Traumatic injuries from events like car crashes, falls, or fires are a leading cause of disability. Survivors often face not only physical challenges but also long-lasting pain, mental health challenges and difficulty returning to work and family life. Although medical care focuses on physical recovery, survivors frequently report that their emotional and social needs are overlooked and unmet. Peer support-guidance from people who have lived through similar injuries-can reduce distress and improve coping. However, no programs in Canada currently provide peer support to trauma survivors across their recovery journey, from hospital to rehabilitation to community living. The investigators worked with trauma survivors, caregivers, and healthcare providers to co-design a Peer Support Program (PSP) that offers support throughout these stages. This pilot study will test whether the program is feasible and acceptable, and explore its early impact on recovery. Results will guide a future larger trial to expand peer support in trauma care.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
49
Trained trauma-survivor peer supporters (n=4), supported by a research team member; peers complete a 5-session training covering trauma-informed communication, boundaries, crisis de-escalation, self-care, and secondary trauma. Trauma survivors will be recruited in acute care and have the option to meeting once with a trained peer supporter prior to discharge to inpatient rehabilitation. In in-patient rehab they will attend 1 hour peer support group sessions facilitated by the trained peer supporters twice a week for a total of 3 weeks. Once discharged the community, they will attend 1 hour peer support group sessions facilitated by the trained peer supporters once a week for a total of 12 weeks.
St. John's Rehab at Sunnybrook
Toronto, Ontario, Canada
Sunnybrook Health Sciences Centre
Toronto, Ontario, Canada
Feasibility of implementing the Peer Support Program
To determine the feasibility of implementing the Peer Support Program (PSP) for trauma survivors. We will measure the criteria below to establish feasibility. These feasibility goals were established with reference to another study our group conducted aimed at assessing the feasibility of a novel psychosocial group intervention for amputees. * RECRUITMENT (proportion of eligible participants approached who consent-GOAL: ≥50%), * WITHDRAWAL (proportion of study participants who withdraw from the study before the end of Phase II (Inpatient Rehabilitation)-GOAL: ≤ 25%) * ADHERENCE (proportion of PSP sessions attended by participants-GOAL: ≥60%), * RETENTION (proportion of participants who complete the program-GOAL: ≥60%); * BASELINE SURVEYS (proportion of surveys completed-GOAL: ≥70%). * POST-INTERVENTION SURVEY (proportion of surveys completed-GOAL: ≥60%): * SURVEY AT 3 MONTH FOLLOW UP (proportion of surveys completed-GOAL: ≥50%):
Time frame: From recruitment to 3 months post intervention
Community Reintegration - Normal Living Index (RNL) Index
The 11-item Reintegration to Normal Living Index (RNL) Index covers areas such as involvement in recreational and social activities, perceived ability to move within the community, and the degree of comfort people have with their relationships. It is a valid and reliable tool for assessing participation in various populations. Scores range from 0 to 110, with a higher score indicating a higher level of community reintegration.
Time frame: Baseline, up to 2 weeks post intervention, and 3-months post intervention
Coping Self-Efficacy (CSE) - 20-item CSE Scale
The 20-item CSE Scale66 is a coping self-efficacy scale that has a robust factor structure across different types of post-traumatic events, making it especially suitable for use in various trauma populations. For each item, respondents rate their perceived efficacy on dealing with different consequences of trauma on a 7-point scale (e.g. 'resuming normal life'; 'being optimistic since the event'). Scores range from 20 (low self-efficacy) to 140 (high self-efficacy). The internal consistency of the scale has been found to be excellent across three panel waves of data in persons who had experienced a traumatic event in the previous two years
Time frame: Baseline, up to 2 weeks post intervention, and 3-months post intervention
Health-Related Quality of Life - The Short-Form 36 (SF-36)
The Short-Form 36 (SF-36) is the most widely used generic health-related QoL instrument, including Neuro-musculoskeletal injuries, which measures 8 multi-item dimensions of health: physical functioning, social functioning, role limitations due to physical and emotional problems, mental health, energy/vitality, pain, and general health perception. Scores range from 0 to 100 on each domain, with lower scores indicating poorer function. These eight dimensions are summarized into a physical and mental health summary score. The SF-36 is sensitive to changes in functioning over time, and has demonstrated clinically meaningful, albeit modest, change in trauma patients.
Time frame: Baseline, up to 2 weeks post intervention, and 3-months post intervention
Post-Traumatic Stress Disorder (PTSD) - The PTSD Checklist-Civilian Version (PCL-C)
The PTSD Checklist-Civilian Version (PCL-C) is a standardized 17-item self-report rating scale for PTSD that is well-validated across different populations. Respondents indicate how much they have been bothered by a symptom over the past month using a 5-point scale, with higher scores indicating more severe levels of PTSD.
Time frame: Baseline, up to 2 weeks post intervention, and 3-months post intervention
Post-Traumatic Growth - The Post-Traumatic Growth Inventory (PTGI)
The Post-Traumatic Growth Inventory (PTGI) is a 21-item scale assessing positive outcomes reported by those who have experienced traumatic events. Items are scored on a 6-point scale and scores range from 0 to 105, with higher scores indicating greater levels of growth. It has good levels of internal consistency reliability (α=.90) and 2-month test-retest stability (r =.71).
Time frame: Baseline, up to 2 weeks post intervention, and 3-months post intervention
Social Support - The Medical Outcomes Study Social Support Survey (MOS-SS)
The Medical Outcomes Study Social Support Survey (MOS-SS) is a 19-item measure of perceived social support across four subscales: emotional/information support; tangible support; affectionate support; and positive social interaction. Questions are answered on a 5-point scale ranging from "none of the time" to "all of the time", with higher scores indicating more support. The MOS-SS has very good internal consistency across populations including chronic disease and chronic pain.
Time frame: Baseline, up to 2 weeks post intervention, and 3-months post intervention
Loneliness and Social Isolation -The UCLA 3-Item Loneliness Scale
The UCLA 3-Item Loneliness Scale measures three dimensions of loneliness: relational connectedness, social connectedness and self-perceived isolation. Items are scored from 1 (hardly ever) to 3 (often), with higher scores indicating greater loneliness and isolation. It has satisfactory reliability and both concurrent and discriminant validity.
Time frame: Baseline, up to 2 weeks post intervention, and 3-months post intervention
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