Community partnered peer support after traumatic brain injury: a feasibility case study

Janna Griffioen; Alyssa Turcott; Kix Citton; Adele Rogers; Courtney L. Pollock; Bill Miller; Brodie M. Sakakibara; Nick Bansback; Derry Dance; Amy Schneeberg; Noah D. Silverberg; W. Ben Mortenson; Janice J. Eng; Julia Schmidt

doi:10.1071/IB24145

RESEARCH ARTICLE (Open Access)

Previous Next Contents Vol 26(4)

Community partnered peer support after traumatic brain injury: a feasibility case study

Janna Griffioen

^A ^B ^* , Alyssa Turcott

^B , Kix Citton ^C , Adele Rogers ^C , Courtney L. Pollock ^A ^B ^D , Bill Miller ^A ^B ^E , Brodie M. Sakakibara ^A ^B ^E ^F , Nick Bansback ^G , Derry Dance ^H ^I ^J , Amy Schneeberg ^B , Noah D. Silverberg ^B ^K , W. Ben Mortenson ^A ^B ^E , Janice J. Eng ^A ^B ^D and Julia Schmidt ^A ^B ^E

+ Author Affiliations

- Author Affiliations

^A Graduate Program in Rehabilitation Sciences, Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, BC, Canada.

^B Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.

^C Nanaimo Brain Injury Society, Nanaimo, BC, Canada.

^D Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.

^E Department of Occupational Science and Occupational Therapy Department, University of British Columbia, Vancouver, BC, Canada.

^F Centre for Chronic Disease Prevention and Management, Southern Medical Program, Kelowna, BC, Canada.

^G Department of Health Economics, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.

^H GF Strong Rehabilitation Centre, Vancouver, BC, Canada.

^I Vancouver Coastal Health, Vancouver, BC, Canada.

^J Faculty of Medicine, Vancouver, BC, Canada.

^K Department of Psychology, University of British Columbia, Vancouver, BC, Canada.

^* Correspondence to: janna.griffioen@gmail.com

Handling Editor: Melissa Brunner

Brain Impairment 26, IB24145 https://doi.org/10.1071/IB24145

Submitted: 21 December 2024 Accepted: 10 August 2025 Published: 30 September 2025

© 2025 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of the Australasian Society for the Study of Brain Impairment. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Background

Peer support can enhance the rehabilitation experience for people with traumatic brain injury (TBI). Understanding the feasibility of integrating peer support using a co-design approach can ensure effective delivery. This study aimed to evaluate the feasibility of implementing a community-based peer support program for people with moderate to severe TBI using a co-designed approach.

Methods

A case series pre-post feasibility study was conducted in partnership with a community brain injury organisation. Participants were adults who experienced a moderate to severe TBI <12 months earlier. Feasibility was assessed using process (recruitment and retention rates), resource (adherence to intervention), management (implementation fidelity) and scientific indicators (pre-post intervention changes).

Results

Three participants were included, and most measures of feasibility were achieved. Process was achieved with a recruitment rate of 60% (3/5) and a retention rate of 100%. Resource feasibility was achieved with all peer support sessions (100%). Management feasibility was met through the completion of a co-created checklist of session management by peer support workers. Scientific feasibility outcomes showed limited change between pre- and post-intervention.

Conclusion

This study demonstrates the feasibility of a co-designed peer support program for people with TBI. Future research may examine the implementation of peer support to explore program scalability and refine outcome measures to better capture the benefits of a peer support focused intervention.

Keywords: brain Injury, co-design, community partners, neurorehabilitation, participatory research, peer support, psychosocial support, resilience.

References

Abelson J, Canfield C, Leslie M, Levasseur MA, Rowland P, Tripp L, Vanstone M, Panday J, Cameron D, Forest P-G, Sussman D, Wilson G (2022) Understanding patient partnership in health systems: lessons from the Canadian patient partner survey. BMJ Open 12(9), e061465.
| Crossref | Google Scholar |

Ali M, VandenBerg K, Williams LJ, Williams LR, Abo M, Becker F, et al. (2021) Predictors of Poststroke Aphasia Recovery. Stroke 52(5), 1778-1787.
| Crossref | Google Scholar |

Assonov D (2021) Two-Step Resilience-Oriented Intervention for Veterans with Traumatic Brain Injury: A Pilot Randomized Controlled Trial. Clinical Neuropsychiatry 18(5), 247-259.
| Crossref | Google Scholar |

