'Thriving With Bipolar Disorder': Co-design and Evaluation of a Peer-Led Education Program Focused on Quality of Life

N/ANot Yet RecruitingNCT06878937

University of British Columbia44 enrolled

Overview

Self-management strategies can be used by individuals with bipolar disorder (BD) to cope with symptoms and improve quality of life (QoL). Peer-facilitated education programs have the potential to diversify delivery of self-management information by capitalizing on the expertise of individuals who live well with BD. We have co-designed a novel, peer-facilitated, QoL-focused, group education program for people living with BD. This project will involve administration of the program and an evaluation of the feasibility, acceptability, and efficacy of this program for self-management of BD.

Background and Purpose: Peer support (where individuals with shared lived experience of a mental health condition provide each other with informational, emotional, and social support) may be an acceptable way to disseminate information on self-management strategies, capitalizing on the expertise and knowledge of people who live well with BD. Peer-facilitated group psychoeducation includes the benefits of evidence-based self-management information and tools, with the added advantage of providing role models for recovery and modelling of self-management skills. Unfortunately, there is a dearth of BD-specific peer-facilitated self-management psychoeducation programs, and corresponding evaluations of their efficacy. To capitalize on the potential of peer support to enhance the delivery of BD self-management information, content from two, web-based, self-directed psychoeducational interventions was adapted to create a peer-facilitated psychoeducation program using a community-based participatory research (CBPR) framework. The resulting program contains eight, weekly, two-hour sessions. Each session focuses on a topic related to QoL in BD (including Mood, Sleep, Physical Health, Relationships, Money, Self-esteem, and Independence), and contains a combination of education, opportunities for peer-to-peer knowledge exchange, and activities that facilitate practice of self-management strategies. A facilitator and attendee manual have been created for use in this program. Methods: The project will be implemented across two phases: In the first phase, which we have already completed, we have applied CBPR principles to develop a peer-facilitated, QoL-focused group psychoeducation program for individuals with BD. The resulting program, entitled 'Thriving with bipolar disorder' will be delivered in eight, weekly, two-hour sessions that will be co-facilitated by two peer facilitators with lived experience of BD. In the second phase, we will conduct a pilot evaluation of the feasibility, acceptability, and preliminary efficacy of the program. The program will be delivered through Hope+Me, an Ontario-based charity that supports people living with mood and anxiety disorders through education, advocacy, training, and support services. Four peer facilitators will be recruited through Hope+Me and will attend a \~5.5 hour training session prior to commencing the program. We will aim to recruit 32-40 program participants (8-10 per group) given previous research summarizing the ideal group size. The evaluation will be conducted as a single-arm, uncontrolled, pilot feasibility trial. An explanatory sequential mixed-methods design will be used. The following data will be collected: * Participants will provide baseline demographic and clinical information in a survey as part of their consent. * Participants will complete surveys for efficacy measures at baseline, immediately after completing the program and 1 month after completing the program. * Program feedback will be collected from participants immediately after completing the program through a Qualtrics survey. * Peer facilitators will complete a brief, post-session Qualtrics survey each week, recording attendance, fidelity, and session feedback. At the end of the intervention period, a subset of consenting participants (\~n=12) and peer facilitators (\~n=4) will be invited to participate in a one-hour qualitative individual interview over Zoom. Study Population: Four peer facilitators will be recruited through Hope+Me. We hope to recruit \~fourty program participants. Inclusion and exclusion criteria are specified in the 'Eligibility' section.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Program facilitators * aged 18 or older * a self-reported diagnosis of a mood disorder * sufficient access to an internet-enabled computer or smartphone device to access the Zoom teleconferencing platform * ability to understand, read and write English * at least one year of prior experience leading peer support groups or recovery programs through Hope+Me * previously received training through Hope+Me * completed a Criminal Records Check 2. Program participants * aged 18 or older * residing in Canada * a self-reported diagnosis of BD * ability to understand, read and write English * sufficient access to an internet-enabled computer or smartphone device to access the Zoom teleconferencing platform Exclusion Criteria: * inability to communicate in written and verbal English to a sufficient level to allow participation in the program and research activities

Outcomes

Primary Outcomes

Feasibility (Session Attendance)

Feasibility will be assessed using program attendance rates. After each session, peer facilitators will complete a brief questionnaire to record the number of participants who attended each session. Feasibility is defined as the proportion of participants achieving the minimum attendance of 62.5% (i.e., five out of eight sessions), based on the median therapeutic dose in a review of group therapy program evaluations.

Time frame: Every week, from enrollment to the end of the intervention at 8 weeks.

Secondary Outcomes

Patient Health Questionnaire 8 (PHQ-8)

Self-reported depressive symptoms will be assessed by the Patient Health Questionnaire-8 (PHQ-8), which evaluates 8 of the 9 criteria for depression from the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). The eight Likert-type items ask about the frequency of depressive symptoms experienced in the past two weeks (0 = "Not at all" to 3 = "Nearly every day"). Responses are summed to create a total score (range: 0-24); higher scores indicate greater depression severity. The PHQ-8 performs comparably with clinician assessments; internal reliability has been demonstrated in population studies (Cronbach α=0.87). The PHQ-8 has comparable performance to the original nine item version (PHQ-9), which assesses all DSM-IV criteria, including current suicidal ideation. The PHQ-8 is chosen for this evaluation because this program doesn't incorporate formal psychiatric evaluation and supports, data collected is self-reported, and immediate follow-up isn't possible.