title: Qualities and health of lay trainers with migraine for behavioral attack prevention.
abstract: OBJECTIVE
  To evaluate the qualities of lay trainers with migraine and to quantify their self-management results.
  
  
  BACKGROUND
  Little is known about the qualities of lay trainers with chronic diseases and the benefits for their own health.
  
  
  METHODS
  Thirteen lay trainers (12 F, 1 M) completed a 3-step program that consisted of self-experience of a behavioral training (BT), providing BT to one fellow patient, and subsequently to a small group at home. Successful mastery of own migraine attacks was required for participation, and lay trainers received intensive guidance. Evaluation of the qualities of trainers took place post-BT by means of a specially constructed questionnaire. Their self-management was measured before self-experience of BT, post-BT, and at 6-month follow-up by a headache diary and questionnaires.
  
  
  RESULTS
  The qualities of the 13 trainers were positively evaluated by 95 trainees, particularly their warmth, expertise, organization, explanation of BT, active control, and advice and guidance. Higher active control of lay trainers during the group sessions was significantly related to improvements on migraine frequency and internal locus of control in their trainees post-BT. Advice and guidance increased the likelihood of less attacks at follow-up and supportive encouragement promoted a higher internal locus of control. However, humor slightly increased the likelihood of more attacks post-BT, while fellowship and individualization negatively influenced internal locus of control. Lay trainers showed significantly more improvement in migraine frequency than their trainees at follow-up, as well as enhanced internal locus of control and quality of life.
  
  
  CONCLUSIONS
  Participation in a stepwise training program can produce capable trainers and may positively influence their own health. Lay trainers may be more motivated to enhance their self-management skills as they have to present the benefits to their trainees.
authors.affiliation: Department of Medical Psychology and Psychotherapy, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Saskia Y M
authors.initials: SY
authors.lastname: Mérelle
authors.forename: Marjolijn J
authors.initials: MJ
authors.lastname: Sorbi
authors.forename: Hugo J
authors.initials: HJ
authors.lastname: Duivenvoorden
authors.forename: Jan
authors.initials: J
authors.lastname: Passchier
mesh_terms: D000223:Adaptation, Psychological; D001521:Behavior Therapy / Q000379:methods* / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000193:education* / Q000523:psychology / Q000706:statistics & numerical data; D006304:Health Status; D006699:Home Care Services; D006801:Humans; D007318:Inservice Training; D008881:Migraine Disorders / Q000517:prevention & control / Q000523:psychology / Q000628:therapy*; D010147:Pain Measurement; D010353:Patient Education as Topic / Q000379:methods; D010358:Patient Participation; D015397:Program Evaluation; D011569:Psychiatric Status Rating Scales; D011785:Quality Assurance, Health Care / Q000379:methods*; D012008:Recurrence; D012646:Self Administration; D012647:Self-Assessment; D012655:Self-Evaluation Programs / Q000379:methods; D011795:Surveys and Questionnaires; D013663:Teaching / Q000379:methods* / Q000706:statistics & numerical data; D016896:Treatment Outcome