A peer mentoring program for eating disorders: improved symptomatology and reduced hospital admissions, three years and a pandemic on.
Eating disorders
Hospitalisations
Implementation
Intervention
Lived experience
Peer mentoring
Peer work
Treatment
Journal
Journal of eating disorders
ISSN: 2050-2974
Titre abrégé: J Eat Disord
Pays: England
ID NLM: 101610672
Informations de publication
Date de publication:
15 Jul 2024
15 Jul 2024
Historique:
received:
21
10
2023
accepted:
19
06
2024
medline:
16
7
2024
pubmed:
16
7
2024
entrez:
15
7
2024
Statut:
epublish
Résumé
Peer support involves people (mentors) using their own experiences to assist others (mentees). The impetus to include peer support in eating disorder recovery is high, however research on implementation of peer roles in eating disorder management is limited. A previous pilot study found positive but preliminary results for a Peer Mentor Program (PMP) for eating disorders. The PMP has since developed over time, including broadening its eligibility criteria and shifting to predominantly online delivery during COVID-19. This study aimed to evaluate the updated version of the PMP, on a larger and more diverse group of mentees. Previously collected PMP service data from July 2020 to April 2022 (during COVID-19 lockdowns) was evaluated for fifty-one mentees using mixed methods. Data from program start (baseline), mid-point (3-months) and end (6-months) for measures of eating disorder symptoms as measured by the Eating Disorder Examination Questionnaire (EDE-Q) and psychological wellbeing as measured by the Depression, Anxiety and Stress Scale (DASS) was evaluated. Frequency of eating disorder-related hospital admissions during PMP participation versus the 6 months prior, direct program costs and qualitative mentee feedback were also analysed. One way ANOVA's with post hoc tests were used to evaluate symptom change and thematic analysis was conducted on qualitative data. Program attendance averaged 12.12 (SD ± 1.57) of a possible 13 sessions. Statistically significant and clinically meaningful improvements were demonstrated across all subscales of the eating disorder and psychological wellbeing symptom measures. EDE-Q Global score and DASS scores decreased significantly by program end. Fewer eating disorder-related hospital admissions were reported during PMP than the 6-months prior. Qualitative findings were positive and themed around the unique benefits of lived experience connection, a new kind of space for recovery, hope and motivation for change. Challenges with the time limited nature of the mentee-mentor relationship were expressed. The important benefits of a PMP for individuals with eating disorders are further supported. There is a pressing need for high quality, co-produced research, utilising a mixture of designs and fidelity to core peer work principles, to inform further implementation of peer work into eating disorder policy and practice. Peer mentoring involves people using their personal lived experiences to support others. A pilot Peer Mentoring Program for eating disorders (PMP) offered through Eating Disorders Victoria (EDV) was evaluated previously, showing positive findings. Subsequent demand for the program was high. As a result, the PMP has been running and evolving over time. Key changes included a broadening of program eligibility to all individuals with an eating disorder (versus only people recently discharged from hospital), larger participant numbers and a shift to largely online delivery due to COVID-19. This study evaluated this current version of the PMP. Five rounds of anonymised PMP data, from July 2020 to April 2022, were evaluated with mentee prior consent. Individuals in recovery from an eating disorder (mentees), had been paired with individuals recovered from an eating disorder for 2-years minimum (mentors). PMP rounds were 6-months, with fortnightly meetings. Mentees overall showed improvements in eating disorder symptoms and psychological wellbeing. Fewer mentee eating disorder-related hospital admissions during PMP participation were reported, compared to the 6-months prior. Feedback from mentees identified many positive benefits and some challenges. Overall, the results provide further support for the use of peer mentoring in eating disorder recovery.
Sections du résumé
BACKGROUND
BACKGROUND
Peer support involves people (mentors) using their own experiences to assist others (mentees). The impetus to include peer support in eating disorder recovery is high, however research on implementation of peer roles in eating disorder management is limited. A previous pilot study found positive but preliminary results for a Peer Mentor Program (PMP) for eating disorders. The PMP has since developed over time, including broadening its eligibility criteria and shifting to predominantly online delivery during COVID-19. This study aimed to evaluate the updated version of the PMP, on a larger and more diverse group of mentees.
