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The goal of this interventional study is to assess whether a peer coaching intervention (PEER) can improve the well-being in individuals who experienced a stroke. The main questions it aims to answer are
For intervention recipient recruitment, stroke survivors who have been diagnosed with stroke in the past 12 months and have been discharged from hospitals will be recruited from the collaborating community services and open recruitment. Recruited intervention recipients will proceed to take a baseline survey which collects their demographic characteristics, stroke-related information, wellbeing measures, and quality of life measure (T1). For peer coach recruitment, experienced stroke survivors who have been diagnosed with stroke in the past 5 years will be invited to participate in the study as peer coaches.
Recruited peer coaches will be asked to complete a preliminary survey. The preliminary survey collects peer coaches' demographic characteristics and stroke-related information, which will be sued for the matching between peer coaches and intervention recipients. The preliminary survey will also assess their well-being outcomes, QoL, self-determination level, coaching skills, and cognitive ability. Peer coaches with limited cognitive ability to perform peer-coaching will not proceed to peer coach training. Following the preliminary survey, peer coaches will undergo peer coach training sessions and the post-training assessment before performing peer-coaching in the intervention. The post-training assessment will include measurement of well-being outcomes, QoL, self-determination level, coaching skills, and cognitive ability. Peer coaches with limited cognitive ability to perform peer-coaching will not proceed to the intervention delivery.
Following the post-training survey, each peer coach will be matched with an intervention recipient based to their demographic characteristics and stroke experience. Following the matching process, peer coaches and intervention recipients will proceed into the intervention process. During the intervention, intervention recipients will be asked to attend peer-coaching sessions led by the matched peer coaches. The time of peer-coaching sessions will be decided based on participants' schedules. In the peer-coaching sessions, intervention recipients and peer coaches will meet in-person, and peer coaches will guide them to carry out arranged activities collaboratively. After the last peer coaching session is completed, intervention recipients will proceed to a post-intervention survey, which measures their satisfaction with the intervention as recipients, and a personal interviews, in which they will be asked about their perceptions and opinions on the PEER program. Intervention recipient will also be asked to take the follow-up survey at 3 time points - immediately after the intervention (T2), 4 weeks after the intervention (T3), and 8 weeks after the intervention (T4). The follow-up survey measures intervention recipients' wellbeing and quality of life. After the delivery of all peer coaching sessions, peer coaches will undergo the post-intervention survey, which assesses their well-being outcomes, QoL, self-determination level, cognitive ability, coaching skills, and satisfaction with the intervention as peer coaches; peer coaches will also be asked to attend a personal interview, in which they will be asked about their perceptions and opinions on the PEER program.
The interviews for peer coaches and intervention recipients will be audio-recorded with participants' consent. The recordings will be transcribed verbatim and proceed to thematic analyses. The analysis results of collected quantitative and qualitative data will be synthesized to evaluate the feasibility and the effectiveness of the peer-coaching intervention and the feasibility of the evaluation procedures. Elements of the PEER programme and the evaluation procedure will be improved based on the analysis results for future research and implementation.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Treatment | Experimental | Intervention recipient participants in this arm will undergo the peer coaching intervention to receive support from peer coaches |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Peer-Enriched Environment for Recovery (PEER) | Behavioral | The PEER intervention is a post-stroke peer coaching intervention. Participants who undergo this intervention will have 5 coaching sessions, which are delivered by trained peer coaches in-person. In each session, peer coaches will practice psychoeducation, experience sharing, and interactive activity, to provide intervention recipients with psychosocial support. Each coaching session will focus on a specific topic related to post-stroke recovery. |
| Measure | Description | Time Frame |
|---|---|---|
| Mental well-being of intervention recipients | This outcome will be assessed by the Short Warwick Edinburgh Mental Well-being Scale (SWEMBS), a validated 7-item questionnaire designed to measure positive mental wellbeing with a 5-point Likert scale. Scores of this scale range from 7 to 35, where higher scores indicate better mental well-being. | From enrollment to 8-week post intervention |
| Psychological distress of intervention recipients | This outcome will be assessed by the Hospital Anxiety and Depression Scale (HADS), a widely used 14-item questionnaire designed to detect anxiety and depression. Scores of this scale range from 0 to 21, where higher scores indicate higher levels of anxiety and depression. | From enrollment to 8-week post intervention |
