Peer Support + Financial Education for Psychological Distress

(CARES Trial)

Overseen By Tonia C Poteat, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Duke University

Disqualifiers: Inability to consent in English

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

Duration: 6 months

360 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Peer Support + Financial Education for Psychological Distress?

Research shows that patient education can improve compliance with treatment plans and lead to better health outcomes, especially when combined with behaviorally-oriented programs that change the patient's environment. Additionally, social networks and peer support can play a crucial role in managing long-term conditions by providing necessary resources and support. ^{1 2 3 4 5}

Is the combination of peer support and financial education safe for participants in clinical trials?

The research articles reviewed do not provide specific safety data for the combination of peer support and financial education. However, peer support programs, like 'the Buddy Study', are generally considered safe and beneficial for emotional support. ^{6 7 8 9 10}

How does the Peer Support + Financial Education treatment differ from other treatments for psychological distress?

This treatment is unique because it combines peer support with financial education to address psychological distress, focusing on improving financial literacy and reducing financial stress, which are not typically targeted by standard psychological treatments. ^{11 12 13 14 15}

What is the purpose of this trial?

The goal of this study is to test the ability of small grants and/or peer support to improve mental health among transgender people experiencing material hardship. The main questions the study will answer are: 1. Do microgrants with or without peer mentoring improve mental health? 2. Do microgrants with or without peer mentoring improve mental health by reducing material hardship and/or increasing a sense of community connection? Researchers will compare mental health outcomes among three groups of participants: A. Participants who receive one small grant and monthly financial education videos B. Participants who receive a small grant every month and monthly financial education videos for a total of 6 months. C. Participants who receive a small grant every month, peer mentoring support, and monthly financial education videos for a total of 6 months.

Research Team

Tonia C. Poteat, PhD

Principal Investigator

Duke University

Eligibility Criteria

This trial is for transgender individuals over the age of 18 who are experiencing material hardship. Participants must have a gender identity different from their sex assigned at birth, access to mobile phone or email, and score above zero on the material hardship index.

Inclusion Criteria

You have an index score greater than 0 on the material hardship scale.

You have access to a cellular device or electronic mail.

My gender identity is different from the sex assigned at birth.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive small grants and/or peer support along with monthly financial education videos

6 months

Monthly visits (virtual)

Follow-up

Participants are monitored for changes in psychological distress and substance use

6 months

2 visits (virtual)

Treatment Details

Interventions

• Financial education videos
• Microgrant
• Peer mentoring

Trial Overview The study tests if small grants and peer support can improve mental health among transgender people in need. It compares three groups: one receiving a single grant and financial education videos; another getting monthly grants and videos for six months; and a third adding peer mentoring to the monthly grants and videos.

Participant Groups

Group I: Usual Care Active Control 2 Interventions

Monthly financial education videos and one-time microgrant

Group II: Monthly microgrants Active Control 2 Interventions

Monthly financial education videos and monthly microgrants

Group III: Monthly microgrants plus peer mentoring Active Control 3 Interventions

Monthly financial education videos, monthly microgrants, and peer mentoring support

Who Is Running the Clinical Trial?

Duke University

Lead Sponsor

Trials

2,495

Recruited

5,912,000+

National Institute on Minority Health and Health Disparities (NIMHD)

Collaborator

Trials

473

Recruited

1,374,000+

Findings from Research

Patient education significantly improves compliance with therapeutic regimens in chronic disease management, with an average improvement of 0.67 sigma over control groups, indicating a strong effect.

While patient education also leads to improvements in physiological progress (0.49 sigma) and health outcomes (0.02 sigma), the most effective strategies involve behaviorally-oriented programs that focus on changing the patient's environment rather than just increasing knowledge.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Does patient education in chronic disease have therapeutic value? Mazzuca, SA.[2019]

A pilot study involving 49 patients with schizophrenia showed that a peer-to-peer psychoeducation program significantly increased patients' knowledge about their illness and improved their trust in physicians and medications.

The structured 5-step curriculum for training peer moderators was found to be feasible, indicating that peer-led psychoeducation could be an effective alternative to traditional professional-led sessions for improving patient outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Peer-to-peer psychoeducation in schizophrenia: a new approach. Rummel, CB., Hansen, WP., Helbig, A., et al.[2022]

A study involving 300 patients with chronic heart disease or diabetes found that having a diverse social network significantly enhances self-management and overall well-being, suggesting that social connections play a crucial role in managing long-term health conditions.