METHODS
METHODS
Previously collected PMP service data from July 2020 to April 2022 (during COVID-19 lockdowns) was evaluated for fifty-one mentees using mixed methods. Data from program start (baseline), mid-point (3-months) and end (6-months) for measures of eating disorder symptoms as measured by the Eating Disorder Examination Questionnaire (EDE-Q) and psychological wellbeing as measured by the Depression, Anxiety and Stress Scale (DASS) was evaluated. Frequency of eating disorder-related hospital admissions during PMP participation versus the 6 months prior, direct program costs and qualitative mentee feedback were also analysed. One way ANOVA's with post hoc tests were used to evaluate symptom change and thematic analysis was conducted on qualitative data.
RESULTS
RESULTS
Program attendance averaged 12.12 (SD ± 1.57) of a possible 13 sessions. Statistically significant and clinically meaningful improvements were demonstrated across all subscales of the eating disorder and psychological wellbeing symptom measures. EDE-Q Global score and DASS scores decreased significantly by program end. Fewer eating disorder-related hospital admissions were reported during PMP than the 6-months prior. Qualitative findings were positive and themed around the unique benefits of lived experience connection, a new kind of space for recovery, hope and motivation for change. Challenges with the time limited nature of the mentee-mentor relationship were expressed.
CONCLUSIONS
CONCLUSIONS
The important benefits of a PMP for individuals with eating disorders are further supported. There is a pressing need for high quality, co-produced research, utilising a mixture of designs and fidelity to core peer work principles, to inform further implementation of peer work into eating disorder policy and practice.
Peer mentoring involves people using their personal lived experiences to support others. A pilot Peer Mentoring Program for eating disorders (PMP) offered through Eating Disorders Victoria (EDV) was evaluated previously, showing positive findings. Subsequent demand for the program was high. As a result, the PMP has been running and evolving over time. Key changes included a broadening of program eligibility to all individuals with an eating disorder (versus only people recently discharged from hospital), larger participant numbers and a shift to largely online delivery due to COVID-19. This study evaluated this current version of the PMP. Five rounds of anonymised PMP data, from July 2020 to April 2022, were evaluated with mentee prior consent. Individuals in recovery from an eating disorder (mentees), had been paired with individuals recovered from an eating disorder for 2-years minimum (mentors). PMP rounds were 6-months, with fortnightly meetings. Mentees overall showed improvements in eating disorder symptoms and psychological wellbeing. Fewer mentee eating disorder-related hospital admissions during PMP participation were reported, compared to the 6-months prior. Feedback from mentees identified many positive benefits and some challenges. Overall, the results provide further support for the use of peer mentoring in eating disorder recovery.
Autres résumés
Type: plain-language-summary
(eng)
Peer mentoring involves people using their personal lived experiences to support others. A pilot Peer Mentoring Program for eating disorders (PMP) offered through Eating Disorders Victoria (EDV) was evaluated previously, showing positive findings. Subsequent demand for the program was high. As a result, the PMP has been running and evolving over time. Key changes included a broadening of program eligibility to all individuals with an eating disorder (versus only people recently discharged from hospital), larger participant numbers and a shift to largely online delivery due to COVID-19. This study evaluated this current version of the PMP. Five rounds of anonymised PMP data, from July 2020 to April 2022, were evaluated with mentee prior consent. Individuals in recovery from an eating disorder (mentees), had been paired with individuals recovered from an eating disorder for 2-years minimum (mentors). PMP rounds were 6-months, with fortnightly meetings. Mentees overall showed improvements in eating disorder symptoms and psychological wellbeing. Fewer mentee eating disorder-related hospital admissions during PMP participation were reported, compared to the 6-months prior. Feedback from mentees identified many positive benefits and some challenges. Overall, the results provide further support for the use of peer mentoring in eating disorder recovery.
