Mental health |
Peer support for discharge from inpatient mental health care versus care as usual in England (ENRICH): a parallel, two-group, individually randomised controlled trial(14)
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Gillard S et al.(14)
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2022 |
England |
Two-group, randomized, parallel, controlled superiority study with study personnel masked to allocation |
Establish if peer support for discharge reduces readmissions in the year after discharge |
The peer support group received individualized manual-based peer support focused on building individual strengths and engagement with community activities, beginning during initial admission and continuing for 4 months after discharge in addition to usual care. Usual care consisted of follow-up by community mental health services within 7 days of discharge. The primary outcome was psychiatric readmission 12 months after discharge (number of patients readmitted at least once), analyzed based on intention to treat. |
In the peer support group 47% of patients were readmitted at least once within 12 months of discharge, and 50% were readmitted in the usual care group |
Adoption of the intervention was assessed in 91% of patients before discharge and 90% after discharge |
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Did not use theoretical implementation framework |
Sexually transmitted infections |
Effects of behavioural interventions on postpartum retention and adherence among women with HIV on lifelong ART: the results of a cluster randomized trial in Kenya (the MOTIVATE trial) (15)
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Abuogi LL, et al (15)
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2022 |
Kenya |
Cluster randomized controlled trial |
Assess the impact of two evidence-based behavioral interventions on postpartum adherence and retention in Kenya |
The text messaging intervention was developed based on qualitative formative research and the Health Belief Model. Participants received text messages. Messages were sent weekly from study enrollment during pregnancy until 12 months postpartum. Participants could also communicate by phone free of charge with a study nurse |
In the secondary analysis of viral load suppression, among 791 (59.4%) women with a viral load result 12 months postpartum, only 43 (5.4%) were not suppressed. These women more frequently reported adherence below the ideal at inclusion in the study (p = 0.040) and had a history of previous high viral load |
Adjusted hazard ratios for good versus fair/poor adoption at 12 months postpartum were not statistically different between the intervention arms and the control arm |
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Did not use theoretical implementation framework |
Project Shikamana: Community Empowerment-Based Combination HIV Prevention Significantly Impacts HIV Incidence and Care Continuum Outcomes Among Female Sex Workers in Iringa, Tanzania (16)
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Kerrigan D, et al (16)
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2019 |
Iringa, Tanzania |
Randomized study |
Determine the impact of a community empowerment model of combined HIV prevention (Project Shikamana) among female sex workers (FSW) |
Intervention elements included the following: (1) Center for embracement and community-led mobilization activities; (2) place-based peer education, condom distribution, and HIV testing; (3) peer service navigation; (4) provider sensitivity trainings; and (5) SMS reminders |
Participants had an incidence of HIV infection of 5.0% in the intervention versus 10.4% in the control at 18 months. Reductions in inconsistent condom use over time were significantly greater in intervention (72.0%-43.6%) versus control |
Adoption |
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Did not use theoretical implementation framework |
Effect of a differentiated service delivery model on virological failure in adolescents with HIV in Zimbabwe (Zvandiri): a cluster-randomised controlled trial (17)
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Mavhu W, et al (17)
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2020 |
Zimbabwe |
Cluster randomized controlled trial |
Evaluate a peer-led differentiated service delivery intervention on HIV clinical and psychosocial outcomes among adolescents with HIV in Zimbabwe |
16 public primary care facilities (clusters) in two rural districts in Zimbabwe (Bindura and Shamva) were randomly assigned (1:1) to provide enhanced HIV treatment support (the intervention group) or standard HIV care (the control group) for adolescents (13-19 years of age) with HIV. The intervention program, recommended by the WHO in 2013 as a program of good practices, is a multicomponent and theoretically based differentiated service delivery model for children, adolescents and young people with HIV |
Process evaluation data suggested that the Zvandiri intervention improved adolescents’ quality of life through a focus on shared experiences, role modeling, and supportive friendship |
