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Library›Open textbooks›Development and evaluation of a collaborative care intervention for male prison leavers with mental health problems: the Engager research programme›Patient and public involvement

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Development and evaluation of a collaborative care intervention for male prison leavers with mental health problems: the Engager research programme · Patient and public involvement

Patient and public involvement

CC BY 4.0 · National Institute for Health and Care Research · approximately 3 min read

Active involvement of men who had previously served prison sentences was an integral part of the Engager intervention development and evaluation.60 The group of people who were self-coined as ‘peer researchers’ reflected that they brought their lived experience, the research team brought their academic experience, and that they all worked together as ‘peers’. The peer researchers contributed to the design, delivery and evaluation of the Engager intervention, inputting into:

  • trial science, including refining study documents (e.g. invitation letters, consent forms, interview schedules), deciding on outcome measures and explaining randomisation
  • qualitative data capture (e.g. co-facilitating focus groups, allowing participants to feel more comfortable to contribute) and analysis (e.g. reviewing focus groups transcripts ‘line by line’ with an academic researcher)
  • training new academic researchers in delivering interview schedules
  • intervention theory development
  • dissemination.

The peer researchers validated, challenged and actively contributed to the research team’s findings.60 The Engager team committed to the importance of resourcing meaningful involvement as a central part of the research funding bid. The team used their previous experience to support and facilitate the Peer Researcher Group, dedicating time, specific skills and a method of quick and easy payment for participants. A member of staff was appointed as a ‘bridge’ between those with academic experience and those with lived experience, and this member of staff functioned as a key contact point for the peer researchers and facilitated discussions between the two types of expertise.

The Peer Researcher Group was developed through working with local community organisations. The group first met at a local drug and alcohol charity, which provided a neutral and unthreatening environment. Once relationships and trust developed, the group held some meetings on the university campus, which helped the peer researchers to feel respected and part of the Engager team.

Group membership was maintained by regular contact with participants by text, telephone, Facebook (Meta Platforms, Inc., Menlo Park, CA, USA) and e-mail. The group maintained its size through a rolling membership and consisted of a core group of around eight peer researchers aged 25–56 years. During the intervention development phase, the group met 18 times, fortnightly. Ongoing relationships with the individuals in the group were maintained, where possible, through regular updates on the project’s progress. Members with whom contact had been maintained reconvened to develop a dissemination strategy, meeting eight times over a 5-month period, with an average of seven participants per meeting.

Delivering group activities in interactive, accessible and bite-size pieces facilitated peer researcher engagement, understanding, concentration and self-reflection. During the first iteration of the intervention, the academic researchers spoke about their areas of expertise within the project, which the peer researchers then contributed to and critiqued. These sessions included collaborative discussions within which the academic researchers were open to having their conceptions challenged and changed. Positive relationships were built because the atmosphere was relaxed, as one peer researcher said:

. . . so relaxed, I mean people haven’t got much confidence it makes it so much easier for them to come out with stuff.

The peer researchers reported that the academic researchers were ‘not seeing the barriers’, allowing them to feel ‘the same’ (Steve) and this helped the peer researchers to be ‘open and not to be held back by guilt and shame’ and to feel that they were ‘not getting judged’ (Lee). A key moment was resolving how peer researchers would be referenced. This report uses their first names so that they can evidence to others their achievements, but not their family names, therefore avoiding harming subsequent employment opportunities.

Demonstrating tangible impacts helped maintain engagement. The group sessions helped the peer researchers to build an understanding of the developing intervention, to critique and challenge project decisions and to receive feedback on how their previous contributions had contributed to the project’s progress. The peer researchers said that the academic researchers keeping in touch made them feel that ‘the project genuinely had an interest in our well-being’ (Steve).

Peer researchers felt that involvement in the Engager project gave them a sense of purpose and self-worth and aided their progressive levels of self-confidence. The group also valued being able to make a positive contribution:

. . . it’s nice to be involved in something pro-social rather than anti-social.

The Engager project experience demonstrated the positive contributions, as well as challenges, to intervention development and evaluation. The academic researchers felt particularly validated when they presented the integrated intervention and the peer researchers, jokingly, asked the academic researchers what they had been doing throughout the project because what the academic researchers had presented to them was how they had conceptualised and understood the intervention.

← Engager evaluation: parallel process evaluation (phase 2, workstream 3)Discussion →

Attribution. Richard Byng; Charlotte Lennox; Tim Kirkpatrick; Cath Quinn; Rob Anderson; Sarah Louise Brand et al. (2022). Development and evaluation of a collaborative care intervention for male prison leavers with mental health problems: the Engager research programme. National Institute for Health and Care Research. Copyright © 2022 Byng et al. This work was produced by Byng et al. under the terms of a commissioning contract issued by the Secretary of State for Health and Social Care. This is an Open Access publication distributed under the terms of the Creative Commons Attribution CC BY 4.0 licence, which permits unrestricted use, distribution, reproduction and adaption in any medium and for any purpose provided that it is properly attributed. See: https://creativecommons.org/licenses/by/4.0/. For attribution the title, original author(s), the publication source – NIHR Journals Library, and the DOI of the publication must be cited. Licensed under CC BY 4.0. NCBI Bookshelf NBK585227. CC BY 4.0. Original source ↗. Text reproduced from the Bookshelf XML without changing wording; figures, images and supplements are not reproduced.

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