Another study from Thailand used a curriculum of group education and role-play sessions to help young men and women reduce their use of metamphetamines and sexual risk-taking, and to communicate with others in their social networks about these risks [20]. Then they would ask us how we were doing and relax us a bit before we got into it. Groups were co-facilitated by a non-peer provider (a Masters-level research assistant, typically with a background in psychology) and a peer provider (a Veteran with lived experience of co-occurring mental health and medical conditions). For training, PCD requires that all facilitators attend three training sessions (totaling ten hours)and attend additional practice facilitation sessions and smaller training sessions throughout the year. We included trials with outcomes across key areas of adolescent health: infectious and vaccine preventable diseases, undernutrition, HIV/AIDS, sexual and reproductive health, unintentional injuries, violence, physical disorders, mental disorders and substance use. Participants emphasized that having a space to learn from each other was an important aspect of the group. Peer mediation is an approach that has been used in schools in the US and UK to help to manage conflicts and disagreements. For the purposes of the present study, two sources of data were utilized: text data from participant transcripts coded under Facilitation and Group Dynamics, and peer facilitator memos and corresponding quotes from peer facilitator transcripts. To address high rates of chronic medical conditions among adults with mental illness, peer specialists can also successfully promote medical illness self-management, weight management, and smoking cessation [410]. Learn what defines the role of a facilitator and how to acquire the skills, presence and tools to be great facilitative leaders! Working in small groups encourages each student to be a facilitator in the learning process of the other students, and students reflect on their learning as they act as facilitators.. - P18: Well it was good because, like I say, for me there were never more than six people. Five studies did not provide information on the education level of facilitators. What Does A Peer Counselor Do - Zippia Peer Facilitators Peer facilitators are trained undergraduate or graduate student staff members who facilitate discourse sessions amongst the variety of programs that The Project on Civil Discourse offers. Finally, we found eight studies on substance use, four of which reported reductions in alcohol consumption and smoking or tobacco use. The literature on facilitation as a practice innovation is growing. You can be early and contribute. Now, a lot of the groups that they hold here it can be a real quiet room. The selection, training, supervision and incentivisation of peer facilitators are all deemed critical to success and sustainability [21]. This appears to be the key ingredient for the success of the co-facilitation model: establishing the norm that group participants and facilitators are equals, sharing and learning together. TIES Peer Engagement Practice Guides | A Guide to Implementing Nine studies had clinical sexual and reproductive health outcomes, but only one reported a positive effect: a reduction in Herpes Simplex Virus-2 incidence. A second limitation was our inability to assess publication bias. Most facilitators are trained by peer facilitator coordinators who have undergone training from a national organization. They work well with others and might have a desire to give back to others experiencing obstacles similar to ones they've faced. Finally, several trials only included our outcomes of interest as secondary indicators. Balaji et al.s Yuva Mitr (Friend of Youth) intervention reduced perpetration of physical violence (rural areas OR 0.29 CI 0.150.57; urban areas OR 0.59 CI 0.400.87) and the experience of sexual violence (urban areas only: OR 0.19 CI 0.090.41) among adolescents in India [37]. First, the group atmosphere appears to mirror the relationship between the peer and non-peer facilitator. 1Veterans Affairs (VA) Capitol Health Care Network (VISN 5), Mental Illness, Research, Education, and Clinical Center (MIRECC), Baltimore, MD, USA, 2Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA, 3University of Maryland School of Social Work, Baltimore, MD, USA, 4Geisel School of Medicine, Department of Psychiatry, Dartmouth College, Lebanon, NH, USA, 5CDC Health Promotion Research Center, Dartmouth, Lebanon, NH, USA, 6Department of Psychology, American University, Washington, DC, USA. What does a Peer Facilitator do? government site. The present analysis also would have benefitted from input from the non-peer facilitators regarding their experiences. Participants were purposefully chosen for variability in demographics, intervention attendance, and group cohort. More important than the peer versus non-peer distinction, or any demographic characteristic, was that the facilitators created a positive group atmosphere in which participants felt comfortable and safe. Research has shown that paraprofessional support that involves unnecessary proximity and excessive assistance can actually interfere with the peer interaction and class participation of students with disabilities (Giangreco, 2021). There was some evidence that interventions improved mental health and reduced violence and substance use, but the diversity of components and outcomes prevented us from making definitive statements about effectiveness. everybody