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

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.

• Patient Health Questionnaire 8 (PHQ-8) [Срок оценки: At enrollment, immediately after the intervention at 8 weeks, and a follow-up 4 weeks after the intervention.]
• Quality of Life in Bipolar Disorder (QoL.BD) Scale [Срок оценки: At enrollment, immediately after the intervention at 8 weeks, and a follow-up 4 weeks after the intervention.]
• Altman Self-Rating Mania Scale [Срок оценки: At enrollment, immediately after the intervention at 8 weeks, and a follow-up 4 weeks after the intervention.]
• Bipolar Recovery Questionnaire [Срок оценки: At enrollment, immediately after the intervention at 8 weeks, and a follow-up 4 weeks after the intervention.]
• Stanford's Chronic Disease Self-Efficacy 'Manage Disease in General' Subscale [Срок оценки: At enrollment, immediately after the intervention at 8 weeks, and a follow-up 4 weeks after the intervention.]
• Self-Compassion Scale-Short Form [Срок оценки: At enrollment, immediately after the intervention at 8 weeks, and a follow-up 4 weeks after the intervention.]
• Internalised Stigma of Mental Illness Scale Brief Version [Срок оценки: At enrollment, immediately after the intervention at 8 weeks, and a follow-up 4 weeks after the intervention.]
• Social Provisions Scale Short Form [Срок оценки: At enrollment, immediately after the intervention at 8 weeks, and a follow-up 4 weeks after the intervention.]
• Client Satisfaction Questionnaire-8 [Срок оценки: Immediately after the intervention at 8 weeks.]
• Group Climate Questionnaire Short Form [Срок оценки: Every week, from enrollment to the end of the intervention at 8 weeks.]
• Feasibility (Fidelity) [Срок оценки: Every week, from enrollment to the end of the intervention at 8 weeks.]