'thriving with bipolar disorder': co-design and evaluation of a peer-led education program focused on quality of life

Conditions: Bipolar Disorder (BD); Quality of Life (QOL)

Summary: self-management strategies can be used by individuals with bipolar disorder (bd) to cope with symptoms and improve quality of life (qol). peer-facilitated education programs have the potential to diversify delivery of self-management information by capitalizing on the expertise of individuals who live well with bd. we have co-designed a novel, peer-facilitated, qol-focused, group education program for people living with bd. this project will involve administration of the program and an evaluation of the feasibility, acceptability, and efficacy of this program for self-management of bd.

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.

Eligibility criteria:
inclusion criteria: 1. program facilitators * aged 18 or older * a self-reported diagnosis of a mood disorder * sufficient access to an internet-enabled computer or smartphone device to access the zoom teleconferencing platform * ability to understand, read and write english * at least one year of prior experience leading peer support groups or recovery programs through hope+me * previously received training through hope+me * completed a criminal records check 2. program participants * aged 18 or older * residing in canada * a self-reported diagnosis of bd * ability to understand, read and write english * sufficient access to an internet-enabled computer or smartphone device to access the zoom teleconferencing platform exclusion criteria: * inability to communicate in written and verbal english to a sufficient level to allow participation in the program and research activities

Keywords: psychoeducation peer-support bipolar disorder quality of life self-management