The use of peer mentors to enhance a smoking cessation intervention for persons with serious mental illnesses.

Abstract

Objective We evaluated a well-specified peer mentor program that enhanced a professionally-led smoking cessation group for persons with serious mental illnesses. Methods Participants were 8 peer mentors, persons with serious mental illnesses who had successfully quit smoking, and 30 program participants, persons with serious mental illnesses enrolled in a 6 month intervention. Peer mentors were trained and then helped to deliver a smoking cessation group and met with program participants individually. We assessed the mentors’ skills after training, their fidelity to the model, and the program’s feasibility and acceptability. We also measured the smoking outcomes of the program participants including change in exhaled carbon monoxide, a measure of recent smoking, and aspects of the peer mentor-program participant relationship. Results Peer mentors attained a mean score of 13.6/14 on role play assessments after training and delivered the intervention with fidelity as assessed by adherence and competence ratings (mean scores of 97% and 93%, respectively). The feasibility and acceptability of the intervention was demonstrated in that 28/30 participants met with their peer mentors regularly and only 1 participant and no peer mentor discontinued in the study. Both parties rated the interpersonal alliance highly, mean of 5.9/7. The program participants had a decline in carbon monoxide levels and number of cigarettes smoked per day (repeated measures ANOVA F=6.04, p=.008; F=15.87, p<.001, respectively). A total of 22/30 (73%) made a quit attempt but only 3 (10%) achieved sustained abstinence. Conclusions and Implications for Practice Our study adds to the growing literature about peer-delivered interventions.

Barriers and Facilitators to Tobacco Cessation in a Nationwide Sample of Addiction Treatment Programs

“…Respondents in our study referred to enhanced training of existing staff, and also commented on the potential advantages of trained peer mentors. Peer mentorship, in combination with professionally-led tobacco cessation counseling, has proven successful for helping persons with mental illness to quit smoking (Dickerson et al, 2016). …”

The Experience of Peer Mentors in an Intervention to Promote Smoking Cessation in Persons with Psychiatric Illness

“…(Dickerson, et al, In press). Although other qualitative explorations of peer specialists have been conducted, to our knowledge there has not been a detailed analysis of the experiences of the peer mentors, themselves, in such programs, despite important implications for intervention refinement.…”

Helping Smokers with Severe Mental Illness Who Do Not Want to Quit

“…To these roles can now be added peers as researchers as they successfully administered the motivational interventions. This suggests good dissemination potential for this and other similar brief tobacco interventions for individuals with severe and persistent mental illness especially because a large portion of ex-smokers coping with serious mental illness indicates an interest in helping peers quit (Dickerson et al, 2011) and find such work personally rewarding (Dickerson et al 2016). …”

“…This is consistent with the quit rate reported by others across levels of treatment intensity, motivational level of smokers, and follow-up periods. For example, Dickerson et al, (Dickerson, et al, 2016) reported 10% sustained abstinence measured at the last intervention visit of smokers in the contemplation or preparation stage of change who received 24, one-hour group meetings and individual meetings. Similarly, Ferron et al (Ferron, et al, 2016) reported a biochemically verified quit rate of 9% six months after a single use of a motivational decision support system.…”

“…Peers first held informational sessions at community agencies and then followed up by providing a 20-minute peer-to-peer intervention based on Steinberg’s (Steinberg, et al, 2004) brief motivational intervention that also included CO level feedback. Dickerson et al, (Dickerson, et al, 2016) successfully used peers as co-facilitators of a group intervention. Peers also met one-on-one with group members.…”