| Hope of intervention recipients | This outcome will be assessed by the Herth Hope Index (HHI), a 12-item questionnaire developed to measure the level of hope. Scores of this scale range from 12 to 84, where higher scores indicate greater levels of hope. | From enrollment to 8-week post intervention |
| Resilience of intervention recipients | This outcome will be assessed by the Brief Resilience Scale (BRS), a 6-item measure designed to assess an individual's ability to bounce back or recover from stress, adversity, and challenging life circumstances. Scores of this scale range from 6 to 30, where higher scores indicate more resilience and a better ability to bounce back from stress and adversity. | From enrollment to 8-week post intervention |
| Stroke self-efficacy of intervention recipients | This outcome will be assessed by the Stroke Self-Efficacy Questionnaire (SSEQ), a 13-item tool used to measure a stroke survivor's confidence in performing functional activities and managing their condition. Scores of this scale range from 7 to 35, where higher scores indicate better mental well-being. Scores of this scale range from 0 to 39, where higher scores indicate better self-efficacy. |
| Measure | Description | Time Frame |
|---|---|---|
| Quality of life of peer coach | This secondary outcome will be assessed by the Single-Item Assessment of Quality of Life, an 1-item questionnaire to assess quality of life with a 10-point Likert scale. Scores of this scale range from 0 to 10, where higher scores indicate greater quality of life. | Baseline, pre-intervention, immediately post-intervention |
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Inclusion criteria for peer coach:
Inclusion criteria for intervention recipients
Exclusion criteria for all participants:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Andy Hau Yan ho, PhD, EdD | Contact | +65 80112011 | andyhyho@ntu.edu.sg | |
| Farrah Dewanti, BSc | Contact | +65 8355 6789 | farrah.dewanti@ntu.edu.sg |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Nanyang Technological University | Recruiting | Singapore | 639798 | Singapore |
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| ID | Term |
|---|---|
| D020521 | Stroke |
| ID | Term |
|---|---|
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| ID | Term |
|---|---|
| D016879 | Salvage Therapy |
| ID | Term |
|---|---|
| D013812 | Therapeutics |
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| From enrollment to 8-week post intervention |
| Reintegration of intervention recipients | This outcome will be assessed by the Modified Reintegration to Normal Living Index (mRNLI), a validated 11-item assessment tool used to measure the degree to which individuals with chronic illnesses, disabilities, or traumatic injuries resume their normal social roles and activities. Scores of this scale range from 0 to 110, where higher scores indicate higher, more satisfying levels of reintegration. | From enrollment to 8-week post intervention |
| Social support of intervention recipients | This outcome will be assessed by the Inventory of Social Support, a 5-item questionnaire developed to assess the level of social support. Scores of this scale range from 5 to 25, where higher scores indicate higher levels of social support. | From enrollment to 8-week post intervention |
| Spiritual well-being of intervention recipients | This outcome will be assessed by the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being 12 Scale (FACIT-Sp-12), a widely used 12-item measure of spiritual wellbeing. Scores of this scale range from 0 to 48, where higher scores indicate greater spiritual well-being. | From enrollment to 8-week post intervention |
| Stroke specific quality of life of intervention recipients | This outcome will be assessed by the Stroke Specific Quality of Life Scale (SS-QOL), a 12-item questionnaire to assess health-related quality of life specifically for stroke survivors. Scores of this scale range from 12 to 60, where higher scores indicate better function and greater quality of life. | From enrollment to 8-week post intervention |
| Life satisfaction of peer coach | This secondary outcome will be assessed by the Single-Item Life Satisfaction Measure, an 1-item questionnaire designed to assess life satisfaction, with a 4-point Likert scale. Scores of this scale range from 1 to 4, where higher scores indicate lower levels of life satisfaction. | Baseline, pre-intervention, immediately post-intervention |
| Spiritual well-being of peer coach | This outcome will be assessed by the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being 12 Scale (FACIT-Sp-12), a widely used 12-item measure of spiritual wellbeing. Scores of this scale range from 0 to 48, where higher scores indicate greater spiritual well-being. | Baseline, pre-intervention, immediately post-intervention |
| Resilience of peer coach | This outcome will be assessed by the Brief Resilience Scale (BRS), a 6-item measure designed to assess an individual's ability to bounce back or recover from stress, adversity, and challenging life circumstances. Scores of this scale range from 6 to 30, where higher scores indicate more resilience and a better ability to bounce back from stress and adversity. | Baseline, pre-intervention, immediately post-intervention |
| Self determination of peer coach | This secondary outcome will be assessed by the Self Determination Scale, a 10-item scale designed to assess individual differences in the extent to which people tend to function in a self-determined way. Scores of this scale range from 10 to 50, where higher scores indicate higher levels of self determination. | Baseline, pre-intervention, immediately post-intervention |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |