, and PsycINFO. Search terms included peer support, peer support in mental health, social support, peer, family support, and integrated care. Results There is abundant literature defining and describing PSSs in different contexts as well as tracking their origins. Two main transformational concepts have been described, namely, intentional peer support and transformation from patients to peer support providers. The effects of PSSs are extensive and integrated into different fields, such as forensic PSSs, addiction, and mental health, and in different age groups and mental health condition severity. Satisfaction of and challenges to PSS integration have been clearly dependent on a number of factors and consequently impact the future prospect of this workforce. Conclusions There is an internationally growing trend to adopt PSSs within addiction and mental health services, and despite the ongoing challenges, large sections of the current literature support the inclusion of peer support workers in the mental health care workforce. The feasibility and maintenance of a robust PSS in health care would only be possible through collaborative efforts and ongoing support and engagement from all health care practitioners, managers, and other stakeholders.

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Section: Resultsmentioning

confidence: 99%

Peer Support in Mental Health: Literature Review

Shalaby¹,

Agyapong²

2020

JMIR Ment Health

257

164

View full text Add to dashboard Cite

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“…Key findings curated by Peers for Progress and reported by papers in this supplement [35][36][37][38][39][40][41] help to guide these efforts.…”

Section: Scaling Upmentioning

confidence: 99%

“…Instead, a variety of other considerations were applied by ethics committees, including scientific, organizational and administrative issues that sometimes delayed studies or (of special concern for S6 research seeking to reach and engage diverse groups) increased participant burden and mandated consent processes that could hinder the responsiveness of peer support to diverse needs-as the paper concludes, "creating a new ethical dilemma." 41 …”

Section: Research Challengesmentioning

confidence: 99%

Contributions of Peer Support to Health, Health Care, and Prevention: Papers from Peers for Progress

Fisher

Ayala

Ibarra

et al. 2015

The Annals of Family Medicine

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SUBSTANTIAL evidence documents the benefits of peer support provided by community health workers, lay health advisors, promotores de salud, and others. The papers in this supplement, all supported by the Peers for Progress program of the American Academy of Family Physicians Foundation, contribute to the growing body of literature addressing the efficacy, effectiveness, feasibility, reach, sustainability, and adoption of peer support for diabetes self-management. They and additional papers supported by Peers for Progress contribute to understanding how peer support can be implemented in real world settings. Topics include examination of the peers who provide peer support, reaching the hardly reached, success factors in peer support interventions, proactive approaches, attention to emotions, peer support in behavioral health, dissemination models and their application in China, peer support in the patient-centered medical home, research challenges, and policy implications.

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“…For instance, if an investigator’s role is limited to protocol development or the analysis of study data, must approval from her institution be sought? Too many full board REC reviews add needless burdens to CRTs 15…”

Section: Identifying Gaps In the Ottawa Statement Through An Analysismentioning

confidence: 99%

Ethical issues raised by cluster randomised trials conducted in low-resource settings: identifying gaps in the Ottawa Statement through an analysis of the PURE Malawi trial

Mtande¹,

Weijer

Hosseinipour

et al. 2019

J Med Ethics

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The increasing use of cluster randomised trials in low-resource settings raises unique ethical issues. The Ottawa Statement on the Ethical Design and Conduct of Cluster Randomised Trials is the first international ethical guidance document specific to cluster trials, but it is unknown if it adequately addresses issues in low-resource settings. In this paper, we seek to identify any gaps in the Ottawa Statement relevant to cluster trials conducted in low-resource settings. Our method is (1) to analyse a prototypical cluster trial conducted in a low-resource setting (PURE Malawi trial) with the Ottawa Statement; (2) to identify ethical issues in the design or conduct of the trial not captured adequately and (3) to make recommendations for issues needing attention in forthcoming revisions to the Ottawa Statement. Our analysis identified six ethical aspects of cluster randomised trials in low-resource settings that require further guidance. The forthcoming revision of the Ottawa Statement should provide additional guidance on these issues: (1) streamlining research ethics committee review for collaborating investigators who are affiliated with other institutions; (2) the classification of lay health workers who deliver study interventions as health providers or research participants; (3) the dilemma experienced by investigators when national standards seem to prohibit waivers of consent; (4) the timing of gatekeeper engagement, particularly when researchers face funding constraints; (5) providing ancillary care in health services or implementation trials when a routine care control arm is known to fall below national standards and (6) defining vulnerable participants needing protection in low-resource settings.

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Challenges in the Ethical Review of Peer Support Interventions

Cited by 7 publications

References 33 publications

Peer Support in Mental Health: Literature Review

Peer Support in Mental Health: Literature Review

Contributions of Peer Support to Health, Health Care, and Prevention: Papers from Peers for Progress

Ethical issues raised by cluster randomised trials conducted in low-resource settings: identifying gaps in the Ottawa Statement through an analysis of the PURE Malawi trial

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