Support from personal social networks can reduce reliance on formal healthcare services, leading to substantial cost savings in healthcare utilization, highlighting the importance of community involvement in effective illness management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The contribution of social networks to the health and self-management of patients with long-term conditions: a longitudinal study. Reeves, D., Blickem, C., Vassilev, I., et al.[2022]

Chronic disease self-management education programs are designed to empower patients by teaching them skills and techniques to enhance their self-care and improve interactions with healthcare providers, ultimately aiming to boost their quality of life.

The Australian government has committed AU$515 million over five years to support patient self-management activities, highlighting the importance of integrating these programs into primary care and the need for healthcare professionals' support for successful implementation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Chronic disease self-management education programmes: challenges ahead. Jordan, JE., Osborne, RH.[2008]

Both diabetes education programs, 'the ABC's of Diabetes' and 'Conversation Maps', showed a trend towards improved glycemic control, with reductions in HbA1c levels of 0.2% and 0.6% respectively after 6 months, indicating their effectiveness in managing diabetes.

Patients with higher initial HbA1c levels (≥8%) experienced a significant drop of 1.1% in HbA1c three months after attending either class, suggesting that both educational formats can effectively support diabetes self-management, regardless of their intensity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A pragmatic comparison of two diabetes education programs in improving type 2 diabetes mellitus outcomes. Dorland, K., Liddy, C.[2022]

A study involving 134 patients found that 90% rated the animated video on patient safety as good or very good, while 100% of those receiving oral information felt the same, indicating high satisfaction with both methods.

Despite the positive feedback for the video, 74% of patients who received both formats preferred the oral presentation, suggesting that while videos can enhance understanding, they should not replace traditional verbal communication for optimal patient engagement.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Communicating Patient Safety Information Through Video and Oral Formats-A Comparison. Bånnsgård, M., Nouri, A., Finizia, C., et al.[2023]

The pilot Patient Safety Presentation process, implemented in a psychiatry residency program, significantly improved residents' knowledge and engagement in patient safety practices, as evidenced by pre- and post-presentation surveys involving 32 residents.

All participating residents expressed satisfaction with the presentation, highlighting its effectiveness as a model for enhancing patient safety education in residency programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development and Pilot of a Process for Regularly Sharing Summary Patient Safety Data. Kim, B., Grech, SM., Rembisz, AE., et al.[2023]

A 22-month study showed that trainee-led monthly conferences significantly increased the reporting of adverse events by medical trainees, with submissions rising from an average of 6.7 to 14.1 reports per month (P < .001).

These conferences not only improved reporting rates but also empowered trainees to identify system vulnerabilities and propose meaningful solutions, enhancing overall patient safety in the hospital setting.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Increasing Trainee Reporting of Adverse Events With Monthly Trainee-Directed Review of Adverse Events. Smith, A., Hatoun, J., Moses, J.[2022]

The 'Buddy Study' program, which includes a seminar and peer support for healthcare professionals after adverse events, received positive feedback from participants, with 91.6% satisfied with the seminar content and 69.1% feeling it helped them manage their emotional responses.

The program fostered a compassionate culture and attentiveness to colleagues' wellbeing, although it highlighted the need for ongoing support and visibility to maintain its effectiveness, suggesting that while valuable, peer support should complement other forms of support rather than replace them.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluation of'the Buddy Study', a peer support program for second victims in healthcare: a survey in two Danish hospital departments. Schrøder, K., Bovil, T., Jørgensen, JS., et al.[2022]

Near-peer learning (NPL) in rural community-based medical education significantly enhances psychological safety and engagement among medical trainees, as shown by qualitative interviews with 58 participants including medical students and residents.

Implementing NPL fosters self-regulated learning and increases motivation, which can help address the resource limitations in rural medical education and improve the sustainability of healthcare training in these areas.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Psychological safety and self-regulated learning through near-peer learning for the sustainability of rural community-based medical education: grounded theory approach. Ohta, R., Katsube, T., Sano, C.[2023]

Financial stress significantly contributes to health disparities, leading individuals to adopt unhealthy behaviors such as smoking, poor diet, and lack of exercise.

