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NCT Number: NCT07463014

Peer Enriched Environment for Recovery (PEER)

The goal of this interventional study is to assess whether a peer coaching intervention (PEER) can improve the well-being in individuals who experienced a stroke. The main questions it aims to answer are

1. Is the PEER intervention feasible and acceptable for the intervention recipients who receive the intervention? 2. Is the PEER intervention feasible and acceptable for the peer coaches who deliver the intervention? 3. Do intervention recipients show a higher level of quality of life at immediate, 4-week, and 8-week post-intervention? 4. Do intervention recipients display increases in measures of psycho-social-spiritual well-being at immediate, 4-week, and 8-week post-intervention? Peer coach participants will a) take training sessions, b) deliver 5 coaching sessions to an intervention recipient participant, c) complete surveys before training, after training, and after intervention delivery, and d) participate in a personal interview Intervention recipient participants will a) attend 5 coaching sessions delivered by a peer coach participant, b) complete surveys before intervention, immediately post intervention, 4-week post intervention, and 8 week post-intervention, and c) participate in a personal interview.

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Key information

Conditions

Stroke Brain Diseases Cardiovascular Diseases Central Nervous System Diseases Cerebrovascular Disorders Nervous System Diseases Vascular Diseases

Age range

21 year–99 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Nanyang Technological University

Singapore, 639798

Location status: Recruiting

Location contact

Farrah Dewanti, BSc

CONTACT

[email protected]

+65 8355 6789

About this study

For intervention recipient recruitment, stroke survivors who have been diagnosed with stroke in the past 12 months and have been discharged from hospitals will be recruited from the collaborating community services and open recruitment. Recruited intervention recipients will proceed to take a baseline survey which collects their demographic characteristics, stroke-related information, wellbeing measures, and quality of life measure (T1). For peer coach recruitment, experienced stroke survivors who have been diagnosed with stroke in the past 5 years will be invited to participate in the study as peer coaches.

Recruited peer coaches will be asked to complete a preliminary survey. The preliminary survey collects peer coaches' demographic characteristics and stroke-related information, which will be sued for the matching between peer coaches and intervention recipients. The preliminary survey will also assess their well-being outcomes, QoL, self-determination level, coaching skills, and cognitive ability. Peer coaches with limited cognitive ability to perform peer-coaching will not proceed to peer coach training. Following the preliminary survey, peer coaches will undergo peer coach training sessions and the post-training assessment before performing peer-coaching in the intervention. The post-training assessment will include measurement of well-being outcomes, QoL, self-determination level, coaching skills, and cognitive ability. Peer coaches with limited cognitive ability to perform peer-coaching will not proceed to the intervention delivery.

Following the post-training survey, each peer coach will be matched with an intervention recipient based to their demographic characteristics and stroke experience. Following the matching process, peer coaches and intervention recipients will proceed into the intervention process. During the intervention, intervention recipients will be asked to attend peer-coaching sessions led by the matched peer coaches. The time of peer-coaching sessions will be decided based on participants' schedules. In the peer-coaching sessions, intervention recipients and peer coaches will meet in-person, and peer coaches will guide them to carry out arranged activities collaboratively. After the last peer coaching session is completed, intervention recipients will proceed to a post-intervention survey, which measures their satisfaction with the intervention as recipients, and a personal interviews, in which they will be asked about their perceptions and opinions on the PEER program. Intervention recipient will also be asked to take the follow-up survey at 3 time points - immediately after the intervention (T2), 4 weeks after the intervention (T3), and 8 weeks after the intervention (T4). The follow-up survey measures intervention recipients' wellbeing and quality of life. After the delivery of all peer coaching sessions, peer coaches will undergo the post-intervention survey, which assesses their well-being outcomes, QoL, self-determination level, cognitive ability, coaching skills, and satisfaction with the intervention as peer coaches; peer coaches will also be asked to attend a personal interview, in which they will be asked about their perceptions and opinions on the PEER program.

The interviews for peer coaches and intervention recipients will be audio-recorded with participants' consent. The recordings will be transcribed verbatim and proceed to thematic analyses. The analysis results of collected quantitative and qualitative data will be synthesized to evaluate the feasibility and the effectiveness of the peer-coaching intervention and the feasibility of the evaluation procedures. Elements of the PEER programme and the evaluation procedure will be improved based on the analysis results for future research and implementation.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

for peer coach:

  • Aged 21 years and above
  • Diagnosed with stroke within the past 5 years and discharged from the hospital

Inclusion criteria

for intervention recipients

  • Aged 21 years and above
  • Diagnosed with stroke within the past 1 year and discharged from the hospital

Exclusion criteria

for all participants:

  • Unable to communicate in English
  • Unable to provide informed consent
  • Diagnosed with one or multiple conditions which affect cognitive and/or mental health severely
  • Diagnosed with severe or potentially terminal co-morbidities

Treatment and study plan

Peer-Enriched Environment for Recovery (PEER)

Behavioral

The PEER intervention is a post-stroke peer coaching intervention. Participants who undergo this intervention will have 5 coaching sessions, which are delivered by trained peer coaches in-person. In each session, peer coaches will practice psychoeducation, experience sharing, and interactive activity, to provide intervention recipients with psychosocial support. Each coaching session will focus on a specific topic related to post-stroke recovery.

