Development and Evaluation of a Recovery College Fidelity Measure

Abstract

Objective: Recovery Colleges are widespread, with little empirical research on their key components. This study aimed to characterize key components of Recovery Colleges and to develop and evaluate a developmental checklist and a quantitative fidelity measure. Methods: Key components were identified through a systematized literature review, international expert consultation (n ¼ 77), and semistructured interviews with Recovery College managers across England (n ¼ 10). A checklist was developed and refined through semistructured interviews with Recovery College students, trainers, and managers (n ¼ 44) in 3 sites. A fidelity measure was adapted from the checklist and evaluated with Recovery College managers (n ¼ 39, 52%), clinicians providing psychoeducational courses (n ¼ 11), and adult education lecturers (n ¼ 10). Results: Twelve components were identified, comprising 7 nonmodifiable components (Valuing Equality, Learning, Tailored to the Student, Coproduction of the Recovery College, Social Connectedness, Community Focus, and Commitment to Recovery) and 5 modifiable components (Available to All, Location, Distinctiveness of Course Content, Strengths Based, and Progressive). The checklist has service user student, peer trainer, and manager versions. The fidelity measure meets scaling assumptions and demonstrates adequate internal consistency (0.72), test-retest reliability (0.60), content validity, and discriminant validity. Conclusions: Coproduction and an orientation to adult learning should be the highest priority in developing Recovery Colleges. The creation of the first theory-based empirically evaluated developmental checklist and fidelity measure (both downloadable at researchintorecovery.com/recollect) for Recovery Colleges will help service users understand what Recovery Colleges offer, will inform decision making by clinicians and commissioners about Recovery Colleges, and will enable formal evaluation of their impact on students.

Mechanisms of change and participant outcomes in a Recovery Education Centre for individuals transitioning from homelessness: a qualitative evaluation

“…Our findings also suggest that program mechanisms interact to reinforce each other, consistent with the supposition that the overarching mechanism underlying recovery education is not simply knowledge acquisition but a more active, individual and transformative process [19,29]. For example, in our study, role modelling by peers with lived experience contributed to the deconstruction of self-stigma by contradicting previously internalized negative stereotypes about individuals experiencing homelessness and mental health or addiction challenges and their potential for recovery, which in turn supported the development of more positive self-identity and increased feelings of selfworth.…”

“…Member checking strongly validated emerging themes. Our results are likely to be generalizable to other RECs given the close fidelity of our program to the REC model [10,29], suggesting that our findings can be used to inform program and policy development in similar contexts and with similarly marginalized populations.…”

“…The aims of RECs are to support the life goals of participants in the areas of health and well-being, education, employment, and wellness management [4,12,15,27,30]. Key characteristics of RECs include peer and professional involvement in the design and delivery of services through the process of co-production, a community focus, and inclusivity [17,19,29].…”

“…However, despite widespread dissemination, evidence regarding how RECs support the process of recovery and participant outcomes is limited [31]. Recent qualitative research has suggested four potential mechanisms of action, including an empowering environment, relationship-building, the facilitation of personal growth, and deconstruction of traditional power hierarchies through co-production [28,29]. Additional qualitative studies have contributed to our understanding of participant outcomes, describing improved well-being and quality of life; increased feelings of hopefulness, empowerment and belonging; and improved knowledge about and management of mental health challenges [3,20,28,32].…”

A systematic review of influences on implementation of peer support work for adults with mental health problems

“…The most identified influence was organisational culture, and this is an international challenge [48]. Evidence-based approaches are emerging to change organisational culture, including a greater emphasis on supporting strengths [49][50][51], self-management [52], hope [53,54], well-being [55][56][57] and more use of new interventions such as positive psychology [58,59], recovery colleges [60][61][62] and a greater focus on human rights [63]. New measures to evaluate recovery-related outcomes are also becoming available [64,65].…”