Identifiants
pubmed: 39010230
doi: 10.1186/s40337-024-01051-7
pii: 10.1186/s40337-024-01051-7
doi:
Types de publication
Journal Article
Langues
eng
Pagination
99Subventions
Organisme : National Health and Medical Research Council Medical Research Future Fund Million Minds Mission Grant
ID : APP1178922
Organisme : National Health and Medical Research Council Medical Research Future Fund Million Minds Mission Grant
ID : APP1178922
Organisme : National Health and Medical Research Council Medical Research Future Fund Million Minds Mission Grant
ID : APP1178922
Organisme : National Health and Medical Research Council Medical Research Future Fund Million Minds Mission Grant
ID : APP1178922
Informations de copyright
© 2024. The Author(s).
Références
Hay P, Mitchison D, Lopez Collado AE, Gonzalez-Chica DA, Stocks N, Touyz S. Burden and health-related quality of life of eating disorders, including Avoidant/Restrictive Food Intake Disorder (ARFID), in the Australian population. Journal of Eating Disorders. 2017;5.
Mitchison D, Mond J, Bussey K, Griffiths S, Trompeter N, Lonergan A, et al. DSM-5 full syndrome, other specified, and unspecified eating disorders in Australian adolescents: prevalence and clinical significance. Psychol Med. 2020;50(6):981–90.
doi: 10.1017/S0033291719000898
pubmed: 31043181
Demmler JC, Brophy ST, Marchant A, John A, Tan JOA. Shining the light on eating disorders, incidence, prognosis and profiling of patients in primary and secondary care: national data linkage study. Br J Psychiatry. 2020;216(2):105–12.
doi: 10.1192/bjp.2019.153
pubmed: 31256764
van Eeden AE, van Hoeken D, Hoek HW. Incidence, prevalence and mortality of anorexia nervosa and bulimia nervosa. Curr Opin Psychiatry. 2021;34(6).
Guinhut M, Godart N, Benadjaoud M-A, Melchior J-C, Hanachi M. Five-year mortality of severely malnourished patients with chronic anorexia nervosa admitted to a medical unit. Acta Psychiatr Scand. 2021;143(2):130–40.
doi: 10.1111/acps.13261
pubmed: 33247947
Burt A, Mannan H, Touyz S, Hay P. Prevalence of DSM-5 diagnostic threshold eating disorders and features amongst Aboriginal and Torres Strait islander peoples (First Australians). BMC Psychiatry. 2020;20(1):449.
doi: 10.1186/s12888-020-02852-1
pubmed: 32917167
pmcid: 7488483
Nagata JM, Ganson KT, Austin SB. Emerging trends in eating disorders among sexual and gender minorities. Curr Opin Psychiatry. 2020;33(6):562–7.
doi: 10.1097/YCO.0000000000000645
pubmed: 32858597
pmcid: 8060208
Boltri M, Sapuppo W. Anorexia nervosa and autism spectrum disorder: a systematic review. Psychiatry Res. 2021;306:114271.
doi: 10.1016/j.psychres.2021.114271
pubmed: 34798485
Abbott S, Dindol N, Tahrani AA, Piya MK. Binge eating disorder and night eating syndrome in adults with type 2 diabetes: a systematic review. J Eat Disord. 2018;6(1):36.
doi: 10.1186/s40337-018-0223-1
pubmed: 30410761
pmcid: 6219003
Hart LM, Granillo MT, Jorm AF, Paxton SJ. Unmet need for treatment in the eating disorders: a systematic review of eating disorder specific treatment seeking among community cases. Clin Psychol Rev. 2011;31(5):727–35.
doi: 10.1016/j.cpr.2011.03.004
pubmed: 21501580
Sala M, Keshishian A, Song S, Moskowitz R, Bulik CM, Roos CR, et al. Predictors of relapse in eating disorders: a meta-analysis. J Psychiatr Res. 2023;158:281–99.
doi: 10.1016/j.jpsychires.2023.01.002
pubmed: 36623362
Gillard S. Peer support in mental health services: where is the research taking us, and do we want to go there? J Ment Health. 2019;28(4):341–4.
