A Process evaluation of the intervention "Paths to EvERyday Life" (PEER)

Cecilie Høgh EGMOSE1,2,3, Chalotte Heinsvig POULSEN1, Siv Therese Bogevik BJØRKEDAL1, Lene Falgaard EPLOV, 1

1Copenhagen Research Centre for Mental Health (CORE), Mental Health Centre Copenhagen. Copenhagen, Denmark., Copenhagen, Denmark
2University of Copenhagen, Copenhagen, Denmark
3Centre for Applied Research in Mental Health Care (CARMEN), Mental Health Center Glostrup, Glostrup, Denmark

Introduction: 

The peer support intervention “Paths to EvERyday life” (PEER) is a co-peer-led manualized intervention delivered in a Danish municipality civil society setting. PEER is a ten-week group course for people with mental health difficulties facilitated by two voluntary peers. The focus of the course is on everyday life, well-being, and personal recovery. PEER was investigated through an RCT and a process evaluation.

Methods: 

In a process evaluation framework, the perspectives of the participants, as well as the volunteer peers were studied. Participants receiving PEER were interviewed using realistic interviews at the end of the 10-week group course with a focus on mechanisms of change. The analysis was informed by peer support theory and guided by reflective thematic analysis. The perspective of the volunteer group facilitators was studied through focus groups with a focus on their working conditions.

The implementation of PEER throughout the RCT was measured with a fidelity scale developed for the intervention.

Results: 

Four overarching themes were identified, elucidating how, when, and under what circumstances PEER impacted the recovery and well-being of the participants. The preliminary results deal with themes about connectedness, cultivating hope, identity and change process.

The volunteer peers experienced a contradictory dual role between facilitating and sharing equally, the structured manual was safe but challenging for group dynamics. The fidelity measuring showed that implementation had gone well with some differences across municipalities and groups.

Conclusion:

The process evaluation showed that the intervention was mainly implemented according to the values and principles. The qualitative studies indicate that the PEER participants experienced some individual changes that are essential for the recovery of mental illness and that the volunteer peers find the role to sometimes be challenging but find reassurance in the structured manual.