Table 32GRADE Summary of Findings for Symptoms of Depression

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

Post-intervention: 84 (1 RCT 50 )

Post-booster: 97 (1 RCT 39 )

Follow-up: 117 (2 RCTs 40 , 50 )

Two trials39,40,50 with high risk of bias (predicted direction of bias unclear), reported on the impact of peer support interventions on depression among youth with mental health concerns. Participants had a mean age of 1550 to 2139,40 years, most of them female individuals (69.3%50 to 82.2%39,40). The peer support interventions were HOP50 and HOP-C39,40 programs. Outcomes were measured at post-intervention, post-booster and at follow-up (6 weeks50 to 2 months40 after core sessions). Symptoms of depression was measured using the 15 item CES-D (range 0 to 45) in 1 trial50 and the 10 item CES-D-10 in the other,39,40 higher scores indicating more symptoms.

The trials showed that there may be little to no difference in self-reported symptoms of depression from baseline to post-treatment (1 RCT50) and to post-booster (1 RCT39).

At longest follow-up, the results were heterogenous (2 RCTs40,50). Findings from 1 RCT50 favoured HOP-C at 6 weeks after the sessions with a mean between-group difference in change from baseline of 7.25 (95% CI –10.85 to –3.65), whereas the second RCT40 found little to no difference between groups at 2 months after the sessions.

 Very low

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

There may be little to no difference in the effect of HOP vs. TAU on self-reported depressive symptoms at post-intervention, but the evidence is very uncertain.a

There may be little to no difference in the effect of HOP-C vs. TAU on self-reported depressive symptoms post-booster, but the evidence is very uncertain.b

The findings for effect of HOP vs. control (waitlist/ TAU) on depressive symptoms at the longest follow-up are heterogeneous, and the evidence is very uncertain.c

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

a

At post-intervention: 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 this time point, 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.

b

At post-booster: 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 this time point; 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.

c

At longest 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 inconsistent results between the trials at longest follow-up; 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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