was, you know, was able to contribute. Group facilitators also encouraged self-determination, making suggestions but emphasizing that the final decision was up to each participant. In traditional methods of instruction, the teacher provides . They were great in leading us into where we can get it out there, you know. Sample search strategy for Medline. Three studies had violence-related outcomes, two of which reported reductions in physical violence by school staff and perpetration of physical violence by adolescents. Interventions were diverse: peer facilitators conducted education, counselling, outreach and activism. Get hired. Such trials may have been under-powered to detect significant differences between intervention and control arms for secondary indicators, and prone to false positive (Type I errors) due to multiple testing. Self-disclosure occurred across a variety of identities; peer facilitators should not feel beholden to only share their experiences as a mental health service user. If you would like to learn how to help others understand how to find their voice and promote civil discourse, apply to become a Peer Facilitator. - F10: having somebody with like book knowledge and lived knowledge, its great to combine the two together. [I]t gave everyone a chance to get involved andsome of the groups in [mental health program] are so large that it was a challenge for everyone to actually feel relaxed and sharing. Although we contacted authors for clarifications, many articles screened lacked information about facilitator age, and we may not have identified all eligible studies [43, 45]. [T]hat was definitely the opposite, there was more than ample time and I felt relaxed. Upon completion of the intervention, a subset of Living Well participants (n = 16) completed one-time 11.5 h qualitative interviews. Peer learning involves a new role for the students who facilitate the learning of other students. - P9: I think more than eight or nine would be, maybe 10 would be too much, but two or three is not enough You know, you dont want 100 people. Relevant to the present analyses were the codes Group Dynamics (defined as the social dynamics of the group sessions, including feelings of (dis)comfort, camaraderie between Veterans and/or peer specialists, etc.) Future research should focus on theorising and assessing the contribution of peer-facilitated interventions and their interactions with non-peer-facilitated components in these areas of adolescent health. Then check out our website:. Interview transcripts with Living Well participants were analyzed using a general inductive approach [15]. Therefore, we bring you this brief, yet powerful, set of reminders below (alpha-sorted by the highlighted term or phrase). Prepare for your interview. Students are actively involved in their learning, as they must be the ones to find the answer by working through the questions. D. Group pacing/Management Group atmosphere. Table 2 describes the characteristics of peer-facilitated intervention strategies, including the selection, training and supervision of peers. HSV-2 serum test), then outcomes related to self-reported symptoms (e.g. Clearly, peer providers frequently have formal educational backgrounds and clinical training, and non-peer providers frequently have lived experience of mental health conditions. For example, some were powered to detect differences in sexual and reproductive health outcomes but also included outcomes related to violence and mental health [39]. I have learned how hard work helps me in math), but there were no improvements in this outcome. Primary studies and reviews on the effects of peer-facilitated community interventions for adolescent health in LMICs have largely focused on sexual and reproductive health [15, 2225]. Peers can effectively deliver individual and group-based psychosocial interventions, and facilitate treatment engagement, self-efficacy, and community integration [2, 3]. Facilitators are genuine, and they have a genuine interest in others. If it didnt work out for us They didnt kill you because you didnt do it right or you didnt work it out all the way. The focus of her work is the promotion of holistic wellness and recovery among individuals with mental illness, the intersection of mental illness and aging, and the role and mechanisms of peer support for mental health recovery. Facilitators were trained by the study PI (RWG) through in-person workshops which included didactics, review of the manual and intervention materials, and role-play with feedback and repetition. The nonjudgmental and interactive group atmosphere facilitated discussion and brainstorming, which promoted learning and enhanced motivation (path G). You first must be confident and grounded in yourself and your abilities as a facilitator. The type and length of training for peer facilitators depend on where they'll serve, but training often includes role play and learning specific skills critical to facilitating. Citation: Rose-Clarke K, Bentley A, Marston C, Prost A (2019) Peer-facilitated community-based interventions for adolescent health in low- and middle-income countries: A systematic review. (6) Explicitly create space for peer self-disclosure, both structured and spontaneous, during group sessions. Peer Mediation | SkillsYouNeed Group participants are noted with a P and peer facilitators are noted with an F. KR-C or AB screened the title and abstract of each article to identify and exclude those that were irrelevant. Interventions reduced alcohol drinking among young men (OR 0.68 CI 0.490.94) [40] and the risk of non-smokers becoming regular smokers (OR 2.23 CI 1.203.85) [35]. These factors also contributed to a space in which participants could share and learn from one another. The use of peer mentors to enhance a smoking cessation intervention for persons with serious mental illnesses. 