Adoption, appropriateness |
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Did not use theoretical implementation framework |
The Impact of Structured Mentor Mother Programs on Presentation for Early Infant Diagnosis Testing in Rural North-Central Nigeria: A Prospective Paired Cohort Study (18)
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Sam-Agudu NA, et al (18)
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2017 |
Nigeria |
Randomized and matched cohort |
The aim of the MoMent (Mother Mentor) is to evaluate the impact of structured programs on the primary outcomes of timely presentation of early infant diagnosis (EID) and postpartum maternal retention and, secondarily, on HIV-exposed infant disease-free survival |
497 HIV-positive pregnant women were consecutively recruited from 10 primary health care centers with structured support and closely supervised by the Mentor Mother (MM) and 10 pair matched primary healthcare centers with peer support. EID was assessed among HIV-exposed infants delivered to recruited women and was defined by presentation for DNA polymerase chain reaction testing between 35 and 62 days of life |
Effect of MMs on improved early childhood diagnosis presentation. OR = 3.7, 95% CI: 2.8 to 5.0 |
Adoption |
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Did not use theoretical implementation framework |
Sexually transmitted infections |
Project Khanya: results from a pilot randomized type 1 hybrid effectiveness-implementation trial of a peer-delivered behavioural intervention for ART adherence and substance use in HIV care in South Africa (25)
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Magidson JF, et al (25)
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2021 |
Western Cape, South Africa |
Type 1 hybrid randomized study |
Improving Antiretroviral Therapy (ART) adherence and reducing Alcohol and Other Drug Use (AOD) in HIV treatment |
Khanya is a six-session peer-delivered behavioral intervention that integrates multiple evidence-based intervention components—behavioral activation, problem solving, motivational interviewing, and mindfulness-based relapse prevention—adapted during formative work prior to this study. The aim of the intervention is to support increased ART adherence and the establishment of individualized goals for AOD reduction by teaching evidence-based behavioral skills to support achievement of these goals |
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100% of participants started the intervention and 70% (fidelity) attended all six sessions; 88% reported satisfaction with the number of treatment sessions. Feasibility, acceptability and appropriateness of Khanya were rated very highly (feasibility: M = 2.98; SD = 0.18; acceptability: M = 2.98; SD = 0.04; appropriateness: M = 2.94, SD = 0.09). For Enhanced Treatment as Ususal, 80.6% attended the Head Office referral, of which 68% attended just one session. Interventionist self-reported fidelity was 96.5% for Khanya. The average fidelity of the independent evaluator was 91.7% |
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Proctor |
Chronic non-communicable diseases |
Peer support to improve diabetes care: an evaluation of the implementation of the Australasian Peers for Progress Diabetes Program (20)
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Aziz Z, et al (20)
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2018 |
Victoria, Australia |
Implementation |
To evaluate the implementation of a cluster randomized controlled trial of a group-based peer support program to improve diabetes self-management and thereby, diabetes control in people with type 2 diabetes in Victoria, Australia |
The intervention program is designed to address four key functions of peer support, namely 1) assistance with daily management, 2) social and emotional support, 3) regular linkage to clinical care, and 4) ongoing and sustained support to help with the lifelong needs of diabetes self-care management |
Briefly, the proportion of participants who showed improvement in the primary outcome, i.e., 5-year reduction in score of the UKPDS risk engine, was 0.651 (65.1%) in the intervention arm and 0.448 (44.8%) in the usual care group. Effectiveness Coefficient = 0.651 (65.1%) |
Adoption 91.6% Reach 61.9% Intervention fidelity was high (92.7%) |
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RE-AIM and PIPE |
A peer-support lifestyle intervention for preventing type 2 diabetes in India: A cluster-randomized controlled trial of the Kerala Diabetes Prevention Program (21)
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Thankappan KR, et al (21)
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2019 |
India |
Cluster randomized controlled trial |
To evaluate the effectiveness of a peer-supported lifestyle intervention in preventing type 2 diabetes among high-risk individuals identified based on a simple diabetes risk score |