Babatunde S, Ahmed S, Santana MJ, Nielssen I, Zelinsky S, Ambasta A (2023) Working together in health research: a mixed-methods patient engagement evaluation. Research Involvement and Engagement 9(1), 62.
| Crossref | Google Scholar |

Blomkamp E. (2018) ‘The Promise of Co-Design for Public Policy 1’, 1st edn. (Routledge)

Borg DN, Nielsen M, Kennedy A, Drovandi C, Beadle E, Bohan JK, Watter K, Foster MM, Fleming J (2020) The effect of access to a designated interdisciplinary post-acute rehabilitation service on participant outcomes after brain injury. Brain Injury 34(10), 1358-1366.
| Crossref | Google Scholar |

Brett J, Staniszewska S, Mockford C, Herron‐Marx S, Hughes J, Tysall C, Suleman R (2014) Mapping the impact of patient and public involvement on health and social care research: a systematic review. Health Expectations 17(5), 637-650.
| Crossref | Google Scholar |

Canadian Institutes of Health Research (2014) Strategy for Patient-Oriented Research: Patient engagement framework. Available at https://cihr-irsc.gc.ca/e/48413.html

Coles J, Snow B (2011) Applying the Principles of Peer Mentorship in Persons with Aphasia. Topics in Stroke Rehabilitation 18(2), 106-111.
| Crossref | Google Scholar |

Covington NV, Duff MC (2021) Heterogeneity is a hallmark of traumatic brain injury, not a limitation: A new perspective on study design in rehabilitation research. American Journal of Speech-Language Pathology 30(2S), 974-985.
| Crossref | Google Scholar |

D’Cruz K, Antonopoulos S, Rothman R, Douglas J, Winkler D, Oliver S (2022) Co-designing with adults with acquired neurological disability in the community: a scoping review protocol. BMJ Open 12(12), e064921.
| Crossref | Google Scholar |

De Dios Perez B, Morris RPG, Craven K, Radford KA (2024) Peer mentoring for people with acquired brain injury–a systematic review. Brain Injury 38(4), 316-329.
| Crossref | Google Scholar |

Eldridge SM, Chan CL, Campbell MJ, Bond CM, Hopewell S, Thabane L, Lancaster GA (2016) CONSORT 2010 statement: extension to randomised pilot and feasibility trials. BMJ 355, i5239.
| Crossref | Google Scholar |

Fleming J, Braithwaite H, Gustafsson L, Griffin J, Collier AM, Fletcher S (2011) Participation in leisure activities during brain injury rehabilitation. Brain Injury 25(9), 806-818.
| Crossref | Google Scholar |

Golicki D, Niewada M, Karlińska A, Buczek J, Kobayashi A, Janssen MF, Pickard AS (2015) Comparing responsiveness of the EQ-5D-5L, EQ-5D-3L and EQ VAS in stroke patients. Quality of Life Research 24(6), 1555-1563.
| Crossref | Google Scholar |

Graves JM, Mackelprang JL, Moore M, Abshire DA, Rivara FP, Jimenez N, Fuentes M, Vavilala MS (2019) Rural‐urban disparities in health care costs and health service utilization following pediatric mild traumatic brain injury. Health Services Research 54(2), 337-345.
| Crossref | Google Scholar |

Greenhalgh T, Jackson C, Shaw S, Janamian T (2016) Achieving Research Impact Through Co‐creation in Community‐Based Health Services: Literature Review and Case Study. The Milbank Quarterly 94(2), 392-429.
| Crossref | Google Scholar |

Grewal J, Kennedy CJ, Mamman R, Biagioni JB, Garcia-Barrera MA, Schmidt J (2024) Understanding the barriers and facilitators of healthcare services for brain injury and concurrent mental health and substance use issues: a qualitative study. BMC Health Services Research 24(1), 881.
| Crossref | Google Scholar |

Griffioen J, Gingrich N, Pollock CL, Schmidt J (2025) An exploratory review of resiliency assessments after brain injury. PLOS ONE 20(1), e0292502.
| Crossref | Google Scholar |

Haines KL, Nguyen BP, Vatsaas C, Alger A, Brooks K, Agarwal SK (2019) Socioeconomic Status Affects Outcomes After Severity-Stratified Traumatic Brain Injury. Journal of Surgical Research 235, 131-140.
| Crossref | Google Scholar |