1. - P12: Even those conversations that drift off . Developing this ability takes skill and practice. And they started paraphrasing for me It was like he had a translator, you know, so yeah. The key purpose of peer helper programs is to assist students who are struggling emotionally, socially, or academically. Fortuna KL, DiMilia PR, Lohman MC, et al. Formal peer mediation approaches provide training for chosen individuals (the 'peer mediators') to help them to intervene in disagreements and support the participants to reach an agreement. A South African trial of peer-led interpersonal psychotherapy groups to help adolescents learn how to resolve distress and access emotional support also led to girls reporting more condom use among their partners ( 0.21 p = 0.02 [36, 41]. [Peer] would, every, every, every discussion that was started, the first example was always [Peer]. Thematically, there were five main contributors to this positive group atmosphere: the (2) Diverse and Complementary Perspectives of the co-facilitators, (3) Teamwork between the facilitators, (4) Group Pacing and Management, (5) Group Size, and peer facilitator and participant (6) Self-Disclosure. One study in urban schools in India tested Project MYTRI, a multi-component intervention with classroom curricula, a poster campaign and peer-led activism. Simply put, a facilitator aims to let the group achieve its goals by providing them with the best situation to do so. To facilitate effectively, you must be objective and focus on the "group process." That is, the ways that groups work together to perform tasks, make decisions and solve problems. None of the four studies reported a positive effect of the interventions. In summary, the present study identified key strategies to promote the successful implementation of the peer and non-peer group co-facilitation model; see Table 2. Richard W. Goldberg is the Director of the VISN 5 MIRECC and a Professor in the Department of Psychiatry and the University of Maryland, School of Medicine. Muralidharan, Peeples, Fortuna, and Lucksted conceptualized the present study question. Peer and non-peer facilitators were instructed to equally share group facilitation. Only two studies reported outcomes relating to physical disorders. For each study that met the inclusion criteria, KR-C and AB or AP independently extracted data on general study details, trial design, participant characteristics, sample size, intervention, control condition, outcomes and summary measures, for example a risk ratio (RR), odds ratio (OR), or linear regression coefficient (). One study was at high risk of bias because it had a small number of clusters and results were not adjusted for clustering or confounders [37]. A list of paraprofessional facilitation strategies is shown in Figure 1. Facilitators worked together to divide up session material, with each facilitator bringing their point of view to the task (path C). The peer facilitators felt comfortable asking the non-peer facilitators questions. Risk of bias was variable across studies, with no specific pattern within and across areas. A facilitator is not a content provider: she brings activities and processes to groups but lets them set their own targets and find their own solutions. So they complemented each other. KR-C and AB or AP then independently screened the full text of all remaining articles for relevance. All authors contributed to the writing of the manuscript and approved the final version. 1. Peer facilitators (n = 3), two male and one female, were Veterans with a lived experience of mental illness and paid employees at the investigators research center, with varying educational backgrounds and experience in providing peer support. So I think that helped out a lot. Peer facilitators were school students in nine of the 20 studies, and school graduates in six. The present study examined qualitative interviews with Living Well participants and peer facilitators to examine how the peer and non-peer co-facilitation model affected group processes, with the aim of producing a set of recommendations for successful delivery of peer and non-peer co-facilitated groups. Participants labeled the perspective of the non-peer facilitator as the diverse, outsider perspective, suggesting that participants perceived ownership of the group as a space for Veterans like themselves. Were all in this together: Peer-specialist contributions to a healthy lifestyle intervention for people with serious mental illness, Adm Policy Ment Health Ment Health Serv Res. They kind of talked well with each other. The plurality of participant comments was about the atmosphere of the group, which fell into three subthemes: (a) Positive/warm, (b) Respectful/everyone equal, and (c) Interactive/participatory. Two studies encountered unexpectedly high rates of adolescent out-migration and were forced to change their study design substantially with implications for the statistical power of the study [39, 45]. For the larger trial, participants (N = 242) were recruited via chart review, clinician referral, and self-referral at three Mid-Atlantic Veterans Affairs Medical Centers in the United States between