Solid Organ Transplant
Conditions
Keywords
Peer Support Mentorship, Transplant, Pediatrics, Adherence
Brief summary
With the on-going presence of a chronic illness, daily immunosuppressive medications, and the need for continuous medical supervision, pediatric transplant recipients face considerable psychosocial stresses. Treatment nonadherence is a major issue in pediatric transplantation and can lead to increased rates of hospitalization, rejection episodes, graft loss and death. An online peer support mentorship program (iPeer2Peer) is proposed as one intervention that could enhance patient care management, increase treatment adherence, reduce social isolation and improve health outcomes for this highly vulnerable population. The proposed trial will determine 1) implementation outcomes of the iPeer2Peer intervention in terms of: (a) feasibility and adoption, (b) acceptability and appropriateness and (c) level of engagement with the program, and 2) effectiveness of the iPeer2Peer intervention on improving health outcomes including disease self-management skills, treatment adherence, quality of life, perceived social support, stress and coping.
Interventions
BEHAVIORALiPeer2Peer Support Mentorship Program
iPeer2Peer is an online peer support mentorship program that has been established in multiple chronic disease populations as a self-management intervention, including chronic pain and juvenile idiopathic arthritis. The iPeer2Peer program provides modeling and reinforcement by pre-screened and trained young adult peer mentors to adolescent mentees.
Sponsors
Enduring Hearts
University of Alberta/Stollery Children's Hospital
The Hospital for Sick Children
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
12 Years to 25 Years
Healthy volunteers
No
Inclusion criteria
1. heart and/or lung transplant recipient, 2. at least 4 months post-transplant, 3. between the ages of 12 and 25 years, 4. able to speak and read English, 5. willingness to commit to 5-10 texts and/or calls of 20-30 minutes each over a period of 15 weeks.
Exclusion criteria
1. have a significant cognitive impairments as assessed by a qualified healthcare provider, 2. have a diagnosis of an active psychological disorder (e.g., Major Depressive Disorder, Generalized Anxiety Disorder) likely to influence assessment of health-related quality of life and/or interfere with their ability to manage their transplant regimen (a diagnosis of an active psychological disorder will be determined for mentees through medical chart review and self-reported by mentors), and 3. are participating in other peer support or self-management interventions
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Level of Engagement (Mentors) | Study completion, an average of 1 year | Semi-structured Interview |
| Adoption (Mentors) | Study completion, an average of 1 year | Semi-structured Interview |
| Adoption | Mentees - 12 weeks post-program completion; Mentors - study completion, an average of 1 year | Accrual and dropout rates |
| Feasibility: Semi-structured Interview (Mentees) | 15 weeks after baseline/immediately after the intervention | Semi-structured Interview |
| Feasibility: Semi-structured Interview (Mentors) | Study completion, an average of 1 year | Semi-structured Interview |
| Feasibility: Accrual and dropout rates | Mentees - 12 weeks post-program completion; Mentors - study completion, an average of 1 year | Accrual and dropout rates |
| Feasibility: Compliance with iPeer2Peer program (Mentees) | 12 weeks post-program completion | Compliance with iPeer2Peer program (an 80% rate of completion of five calls and online outcome measures) |
| Feasibility: Compliance with iPeer2Peer program (Mentors) | Study completion, an average of 1 year | Compliance with iPeer2Peer program (an 80% rate of completion of five calls and online outcome measures) |
| Appropriateness (Mentees) | 15 weeks after baseline/immediately after the intervention | Semi-structured Interview |
| Appropriateness (Mentors) | Study completion, an average of 1 year | Semi-structured Interview |
| Level of Engagement (Mentees) | 15 weeks after baseline/immediately after the intervention | Semi-structured Interview |
| Acceptability: Semi-structured Interview (Mentees) | 15 weeks after baseline/immediately after the intervention | Semi-structured Interview |