Financial education and coaching may help alleviate financial stress, potentially improving healthy lifestyle choices and overall health outcomes, as suggested by preliminary data from a randomized controlled trial.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Financial Education and Coaching: A Lifestyle Medicine Approach to Addressing Financial Stress. White, ND., Packard, K., Kalkowski, J.[2023]

In a study of 7,840 young adults in Canada and France during the COVID-19 pandemic, it was found that financial support from family and friends significantly reduced the association between income loss and depression, while government support did not have the same effect.

Approximately half of the participants reported depressive symptoms, and while government financial support was linked to continued depression in those with income loss, support from family and friends helped alleviate this link, suggesting the importance of social support in mental health during economic crises.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Moderation of the association between COVID-19-related income loss and depression by receipt of financial support: Repeated cross-sectional surveys of young adults in Canada and France (2020-2021). Coulaud, PJ., Salway, T., Jesson, J., et al.[2023]

Individuals with psychiatric disabilities face significant educational barriers that contribute to poor economic outcomes, especially in challenging economic conditions.

Supported education is a promising approach to help these individuals achieve their educational goals, but further efforts are needed to overcome implementation barriers and increase access to this service.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Barriers to supported education implementation: implications for administrators and policy makers. Manthey, TJ., Goscha, R., Rapp, C.[2016]

Medical students are facing a significant financial burden, with an average debt of over $240,000, which can impact their career decisions, mental health, and even patient care.

To address this issue, a personal finance curriculum was developed for medical students, covering essential topics like saving and investment, and the authors encourage other institutions to implement similar programs to better prepare students for their financial futures.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An Investment in Knowledge: Personal Finance Education for Medical Students. Wu, SA., Neuville, AJ., Bigach, SD., et al.[2023]

A systematic review of 13 studies found that personal finance curricula for medical students and residents significantly improved financial literacy, with 30.8% of studies reporting positive changes in financial behaviors after the courses.

Most curricula focused on essential topics like student loans, budgeting, and retirement savings, and were primarily taught by physicians, highlighting the need for medical institutions to invest in financial literacy education to alleviate financial stress among trainees.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Personal Financial Wellness Curricula for Medical Trainees: A Systematic Review. Wesslund, HM., Payne, JS., Baxter, JD., et al.[2023]

References

1. England pubmed.ncbi.nlm.nih.gov

Does patient education in chronic disease have therapeutic value? [2019]

2. United States pubmed.ncbi.nlm.nih.gov

Peer-to-peer psychoeducation in schizophrenia: a new approach. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

The contribution of social networks to the health and self-management of patients with long-term conditions: a longitudinal study. [2022]

4. England pubmed.ncbi.nlm.nih.gov

Chronic disease self-management education programmes: challenges ahead. [2008]

5. England pubmed.ncbi.nlm.nih.gov

A pragmatic comparison of two diabetes education programs in improving type 2 diabetes mellitus outcomes. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Communicating Patient Safety Information Through Video and Oral Formats-A Comparison. [2023]

7. United States pubmed.ncbi.nlm.nih.gov

Development and Pilot of a Process for Regularly Sharing Summary Patient Safety Data. [2023]

8. United States pubmed.ncbi.nlm.nih.gov

Increasing Trainee Reporting of Adverse Events With Monthly Trainee-Directed Review of Adverse Events. [2022]

9. England pubmed.ncbi.nlm.nih.gov

Evaluation of'the Buddy Study', a peer support program for second victims in healthcare: a survey in two Danish hospital departments. [2022]

10. Australia pubmed.ncbi.nlm.nih.gov

Psychological safety and self-regulated learning through near-peer learning for the sustainability of rural community-based medical education: grounded theory approach. [2023]

11. United States pubmed.ncbi.nlm.nih.gov

Financial Education and Coaching: A Lifestyle Medicine Approach to Addressing Financial Stress. [2023]

12. England pubmed.ncbi.nlm.nih.gov

Moderation of the association between COVID-19-related income loss and depression by receipt of financial support: Repeated cross-sectional surveys of young adults in Canada and France (2020-2021). [2023]

13. United States pubmed.ncbi.nlm.nih.gov

Barriers to supported education implementation: implications for administrators and policy makers. [2016]

14. United States pubmed.ncbi.nlm.nih.gov

An Investment in Knowledge: Personal Finance Education for Medical Students. [2023]

15. United States pubmed.ncbi.nlm.nih.gov

Personal Financial Wellness Curricula for Medical Trainees: A Systematic Review. [2023]