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Developing and testing a principle-based fidelity index for peer support in mental health services
S Gillard1,2, N Banach3, E Barlow4
1Population Health Research Institute, St George's, University of London, London, UK. sgillard@sgul.ac.uk.
Social Psychiatry and Psychiatric Epidemiology
|February 19, 2021
Summary
A new fidelity index was developed to ensure one-to-one peer support in mental health services maintains its unique relational qualities. This tool helps assess adherence to core peer support principles in regulated environments.
Area of Science:
- Mental Health Services Research
- Psychometric Validation
- Healthcare Quality Improvement
Background:
- Peer support offers distinct relational benefits compared to clinical relationships.
- These unique qualities risk being diminished within regulated healthcare settings.
- Measuring fidelity is crucial for evaluating peer support interventions accurately.
Purpose of the Study:
- To develop and test a fidelity index for one-to-one peer support in mental health.
- The index aims to assess adherence to principles that define peer support's distinctiveness.
- To provide a tool for maintaining the integrity of peer support in services.
Main Methods:
- Expert panels (service users, peer supporters) informed index development.
- Index tested across 24 diverse mental health services.
- Fidelity assessed via interviews, analyzed for reliability and refined using feedback.
Main Results:
- A psychometrically sound fidelity index for one-to-one peer support was created.
- The index evaluates four key domains: trust/shared experience, reciprocity, autonomy, and community connection.
- Good inter-rater reliability and internal consistency were achieved.
Conclusions:
- The developed index can enhance the evidence base for mental health peer support.
- It enables future trials to rigorously assess intervention fidelity.
- Service providers can use the index to safeguard the distinctive nature of peer support.
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