| Acceptability: Semi-structured Interview (Mentors) | Study completion, an average of 1 year | Semi-structured Interview |
| Adoption (Mentees) | 15 weeks after baseline/immediately after the intervention | Semi-structured Interview |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Treatment adherence (Mentees) | Baseline, 15 weeks after baseline/immediately after the intervention, 12 weeks post-program completion | Adolescent Medication Barriers Scale; 17-item questionnaire with 3 different sections: Disease Frustration/Adolescent Issues, Ingestion Issues, and Regimen Adaptation/Cognitive. Each question is scored on a scale from 1 to 5. An overall higher score means a worse outcome. |
| Quality of Life (Mentees) | Baseline, 15 weeks after baseline/immediately after the intervention, 12 weeks post-program completion | Pediatric Quality of Life Inventory™ 3.0 Transplant Module; 46-item questionnaire with 8 different sections: About My Medicines I, About My Medicines II, My Transplant and Others, Pain and Hurt, Worry, Treatment Anxiety, How I Look, and Communication. Each question is scored on a scale from 0 to 4. An overall higher score means a better outcome. |
| Perceived Social Support (Mentees) | Baseline, 15 weeks after baseline/immediately after the intervention, 12 weeks post-program completion | National Institute of Health Emotional Support Survey; 7-item questionnaire. Each question is scored on a scale from 1 to 5. An overall higher score means a better outcome. |
| Emotional Distress (Mentees) | Baseline, 15 weeks after baseline/immediately after the intervention, 12 weeks post-program completion | Revised Child Anxiety and Depression Scale - short version; 25-item questionnaire. Each question is scored on a scale with 4 possible responses. An overall higher score means a worse outcome. |
| Resiliency (Mentees) | Baseline, 15 weeks after baseline/immediately after the intervention, 12 weeks post-program completion | Brief Resilience Scale; 6-item questionnaire. Each question is scored on a scale with 5 possible responses. An overall higher score means a better outcome. |
| Quality of Mentor Behaviour (Mentees) | 15 weeks after baseline/immediately after the intervention | Mentor Behaviour Scale; 15-item questionnaire with 4 different sections: Structure, Engagement, Autonomy Support, and Competency Support. Each question is scored on a scale from 1 to 5. |
| Change in Physical and Emotional Symptoms (Mentors) | Baseline, pre-intervention; study completion, an average of 1 year | PROMIS - 29 Adult Profile v2.1; Maximum 29-item questionnaire as responses to some questions may lead participants to answer fewer questions. There are 8 different sections: Physical Function, Anxiety, Depression, Fatigue, Sleep Disturbance, Ability to Participate in Social Roles and Activities, Pain Interference, and Pain Intensity. Each question is scored on a scale from 1 to 5. |
| Change in Perceived Social Role Satisfaction (Mentors) | Baseline, pre-intervention; study completion, an average of 1 year | PROMIS Satisfaction with Social Roles and Activities; Maximum 44-item questionnaire as responses to some questions may lead participants to answer fewer questions. Each question is scored on a scale from 1 to 5. An overall higher score means a better outcome. |
| Change in Self-efficacy (Mentors): Chronic Disease Self-Efficacy Scale | Baseline, pre-intervention; study completion, an average of 1 year | Chronic Disease Self-Efficacy Scale; 33-item questionnaire with 10 different sections: Exercise Regularly Scale, Get Information About Disease Item, Obtain Help from Community/Family/Friends Scale, Communicate With Physician Scale, Manage Disease in General Scale, Do Chores Scale, Social/Recreational Activities Scale, Manage Symptoms Scale, Manage Shortness of Breath Item, and Control/Manage Depression Scale. Each question is scored on a scale from 1 to 10. An overall higher score means a better outcome. |
| Disease self-management skills (Mentees) | Baseline, 15 weeks after baseline/immediately after the intervention, 12 weeks post-program completion | Self-management skills assessment guide (questionnaire); 21-item questionnaire. Each question is scored on a scale from 1 to 5. |
Countries
Canada
Outcome results
None listed