Hanks RA, Rapport LJ, Wertheimer J, Koviak C (2012) Randomized Controlled Trial of Peer Mentoring for Individuals With Traumatic Brain Injury and Their Significant Others. Archives of Physical Medicine and Rehabilitation 93(8), 1297-1304.
| Crossref | Google Scholar |

Haslam C, Holme A, Haslam SA, Iyer A, Jetten J, Williams WH (2008) Maintaining group memberships: Social identity continuity predicts well-being after stroke. Neuropsychological Rehabilitation 18(5–6), 671-691.
| Crossref | Google Scholar |

Herdman M, Gudex C, Lloyd A, Janssen MF, Kind P, Parkin D, Bonsel G, Badia X (2011) Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Quality of Life Research 20(10), 1727-1736.
| Crossref | Google Scholar |

Herth K (1992) Abbreviated instrument to measure hope: development and psychometric evaluation. Journal of Advanced Nursing 17(10), 1251-1259.
| Crossref | Google Scholar |

Hibbard MR, Cantor J, Charatz H, Rosenthal R, Ashman T, Gundersen N, Ireland-Knight L, Gordon W, Avner J, Gartner A (2002) Peer Support in the Community. Journal of Head Trauma Rehabilitation 17(2), 112-131.
| Crossref | Google Scholar |

Hilari K, Behn N, James K, Northcott S, Marshall J, Thomas S, Simpson A, Moss B, Flood C, McVicker S, Goldsmith K (2021) Supporting wellbeing through peer-befriending (SUPERB) for people with aphasia: A feasibility randomised controlled trial. Clinical Rehabilitation 35(8), 1151-1163.
| Crossref | Google Scholar |

Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, Altman DG, Barbour V, Macdonald H, Johnston M, Lamb SE, Dixon-Woods M, McCulloch P, Wyatt JC, Chan A-W, Michie S (2014) Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ 348, g1687.
| Crossref | Google Scholar |

Horvath AO, Greenberg LS (1989) Development and validation of the Working Alliance Inventory. Journal of Counseling Psychology 36(2), 223.
| Crossref | Google Scholar |

Hugentobler JA, Vegh M, Janiszewski B, Quatman-Yates C (2015) Physical therapy intervention strategies for patients with prolonged mild traumatic brain injury symptoms: a case series. International Journal of Sports Physical Therapy 10(5), 676-89.
| Google Scholar | PubMed |

Hughes R, Fleming P, Henshall L (2020) Peer support groups after acquired brain injury: a systematic review. Brain Injury 34(7), 847-856.
| Crossref | Google Scholar |

Jhunjhunwala R, Jayaram A, Mita C, Davies J, Chu K (2024) Community support for injured patients: A scoping review and narrative synthesis. PLoS One 19(2), e0289861.
| Crossref | Google Scholar |

Johnson LW, Diaz I (2023) Exploring the Social Determinants of Health and Health Disparities in Traumatic Brain Injury: A Scoping Review. Brain Sciences 13(5), 707.
| Crossref | Google Scholar |

Kent A (2019) Evidence-informed practices and strategies for patient-oriented research (POR): A “menu” for research teams. Available at https://healthresearchbc.ca/wp-content/uploads/2022/10/POR-Menu_20191004.pdf

Kessler D, Egan M, Kubina L-A (2014) Peer support for stroke survivors: a case study. BMC Health Services Research 14(1), 256.
| Crossref | Google Scholar |

Klassen TD, Dukelow SP, Bayley MT, Benavente O, Hill MD, Krassioukov A, Liu-Ambrose T, Pooyania S, Poulin MJ, Schneeberg A, Yao J, Eng JJ (2020) Higher Doses Improve Walking Recovery During Stroke Inpatient Rehabilitation. Stroke 51(9), 2639-2648.
| Crossref | Google Scholar |

Kleffelgaard I, Soberg HL, Bruusgaard KA, Tamber AL, Langhammer B (2016) Vestibular Rehabilitation After Traumatic Brain Injury: Case Series. Physical Therapy 96(6), 839-849.
| Crossref | Google Scholar |