January 2014 and April 2016. - P16: [Peer] helped by the things he would say about himself and his problem. - P2: Yeah, I thought it was great, especially learning from other people, yeah How they deal with their mental health and physical health, and things that they do, you know, that helped me, that kind of stuff. Data from a randomized controlled trial of Living Well, a peer and non-peer co-facilitated intervention for medical illness management for adults with serious mental illness, were utilized. Living Well groups were closed groups; approximately 46 Veterans were randomized to Living Well in each cohort. official website and that any information you provide is encrypted Privacy Policy, Districtwide ASCA National Model Training, Ignite: Practical Strategies for a Successful Year, ASCA Ethical Standards for School Counselors, ASCA Student Standards: Mindsets & Behaviors for Student Success, ASCA Professional Standards & Competencies, ASCA-Recognized School Counselor Preparation Program, http://www.peerprogramprofessionals.org/uploads/3/4/7/4/34744081/persinpeerprogv28_1_.pdf, https://qprinstitute.com/uploads/instructor/QPR-Training-for-Youth-Guidelines-2019.pdf, https://www.search-institute.org/our-research/development-assets/developmental-assets-framework/, Bullying/Harassment Prevention and the Promotion of Safe Schools, Identification, Prevention and Intervention of Harmful or Disadvantageous Behaviors, Individual Student Planning for Postsecondary Preparation, Prevention of School-Related Gun Violence, Prevention of Sexually Transmitted Infections, Retention, Social Promotion and Age-Appropriate Placement, Use of Non-School-Counseling Credentialed Personnel in Implementing School Counseling Programs, Use of Support Staff in School Counseling Programs, Working with Students Experiencing Issues Surrounding Undocumented Status, follow the ASCA Ethical Standards for School Counselors as they relate to peer support programs, including safeguarding the welfare of students participating in peer support programs and providing appropriate training and supervision for peer helpers (ASCA, 2022; QPR, 2019), use best practices when developing and implementing peer support programs (Berger, et al., 2018), create a selection plan for peer helpers reflecting the diversity of the population to beserved, develop a support system for the program that communicates the programs goals and purpose through positive public relations, monitor, assess and adjust the program and training on a continual basis to meet the assessed needs of the school population the programserves, report results to all school stakeholders (e.g., students, teachers, administrators, parents,community). A facilitator in a school environment might help a fellow student adjust to a new school, deal with friendship conflict or work through a boyfriend or girlfriend issue. All coding was entered into NVivo 11 [16]. Preferred Reporting Items for Systematic Reviews and Meta-Analyses;RCT, Effective peer facilitators are good listeners who are dependable, trustworthy and approachable. Training duration and intensity ranged from a one hour information session [35] to a four-week programme [46]. Overall, the co-facilitation model was positively received. We mapped the evidence using a narrative summary of intervention characteristics by area of health need. Participant interviews focused on Veterans experiences with participating in the Living Well intervention, including their impressions of the quality of facilitation, with questions such as, What did you think about having, [name], who is a peer, co-facilitate the group?. Only one [47] of the four positive studies focused on an actual mental disorder, and reported a reduction in the severity of depression. After formal training, additional hours will consist of helping develop material, staffing events, and promoting PCD. She holds a doctorate in Social Welfare and a masters degree in Social Work. Consent for Publication As part of the written informed consent process, participants were informed that data from the study may be published. Depending on the environment, facilitators might also learn about drugs, alcohol and sexually transmitted diseases. Preliminary analysis of the first five interviews (with three participants and two peer facilitators) allowed for the identification of new questions and topics of interest, resulting in modification of the interview guides to address these topics. - P16: it was nice to have a small group. And sometimes I even saw them kind of overlapping each other they got so comfortable where they started kind of just blending. Karen L. Fortuna is an Assistant Professor in the Department of Psychiatry at the Geisel School of Medicine at Dartmouth. These multi-component interventions require evaluations that theorise and assess the interaction between peer and non-peer-facilitated components, or the environment within which interventions are delivered as complex system [57, 58]. Facilitation has been described as a key component of getting research findings into practice. Australia. Would you like to become a peer facilitator for the Project on Civic Dialogue? Chinman M, George P, Dougherty RH, et al. Peer Facilitation Program Goals, Objectives and Outcome Sample Peeples, Hack, Klingaman, and Lucksted worked on data collection. A peer facilitator helps others work through their problems by offering emotional support as well as guidance regarding different situations.
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