Peer-led recovery groups for people with psychosis in South Africa (PRIZE): protocol for a randomised controlled feasibility trial

Background: The available care for people with psychosis in South Africa is inadequate to support personal recovery. Group peer support interventions are a promising approach to foster recovery, but little is known about the preferences of service users, or the practical application of this care mod...

Full description

Bibliographic Details
Main Authors: Asher, L., Rapiya, B., Repper, J., Reddy, T., Myers, Bronwyn, Hanlon, C., Petersen, I., Brooke-Sumner, C.
Format: Journal Article
Language:English
Published: 2023
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/90526
_version_ 1848765392787341312
author Asher, L.
Rapiya, B.
Repper, J.
Reddy, T.
Myers, Bronwyn
Hanlon, C.
Petersen, I.
Brooke-Sumner, C.
author_facet Asher, L.
Rapiya, B.
Repper, J.
Reddy, T.
Myers, Bronwyn
Hanlon, C.
Petersen, I.
Brooke-Sumner, C.
author_sort Asher, L.
building Curtin Institutional Repository
collection Online Access
description Background: The available care for people with psychosis in South Africa is inadequate to support personal recovery. Group peer support interventions are a promising approach to foster recovery, but little is known about the preferences of service users, or the practical application of this care model, in low- and middle-income countries (LMIC). This study aims to assess the acceptability and feasibility of integrating peer-led recovery groups for people with psychosis and their caregivers in South Africa into existing systems of care, and to determine key parameters in preparation for a definitive trial. Methods: The study is set in Nelson Mandela Bay Metropolitan district of the Eastern Cape Province, South Africa. The design is an individually randomised parallel group feasibility trial comparing recovery groups in addition to treatment as usual (TAU) with TAU alone in a 1:1 allocation ratio. We aim to recruit 100 isiXhosa-speaking people with psychosis and 100 linked caregivers. TAU comprises anti-psychotic medication-focused outpatient care. The intervention arm will comprise seven recovery groups, including service users and caregiver participants. Recovery groups will be delivered in two phases: a 2-month phase facilitated by an auxiliary social worker, then a 3-month peer-led phase. We will use mixed methods to evaluate the process and outcomes of the study. Intervention acceptability and feasibility (primary outcomes) will be assessed at 5 months post-intervention start using qualitative data collected from service users, caregivers, and auxiliary social workers, along with quantitative process indicators. Facilitator competence will be assessed with the GroupACT observational rating tool. Trial procedures will be assessed, including recruitment and retention rates, contamination, and validity of quantitative outcome measures. To explore potential effectiveness, quantitative outcome data (functioning, unmet needs, personal recovery, internalised stigma, health service use, medication adherence, and caregiver burden) will be collected at baseline, 2 months, and 5 months post-intervention start. Discussion: This study will contribute to the sparse evidence on the acceptability and feasibility of peer-led and recovery-oriented interventions for people with psychosis in LMIC when integrated into existing care systems. Results from this feasibility trial will inform preparations for a definitive trial and subsequent larger-scale implementation. Trial registration: Pan-African Clinical Trials Register PACTR202202482587686. Registered on 28 February 2022. https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=21496.
first_indexed 2025-11-14T11:34:32Z
format Journal Article
id curtin-20.500.11937-90526
institution Curtin University Malaysia
institution_category Local University
language eng
last_indexed 2025-11-14T11:34:32Z
publishDate 2023
recordtype eprints
repository_type Digital Repository
