title: The iPeer2Peer Program: a pilot randomized controlled trial in adolescents with Juvenile Idiopathic Arthritis.
abstract: BACKGROUND
  Adolescents with Juvenile Idiopathic Arthritis (JIA) are at risk for physical, emotional, social and role challenges that negatively impact quality of life. Peer mentoring has been shown to improve positive health behaviours in adolescents with chronic disease while simultaneously providing social support. The objectives of this paper are to examine the feasibility and acceptability of an online peer mentoring program (iPeer2Peer Program) for adolescents with JIA.
  
  
  METHODS
  The iPeer2Peer program was examined using a waitlist pilot randomized control trial (RCT). Participants were randomly allocated to the intervention or wait-list control group via a secure, web-based randomization service. Health care providers and investigators were blinded to participant group allocation. Trained peer mentors (16-25 years; successfully managing their JIA) were matched to participants (12-18 years; diagnosed with JIA) randomized to the intervention group to provide peer support and education for effective self-management of JIA. Participant-mentor pairings connected ten times over 8 weeks using Skype video calls. Primary outcomes focused on implementation (i.e. measures of feasibility and acceptability). Secondary outcomes focused on effectiveness (i.e. measures of self-management, self-efficacy, pain, social support and quality of life).
  
  
  RESULTS
  Thirty adolescents (mean age 14.3 ± 1.7 years, 97 % female) completed the RCT (intervention n = 16, control n = 14).
  
  
  METHODS
  One third (32 %) of adolescents approached agreed to participate, completed baseline measures and were randomized. Half of pairings completed ten calls within 8 weeks. Average call length was twice the required amount with call lengths of 44.72 ± 15.76 min. Participants reported satisfaction with the program and all reported that they would recommend it to their peers. Participants' mean engagement level with the program was 8.53/10 (range = 7-10).
  
  
  RESULTS
  Participants who completed the iPeer2Peer Program demonstrated improvements in their perceived ability to manage JIA (p < 0.04), compared to controls. No adverse events were reported.
  
  
  CONCLUSIONS
  The iPeer2Peer Program is a promising intervention that improves acceptability of self-management and peer support treatments for adolescents with JIA. By using the Internet to connect mentors to adolescents with JIA it may also improve accessibility to these resources. Findings will be used to adapt the program and refine the methodology for a full-scale RCT.
  
  
  BACKGROUND
  ClinicalTrials.gov Identifier: NCT01986400 . Registered November 11, 2013.
authors: Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada. jennifer.stinson@sickkids.ca.|The Hospital for Sick Children, Child Health Evaluative Sciences, Toronto, ON, Canada. jennifer.stinson@sickkids.ca.
authors: Jennifer
authors: J
authors: Stinson
authors: Department of Psychology, The Hospital for Sick Children, Toronto, ON, Canada.
authors: Sara
authors: S
authors: Ahola Kohut
authors: University of Ottawa, Faculty of Health Sciences, School of Nursing, Ottawa, ON, Canada.
authors: Paula
authors: P
authors: Forgeron
authors: Department of Psychology, The Hospital for Sick Children, Toronto, ON, Canada.
authors: Khush
authors: K
authors: Amaria
authors: Department of Rheumatology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
authors: Mary
authors: M
authors: Bell
authors: Department of Adolescent Medicine, The Hospital for Sick Children, Toronto, ON, Canada.
authors: Miriam
authors: M
authors: Kaufman
authors: Department of Medicine, Rheumatology, Alberta Children's Hospital, Calgary, AB, Canada.
authors: Nadia
authors: N
authors: Luca
authors: The Hospital for Sick Children, Child Health Evaluative Sciences, Toronto, ON, Canada.
authors: Stephanie
authors: S
authors: Luca
authors: The Hospital for Sick Children, Child Health Evaluative Sciences, Toronto, ON, Canada.
authors: Lauren
authors: L
authors: Harris
authors: University of Toronto, Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
authors: Charles
authors: C
authors: Victor
authors: Department of Rheumatology, The Hospital for Sick Children, Toronto, ON, Canada.
authors: Lynn
authors: L
authors: Spiegel
mesh_terms: D000293:Adolescent; D001171:Arthritis, Juvenile / Q000523:psychology / Q000628:therapy; D005240:Feasibility Studies; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008611:Mentors / Q000523:psychology; D010043:Outcome and Process Assessment, Health Care; D010379:Peer Group; D010865:Pilot Projects; D011580:Psychological Techniques; D011788:Quality of Life; D012648:Self Care / Q000379:methods / Q000523:psychology; D012944:Social Support
keywords: Adolescents; Juvenile Idiopathic Arthritis; Randomized controlled trial; Social support