Primary outcomes

  1. Mental well-being of intervention recipients

    Time frame: From enrollment to 8-week post intervention

    This outcome will be assessed by the Short Warwick Edinburgh Mental Well-being Scale (SWEMBS), a validated 7-item questionnaire designed to measure positive mental wellbeing with a 5-point Likert scale. Scores of this scale range from 7 to 35, where higher scores indicate better mental well-being.

  2. Psychological distress of intervention recipients

    Time frame: From enrollment to 8-week post intervention

    This outcome will be assessed by the Hospital Anxiety and Depression Scale (HADS), a widely used 14-item questionnaire designed to detect anxiety and depression. Scores of this scale range from 0 to 21, where higher scores indicate higher levels of anxiety and depression.

  3. Hope of intervention recipients

    Time frame: From enrollment to 8-week post intervention

    This outcome will be assessed by the Herth Hope Index (HHI), a 12-item questionnaire developed to measure the level of hope. Scores of this scale range from 12 to 84, where higher scores indicate greater levels of hope.

  4. Resilience of intervention recipients

    Time frame: From enrollment to 8-week post intervention

    This outcome will be assessed by the Brief Resilience Scale (BRS), a 6-item measure designed to assess an individual's ability to bounce back or recover from stress, adversity, and challenging life circumstances. Scores of this scale range from 6 to 30, where higher scores indicate more resilience and a better ability to bounce back from stress and adversity.

  5. Stroke self-efficacy of intervention recipients

    Time frame: From enrollment to 8-week post intervention

    This outcome will be assessed by the Stroke Self-Efficacy Questionnaire (SSEQ), a 13-item tool used to measure a stroke survivor's confidence in performing functional activities and managing their condition. Scores of this scale range from 7 to 35, where higher scores indicate better mental well-being. Scores of this scale range from 0 to 39, where higher scores indicate better self-efficacy.

  6. Reintegration of intervention recipients

    Time frame: From enrollment to 8-week post intervention

    This outcome will be assessed by the Modified Reintegration to Normal Living Index (mRNLI), a validated 11-item assessment tool used to measure the degree to which individuals with chronic illnesses, disabilities, or traumatic injuries resume their normal social roles and activities. Scores of this scale range from 0 to 110, where higher scores indicate higher, more satisfying levels of reintegration.

  7. Social support of intervention recipients

    Time frame: From enrollment to 8-week post intervention

    This outcome will be assessed by the Inventory of Social Support, a 5-item questionnaire developed to assess the level of social support. Scores of this scale range from 5 to 25, where higher scores indicate higher levels of social support.

  8. Spiritual well-being of intervention recipients

    Time frame: From enrollment to 8-week post intervention

    This outcome will be assessed by the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being 12 Scale (FACIT-Sp-12), a widely used 12-item measure of spiritual wellbeing. Scores of this scale range from 0 to 48, where higher scores indicate greater spiritual well-being.

  9. Stroke specific quality of life of intervention recipients

    Time frame: From enrollment to 8-week post intervention

    This outcome will be assessed by the Stroke Specific Quality of Life Scale (SS-QOL), a 12-item questionnaire to assess health-related quality of life specifically for stroke survivors. Scores of this scale range from 12 to 60, where higher scores indicate better function and greater quality of life.

Secondary outcomes

  1. Quality of life of peer coach

    Time frame: Baseline, pre-intervention, immediately post-intervention

    This secondary outcome will be assessed by the Single-Item Assessment of Quality of Life, an 1-item questionnaire to assess quality of life with a 10-point Likert scale. Scores of this scale range from 0 to 10, where higher scores indicate greater quality of life.

  2. Life satisfaction of peer coach

    Time frame: Baseline, pre-intervention, immediately post-intervention

    This secondary outcome will be assessed by the Single-Item Life Satisfaction Measure, an 1-item questionnaire designed to assess life satisfaction, with a 4-point Likert scale. Scores of this scale range from 1 to 4, where higher scores indicate lower levels of life satisfaction.

  3. Spiritual well-being of peer coach

    Time frame: Baseline, pre-intervention, immediately post-intervention

    This outcome will be assessed by the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being 12 Scale (FACIT-Sp-12), a widely used 12-item measure of spiritual wellbeing. Scores of this scale range from 0 to 48, where higher scores indicate greater spiritual well-being.

  4. Resilience of peer coach

    Time frame: Baseline, pre-intervention, immediately post-intervention

    This outcome will be assessed by the Brief Resilience Scale (BRS), a 6-item measure designed to assess an individual's ability to bounce back or recover from stress, adversity, and challenging life circumstances. Scores of this scale range from 6 to 30, where higher scores indicate more resilience and a better ability to bounce back from stress and adversity.

  5. Self determination of peer coach

    Time frame: Baseline, pre-intervention, immediately post-intervention

    This secondary outcome will be assessed by the Self Determination Scale, a 10-item scale designed to assess individual differences in the extent to which people tend to function in a self-determined way. Scores of this scale range from 10 to 50, where higher scores indicate higher levels of self determination.

Study contacts

Contact information is provided by the study sponsor or research team.

Andy Hau Yan ho, PhD, EdD

CONTACT

[email protected]

+65 80112011

Farrah Dewanti, BSc

CONTACT

[email protected]

+65 8355 6789

Sponsors and collaborators

Lead sponsor

Nanyang Technological University

Other

Registry information

Official study title

Peer Enriched Environment for Recovery (PEER): An Integrated Health Coaching Intervention Post-Stroke

Acronym: PEER

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
Mar 10, 2026
Registry last updated
Mar 10, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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