spelling curtin-20.500.11937-905262023-03-22T02:13:08Z Peer-led recovery groups for people with psychosis in South Africa (PRIZE): protocol for a randomised controlled feasibility trial Asher, L. Rapiya, B. Repper, J. Reddy, T. Myers, Bronwyn Hanlon, C. Petersen, I. Brooke-Sumner, C. Community mental health services Developing countries Peer-led Psychiatric rehabilitation Psychosocial intervention Psychotic disorders Recovery Schizophrenia Self-help groups Sub-Saharan Africa Background: The available care for people with psychosis in South Africa is inadequate to support personal recovery. Group peer support interventions are a promising approach to foster recovery, but little is known about the preferences of service users, or the practical application of this care model, in low- and middle-income countries (LMIC). This study aims to assess the acceptability and feasibility of integrating peer-led recovery groups for people with psychosis and their caregivers in South Africa into existing systems of care, and to determine key parameters in preparation for a definitive trial. Methods: The study is set in Nelson Mandela Bay Metropolitan district of the Eastern Cape Province, South Africa. The design is an individually randomised parallel group feasibility trial comparing recovery groups in addition to treatment as usual (TAU) with TAU alone in a 1:1 allocation ratio. We aim to recruit 100 isiXhosa-speaking people with psychosis and 100 linked caregivers. TAU comprises anti-psychotic medication-focused outpatient care. The intervention arm will comprise seven recovery groups, including service users and caregiver participants. Recovery groups will be delivered in two phases: a 2-month phase facilitated by an auxiliary social worker, then a 3-month peer-led phase. We will use mixed methods to evaluate the process and outcomes of the study. Intervention acceptability and feasibility (primary outcomes) will be assessed at 5 months post-intervention start using qualitative data collected from service users, caregivers, and auxiliary social workers, along with quantitative process indicators. Facilitator competence will be assessed with the GroupACT observational rating tool. Trial procedures will be assessed, including recruitment and retention rates, contamination, and validity of quantitative outcome measures. To explore potential effectiveness, quantitative outcome data (functioning, unmet needs, personal recovery, internalised stigma, health service use, medication adherence, and caregiver burden) will be collected at baseline, 2 months, and 5 months post-intervention start. Discussion: This study will contribute to the sparse evidence on the acceptability and feasibility of peer-led and recovery-oriented interventions for people with psychosis in LMIC when integrated into existing care systems. Results from this feasibility trial will inform preparations for a definitive trial and subsequent larger-scale implementation. Trial registration: Pan-African Clinical Trials Register PACTR202202482587686. Registered on 28 February 2022. https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=21496. 2023 Journal Article http://hdl.handle.net/20.500.11937/90526 10.1186/s40814-022-01232-8 eng http://creativecommons.org/licenses/by/4.0/ fulltext
spellingShingle Community mental health services
Developing countries
Peer-led
Psychiatric rehabilitation
Psychosocial intervention
Psychotic disorders
Recovery
Schizophrenia
Self-help groups
Sub-Saharan Africa
Asher, L.
Rapiya, B.
Repper, J.
Reddy, T.
Myers, Bronwyn
Hanlon, C.
Petersen, I.
Brooke-Sumner, C.
Peer-led recovery groups for people with psychosis in South Africa (PRIZE): protocol for a randomised controlled feasibility trial
title Peer-led recovery groups for people with psychosis in South Africa (PRIZE): protocol for a randomised controlled feasibility trial
title_full Peer-led recovery groups for people with psychosis in South Africa (PRIZE): protocol for a randomised controlled feasibility trial
title_fullStr Peer-led recovery groups for people with psychosis in South Africa (PRIZE): protocol for a randomised controlled feasibility trial
title_full_unstemmed Peer-led recovery groups for people with psychosis in South Africa (PRIZE): protocol for a randomised controlled feasibility trial
title_short Peer-led recovery groups for people with psychosis in South Africa (PRIZE): protocol for a randomised controlled feasibility trial
title_sort peer-led recovery groups for people with psychosis in south africa (prize): protocol for a randomised controlled feasibility trial
topic Community mental health services
Developing countries
Peer-led
Psychiatric rehabilitation
Psychosocial intervention
Psychotic disorders
Recovery
Schizophrenia
Self-help groups
Sub-Saharan Africa
url http://hdl.handle.net/20.500.11937/90526