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

Journal: Pilot and feasibility studies

Volume: 9

Issue: 1

Year of Publication: 

Affiliated Institutions:  Academic Unit of Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK. laura.asher@nottingham.ac.uk. Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Francie Van Zijl Drive, Parow Valley, Cape Town, , South Africa. Implementing Recovery through Organisational Change, Nottingham, UK. Biostatistics Research Unit, South African Medical Research Council, Durban, South Africa. Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. Centre for Rural Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.

Abstract summary 

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.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.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.Pan-African Clinical Trials Register PACTR202202482587686. Registered on 28 February 2022.  https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=21496 .

Authors & Co-authors:  Asher Laura L Rapiya Bongwekazi B Repper Julie J Reddy Tarylee T Myers Bronwyn B Hanlon Charlotte C Petersen Inge I Brooke-Sumner Carrie C

Study Outcome 

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Statistics
Citations :  Patel V. Universal Health Coverage for Schizophrenia: A Global Mental Health Priority. Schizophr Bull. 2015;42(4):885–890. doi: 10.1093/schbul/sbv107.
Authors :  8
Identifiers
Doi : 19
SSN : 2055-5784
Study Population
Male,Female
Mesh Terms
Other Terms
Community mental health services;Developing countries;Peer-led;Psychiatric rehabilitation;Psychosocial intervention;Psychotic disorders;Recovery;Schizophrenia;Self-help groups;Sub-Saharan Africa
Study Design
Cross Sectional Study
Study Approach
Quantitative,Qualitative,Mixed Methods
Country of Study
South Africa
Publication Country
England