doi: 10.1080/09638237.2019.1608935
pubmed: 31070066
Mead S, Hilton D, Curtis L. Peer support: a theoretical perspective. Psychiatr Rehabil J. 2001;25(2):134–41.
doi: 10.1037/h0095032
pubmed: 11769979
King AJ, Simmons MB. A systematic review of the attributes and outcomes of peer work and guidelines for reporting studies of peer interventions. Psychiatr Serv. 2018;69(9):961–77.
doi: 10.1176/appi.ps.201700564
pubmed: 29962310
Galloway A, Pistrang N. “We’re stronger if we work together”: experiences of naturally occurring peer support in an inpatient setting. J Ment Health. 2019;28(4):419–26.
doi: 10.1080/09638237.2018.1521925
pubmed: 30328759
Lawn S, Smith A, Hunter K. Mental health peer support for hospital avoidance and early discharge: an Australian example of consumer driven and operated service. J Ment Health. 2008;17(5):498–508.
doi: 10.1080/09638230701530242
Rowe M, Bellamy C, Baranoski M, Wieland M, O’Connell M, Benedict P, et al. A peer-support, group intervention to reduce substance use and criminality among persons with severe mental illness. Psychiatr Serv. 2007;58(7):955–61.
doi: 10.1176/ps.2007.58.7.955
pubmed: 17602012
Lewis HK, Foye U. From prevention to peer support: a systematic review exploring the involvement of lived-experience in eating disorder interventions. Mental Health Rev. 2022;27(1):1–17.
doi: 10.1108/MHRJ-04-2021-0033
Utpala R, Squire S, Farrar-Rabbidge M. Eating disorders peer workforce guidelines. Sydney: Butterfly Foundation; 2023.
Pellizzer ML, Wade TD. The effectiveness of lived experience involvement in eating disorder treatment: a systematic review. Int J Eat Disord. 2023;56(2):331–49.
doi: 10.1002/eat.23847
pubmed: 36372976
Ramjan LM, Hay P, Fogarty S. Benefits of a mentoring support program for individuals with an eating disorder: a proof of concept pilot program. BMC Res Notes. 2017;10(1):709.
doi: 10.1186/s13104-017-3026-6
pubmed: 29212554
pmcid: 5719736
Ramjan LM, Fogarty S, Nicholls D, Hay P. Instilling hope for a brighter future: a mixed-method mentoring support programme for individuals with and recovered from anorexia nervosa. J Clin Nurs. 2018;27(5–6):e845–57.
pubmed: 29193481
Ranzenhofer LM, Wilhelmy M, Hochschild A, Sanzone K, Walsh BT, Attia E. Peer mentorship as an adjunct intervention for the treatment of eating disorders: a pilot randomized trial. Int J Eat Disord. 2020;53(5):767–79.
doi: 10.1002/eat.23258
Beveridge J, Phillipou A, Edwards K, Hobday A, Hilton K, Wyett C, et al. Peer mentoring for eating disorders: evaluation of a pilot program. Pilot Feasibility Stud. 2018;4:75.
doi: 10.1186/s40814-018-0268-6
pubmed: 29750119
pmcid: 5934861
Beveridge J, Phillipou A, Jenkins Z, Newton R, Brennan L, Hanly F, et al. Peer mentoring for eating disorders: results from the evaluation of a pilot program. Journal of Eating Disorders. 2019;7.
Hanly F, Torrens-Witherow B, Warren N, Castle D, Phillipou A, Beveridge J, et al. Peer mentoring for individuals with an eating disorder: a qualitative evaluation of a pilot program. J Eat Disord. 2020;8(1):29.
doi: 10.1186/s40337-020-00301-8
pubmed: 32626579
pmcid: 7329554
Creamer EG, Reeping D. Advancing mixed methods in psychological research. Methods Psychol. 2020;3:100035.
doi: 10.1016/j.metip.2020.100035
Fairburn CG, Beglin SJ. Assessment of eating disorders: interview or self-report questionnaire? Int J Eat Disord. 1994;16(4):363–70.