The 12-month intervention program consisted of (1) a group-based peer support program consisting of 15 sessions over a 12-month period for high-risk individuals, (2) peer leader (PL) training and support continuum for delivery of the intervention, (3) diabetes education resource materials, and (4) strategies to encourage broader community engagement. The assessment was informed by the RE-AIM and PIPE frameworks |
Intervention participants were 83% more likely to consume ≥5 servings of fruits and vegetables per day and 23% less likely to consume alcohol compared to control participants at 24 months. Furthermore, the amount of alcohol consumed was significantly lower among intervention participants |
Adoption; implementation costs (low), effect (lower) |
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Did not use theoretical implementation framework |
A group-based lifestyle intervention for diabetes prevention in low- and middle-income country: implementation evaluation of the Kerala Diabetes Prevention Program (26)
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Aziz Z, et al (26)
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2018 |
Kerala, India |
Cluster randomized controlled study of a group-based lifestyle intervention among individuals at high risk of developing type 2 Diabetes Mellitus (T2DM) |
Discover provider-, participant-, and community-level factors relevant to a successful implementation and transferable to other low- and middle-income countries |
The 12-month intervention program consisted of (1) a group-based peer support program consisting of 15 sessions over a 12-month period for high-risk individuals, (2) peer leader (PL) training and support continuum for delivery of the intervention, (3) diabetes education resource materials, and (4) strategies to encourage broader community engagement. The assessment was informed by the RE-AIM and PIPE frameworks |
Intervention participants were 83% more likely to consume ≥5 servings of fruits and vegetables per day and 23% less likely to consume alcohol compared to control participants at 24 months. Furthermore, the amount of alcohol consumed was significantly lower among intervention participants |
Acceptability - Diet improvement 99% Increase in physical activity 96% Reduction of smoking/tobacco 76% Reduction of alcohol consumption 98% |
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RE-AIM and PIPE |
Chronic non-communicable diseases |
Effectiveness of a community-based education and peer support led by women’s self-help groups in improving the control of hypertension in urban slums of Kerala, India: a cluster randomised controlled pragmatic trial (29)
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P Suseela R, et al (29)
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2022 |
Kerala, India |
Cluster randomized controlled trial |
To evaluate the effectiveness of a community-based education and peer support program led by women of the self-help group (SHG) in reducing mean systolic blood pressure (SBP) among people with hypertension in urban slums of Kochi city, Kerala, India |
The intervention was delivered by female SHG members (1 per 20-30 families) who provided (1) assistance in daily hypertension management, (2) social and emotional support to encourage healthy behaviors, and (3) referral to primary health care. Subjects in the control arm received standard care |
The primary outcome was the change in mean SBP. The mean reduction in SBP among participants in the intervention arm was 6.3 mm Hg (SD 21.1) compared to 2.2 (SD 21.3) in the control arm, for a net difference of 4.1 (95% CI 2.2 to 4.1), p< 0.001 |
Secondary outcomes were the proportion of patients using antihypertensive medication and change in self-reported medication adherence scores. A significant increase in medication adherence scores by 0.9 (0.6, 1.1) |
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Did not use theoretical implementation framework |
Health education |
Evaluation of a community-based intervention for health and economic empowerment of marginalized women in India (22)
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Sharma S, et al. (22)
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2020 |
India |
Implementation |
Improve marginalized women’s awareness and utilization of MCH services and access to means of livelihood and savings using peer-led approach from two districts of India |
Peer educators as mediators of knowledge transfer between women and for the creation of a supportive environment at household and community levels. The intervention was implemented in two marginalized districts |
Women’s awareness of maternal and child health appears to have increased after the intervention |
Adoption - awareness (effectiveness /effect) and use of services |
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Did not use theoretical implementation framework |
The evaluation of the Woman’s Condom marketing approach: What value did peer-led interpersonal communication add to the promotion of a new female condom in urban Lusaka? (27)
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Pinchoff J, et al (27)
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2019 |
Lusaka, Zambia |
Randomized study |
To measure the additional impact of a peer-led interpersonal communication (IPC) intervention on awareness and acceptance of the new female condom |
First, we implemented a mystery shopper survey in half of the study wards to visit retail outlets and determine whether the toilet was available, in stock and associated with any advertising such as posters. This information was cross-referenced with previously collected data on distribution to points of sale. Second, we monitored aggregated website data to measure traffic to the website and checked to see if the billboards were still in place. Third, we conducted spot checks of IPC events and shadowing of IPC agents to monitor recruitment and ensure that all components of the IPC curriculum were routinely covered. Finally, we conducted 30 focus group discussions to discuss perceptions and awareness about the Woman’s Condom product |
Adherence to female condoms. Conditional on these covariates, the estimated effect of the PCI intervention is a 1.8 percentage point increase in female condom use (τ = 0.018, 95% CI [-0.001, 0.035], p = 0.06). Although it is statistically significant at the 10% level, it is not significant at the pre-specified 5% level |
Acceptability and acceptance of the new product |
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Did not use theoretical implementation framework |
Health promotion |
Effectiveness and cost-effectiveness of the GoActive intervention to increase physical activity among UK adolescents: A cluster randomised controlled trial (28)
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Corder K., et al (28)
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2020 |
Cambridgeshire and Essex, United Kingdom |
Cluster randomized controlled trial |
To evaluate the effectiveness and cost-effectiveness of the GoActive intervention to increase moderate-to-vigorous physical activity (MVPA) among adolescents aged 13-14 years |
GoActive aims to increase physical activity by increasing peer support, self-efficacy, self-esteem and friendship quality. It was implemented in tutor groups using a student-led hierarchical leadership system |
Mean accelerometer-assessed MVPA decreased in both randomized groups between baseline and 10-month follow-up. The reduction was somewhat greater in the intervention group, although the confidence interval around the intervention effect was wide and inconclusive |
Intervention fidelity was 37.9%; 46.5% entered activity points using the website. Regarding satisfaction, 62.9% of students reported that GoActive was fun, 70% of teachers reported they enjoyed facilitating it, and 87.3% of mentors said it was fun |
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Did not use theoretical implementation framework |
Neglected diseases |
Impact of a tuberculosis treatment adherence intervention versus usual care on treatment completion rates: results of a pragmatic cluster randomized controlled trial (23)
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Puchalski Ritchie LM, et al (23)
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2020 |
Malawi |
Pragmatic randomized controlled trial |
Refine and evaluate an intervention designed to address common causes of tuberculosis (TB) treatment nonadherence and lay health workers (LHW) and skills training needs. |
In intervention health centers, a TB treatment adherence intervention was implemented using educational outreach, a point-of-care reminder tool, and a peer support network. Clusters in the control arm provided usual care |
There was no significant effect of the intervention on TB treatment success. Adjusted OR 1.35 (95% CI 0.93 to 1.98), with high variation in the quality of implementation, a potential contributing factor |
Low levels of reach, adoption and implementation in many intervention sites |
We found no significant effect of the intervention on TB treatment outcomes with high variability in the quality of implementation |
RE-AIM |
Process evaluation of an implementation strategy to support uptake of a tuberculosis treatment adherence intervention to improve TB care and outcomes in Malawi (24)
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Puchalski Ritchie LM, et al (24)
|
2021 |
Malawi |
Pragmatic randomized controlled trial |
To assess implementation and identify barriers and facilitators to the implementation, sustainability and scalability of an implementation strategy to provide lay health workers (LHWs) with the knowledge, skills and tools needed to implement an intervention to support treatment adherence of patients with tuberculosis (TB) |
The strategy employed was on-site peer-led educational outreach, a clinical support tool, and a peer support network to implement a TB treatment adherence intervention |
There was no significant effect of the intervention on TB treatment success. Adjusted OR 1.35 (95% CI 0.93 to 1.98), with high variation in the quality of implementation, a potential contributing factor |
Reach 59% Adoption 91% Sustainability 100% |
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RE-AIM |