Table 26GRADE Summary of Findings for Empowerment

Outcome, follow-up, no. participants (trials) Findings Certainty of the evidence (GRADE) What happens?
Empowerment

Post-intervention: 84 (1 RCT 50 )

Longest follow-up: 84 (1 RCT 50 )

One RCT50 with high risk of bias (unclear direction) reported on participants’ feeling of empowerment. This RCT50 compared the effectiveness of HOP program to treatment as usual among adolescent psychiatric patients, who were mostly were female (69.3%), born in Germany (94.8%) and were around 22 months since the first psychiatric diagnosis.

The outcome was assessed by the Self-esteem (9 items) and the Optimism (4 items) subscales of Empowerment Scale58 A mean score was calculated from the scores of the subscales (range 1 to 4), with higher scores indicating more empowerment.

In the self-esteem subscale of the Empowerment Scale, the results from the trial showed that at post-intervention, participants in the HOP group reported a significantly larger improvement in self-esteem compared to those in the TAU group (mean between-group differences for change from baseline = 0.21[0.04 to 0.39]). At 6-week follow-up there were no significant difference between the groups.

In the optimism subscale, the results showed that there was no significant difference between the groups at post-intervention or at 6 week follow-up. Overall, we concluded that there may be little to no difference in the effect of peer support on feeling of empowerment compared to treatment as usual at all time points.

 Very low

due to serious concerns for risk of bias, concerns for inconsistency, serious concerns for indirectness and imprecision.a

There may be little to no difference in the effect of HOP vs. TAU on HRQoL post-intervention, but the evidence is very uncertain.

There may be little to no difference in the effect of HOP vs. TAU on feeling of empowerment at follow-up, but the evidence is very uncertain.

HOP= Honest, Open, Proud; HOP-C = Honest, Open, Proud–College; RCT = randomized controlled trial; TAU = treatment as usual

a

At post-intervention and at follow-up: rated down once for risk of bias due to serious concerns about the potential for bias arising from missing outcome data and bias in measurement of the outcomes (participant reported subjective outcomes); rated down once due to serious concerns for inconsistency because of limited of evidence of consistency as only 1 trial was available that reported on the outcome at all time points; rated down once due to serious concerns for indirectness because only 1 program (HOP/HOP-C) was identified and the population seemed relatively homogenous, thereby lowering the generalizability of findings to peer support programs in general; rated down once due to serious concerns about imprecision because of the relatively lower sample size in each comparison; publication bias was not detected.

From: Peer Support Programs for Youth Mental Health

Cover of Peer Support Programs for Youth Mental Health
Peer Support Programs for Youth Mental Health: Health Technology Assessment [Internet].
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