doi: 10.1002/1098-108X(199412)16:4<363::AID-EAT2260160405>3.0.CO;2-#
pubmed: 7866415
Lovibond P, Lovibond S. The structure of negative emotional states: comparison of the depression anxiety stress scales (DASS) with the beck depression and anxiety inventories. Behav Res Ther. 1995;33(3):335–43.
doi: 10.1016/0005-7967(94)00075-U
pubmed: 7726811
Black CMD, Wilson GT. Assessment of eating disorders: Interview versus questionnaire. Int J Eat Disord. 1996;20(1):43–50.
doi: 10.1002/(SICI)1098-108X(199607)20:1<43::AID-EAT5>3.0.CO;2-4
pubmed: 8807351
Carey M, Kupeli N, Knight R, Troop NA, Jenkinson PM, Preston C. Eating Disorder Examination Questionnaire (EDE-Q): norms and psychometric properties in U.K. females and males. psychological assessment. 2019;31(7):839–50.
Antony MM, Bieling PJ, Cox BJ, Enns MW, Swinson RP. Psychometric properties of the 42-item and 21-item versions of the depression anxiety stress scales in clinical groups and a community sample psychological assessment. 1998;10(2):176–81.
Ng F, Trauer T, Dodd S, Callaly T, Campbell S, Berk M. The validity of the 21-item version of the Depression Anxiety Stress Scales as a routine clinical outcome measure. Acta Neuropsychiatr. 2007;19(5):304–10.
doi: 10.1111/j.1601-5215.2007.00217.x
pubmed: 26952943
Pallant J. SPSS Survival Manual. Crows Nest, NSW: Allen & Unwin; 2011.
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.
doi: 10.1191/1478088706qp063oa
Lovibond S, Lovibond P. Manual for the depression anxiety stress scales. 2nd ed. Sydney: Psychology Foundation; 1995.
Phillipou A, Meyer D, Neill E, Tan EJ, Toh WL, Van Rheenen TE, et al. Eating and exercise behaviors in eating disorders and the general population during the COVID-19 pandemic in Australia: initial results from the COLLATE project. Int J Eat Disord. 2020;53(7):1158–65.
doi: 10.1002/eat.23317
pubmed: 32476163
pmcid: 7300745
Velkoff EA, Brown TA, Kaye WH, Wierenga CE. Using clinical cutoff scores on the eating disorder examination-questionnaire to evaluate eating disorder symptoms during and after naturalistic intensive treatment. Eat Disord. 2023:1–15.
Vitagliano JA, Jhe G, Milliren CE, Lin JA, Spigel R, Freizinger M, et al. COVID-19 and eating disorder and mental health concerns in patients with eating disorders. J Eat Disord. 2021;9(1):80.
doi: 10.1186/s40337-021-00437-1
pubmed: 34215340
pmcid: 8253465
Eshkevari E, Rieger E, Longo MR, Haggard P, Treasure J. Persistent body image disturbance following recovery from eating disorders. Int J Eat Disord. 2014;47(4):400–9.
doi: 10.1002/eat.22219
pubmed: 24243423
de Vos JA, LaMarre A, Radstaak M, Bijkerk CA, Bohlmeijer ET, Westerhof GJ. Identifying fundamental criteria for eating disorder recovery: a systematic review and qualitative meta-analysis. J Eat Disord. 2017;5(1):34.
doi: 10.1186/s40337-017-0164-0
pubmed: 29118983
pmcid: 5664841
Lin JA, Hartman-Munick SM, Kells MR, Milliren CE, Slater WA, Woods ER, et al. The impact of the COVID-19 pandemic on the number of adolescents/young adults seeking eating disorder-related care. J Adolesc Health. 2021;69(4):660–3.
doi: 10.1016/j.jadohealth.2021.05.019
pubmed: 34266715
pmcid: 8415773
Hower H, LaMarre A, Bachner-Melman R, Harrop EN, McGilley B, Kenny TE. Conceptualizing eating disorder recovery research: Current perspectives and future research directions. J Eat Disord. 2022;10(1):165.
doi: 10.1186/s40337-022-00678-8
pubmed: 36380392
pmcid: 9664434