Multicultural experiences of service users receiving UPSIDES peer support

Yael GOLDFARB1, Alina GRAYZMAN 2, Silvia KRUMM3, Maria HAUN3, Galia S. MORAN2

1Academic College of Tel Aviv Yaffo, Tel Aviv, Israel
2Ben Gurion University of the Negev, Be'er Sheva, Israel
3Ulm University, Ulm, Germany

Introduction: UPSIDES is an multinational research initiative aimed at developing and implementing a peer support (PS) intervention across diverse socio-economic status, cultures and organizational contexts. The intervention is committed to universal core peer principles, while maintaining local flexibility.  However less is known about the experiences of service users (SUs) receiving peer support. The current study investigates the experiences and attitudes of SUs who received the UPSIDES peer support intervention.

Methods: Using a mixed method design ‘edge’  participants were purposively selected based on self-report measures which indicated either high or low changes in the main outcome measure . Thirty-four semi-structured interviews were conducted at six study sites (Germany, Uganda, Tanzania, Israel, & India). Transcripts were analyzed using qualitative content analysis.

Results: Data analysis revealed four themes: (1) Variations in settings (e.g., place, duration, frequency of meetings) highlighting both advantages of flexibility and downsides such as different service-user/peer-support-worker preferences and uncertainty. (2) Positive outcomes of PS such as improvement in intra-personal (e.g., self-care, treatment adherence) inter-personal (e.g., family relationships, social inclusion), and behavioral (starting a job) aspects. (3) ‘Active ingredients’, such as the experience of being seen and cared for and having a role model of recovery. (4) Barriers, such as personal resources invested, criticism of PSWs, and feeling obliged to participate.

Discussion: SUs experienced a wide variety of benefits following UPSIDES peer support intervention. For some, the mere experience of having a person to talk to was rare, more so in low-income-countries. Others highlighted processes of non-judgmental acceptance and having a recovery role model. Barriers suggest that a careful matching process between the PSW and SU could improve benefits.

Conclusion: Findings lead to important insights on the value of PS, and highlight further steps to implement PS services in various cultural and organizational contexts.