Lau SKC, Luong D, Sweet SN, Bayley M, Levy BB, Kastner M, Nelson MLA, Salbach NM, Jaglal SB, Shepherd J, Wilcock R, Thoms C, Munce SEP (2021) Using an integrated knowledge translation approach to inform a pilot feasibility randomized controlled trial on peer support for individuals with traumatic brain injury: A qualitative descriptive study. PLoS One 16(8), e0256650.
| Crossref | Google Scholar |

Levasseur M, Pigot H, Couture M, Bier N, Swaine B, Therriault P-Y, Giroux S (2016) Identifying participation needs of people with acquired brain injury in the development of a collective community smart home. Disability and Rehabilitation: Assistive Technology 11(8), 636-644.
| Crossref | Google Scholar |

Levy BB, Luong D, Perrier L, Bayley MT, Munce SEP (2019) Peer support interventions for individuals with acquired brain injury, cerebral palsy, and spina bifida: A systematic review. BMC Health Services Research 19(1), 288.
| Crossref | Google Scholar |

Levy BB, Luong D, Bayley MT, Sweet SN, Voth J, Kastner M, Nelson MLA, Jaglal SB, Salbach NM, Wilcock R, Thoms C, Shepherd J, Munce SEP (2021) A Pilot Feasibility Randomized Controlled Trial on the Ontario Brain Injury Association Peer Support Program. Journal of Clinical Medicine 10(13), 2913.
| Crossref | Google Scholar |

Manafo E, Petermann L, Mason-Lai P, Vandall-Walker V (2018) Patient engagement in Canada: a scoping review of the ‘how’ and ‘what’ of patient engagement in health research. Health Research Policy and Systems 16(1), 5.
| Crossref | Google Scholar |

Masterson-Algar P, Williams S, Burton CR, Arthur CA, Hoare Z, Morrison V, Radford K, Seddon D, Elghenzai S (2020) Getting back to life after stroke: co-designing a peer-led coaching intervention to enable stroke survivors to rebuild a meaningful life after stroke. Disability and Rehabilitation 42(10), 1359-1372.
| Crossref | Google Scholar |

McCarron TL, Clement F, Rasiah J, Moran C, Moffat K, Gonzalez A, Wasylak T, Santana M (2021) Patients as partners in health research: A scoping review. Health Expectations 24(4), 1378-1390.
| Crossref | Google Scholar |

Moss B, Behn N, Northcott S, Monnelly K, Marshall J, Simpson A, Thomas S, McVicker S, Goldsmith K, Flood C, Hilari K (2022) “Loneliness can also kill:” a qualitative exploration of outcomes and experiences of the SUPERB peer-befriending scheme for people with aphasia and their significant others. Disability and Rehabilitation 44(18), 5015-5024.
| Crossref | Google Scholar |

Neils-Strunjas J, Paul D, Clark AN, Mudar R, Duff MC, Waldron-Perrine B, Bechtold KT (2017) Role of resilience in the rehabilitation of adults with acquired brain injury. Brain Injury 31(2), 131-139.
| Crossref | Google Scholar |

Ohno S, Takahashi K, Inoue A, Takada K, Ishihara Y, Tanigawa M, Hirao K (2017) Smallest detectable change and test‐retest reliability of a self‐reported outcome measure: Results of the Center for Epidemiologic Studies Depression Scale, General Self‐Efficacy Scale, and 12‐item General Health Questionnaire. Journal of Evaluation in Clinical Practice 23(6), 1348-1354.
| Crossref | Google Scholar |

Payne R, Jahoda A (2004) The Glasgow Social Self‐Efficacy Scale—a new scale for measuring social self‐efficacy in people with intellectual disability. Clinical Psychology & Psychotherapy 11(4), 265-274.
| Crossref | Google Scholar |

Peer Support Canada (2024) About Peer Support Canada. Available at https://peersupportcanada.ca/

Reid MW, Cooper DB, Lu LH, Iverson GL, Kennedy JE (2018) Adversity and Resilience Are Associated with Outcome after Mild Traumatic Brain Injury in Military Service Members. Journal of Neurotrauma 35(10), 1146-1155.
| Crossref | Google Scholar |

Rocchi MA, Shi Z, Shaw RB, McBride CB, Sweet SN (2022) Identifying the outcomes of participating in peer mentorship for adults living with spinal cord injury: a qualitative meta-synthesis. Psychology & Health 37(4), 523-544.
| Crossref | Google Scholar |

Sadler E, Sarre S, Tinker A, Bhalla A, McKevitt C (2017) Developing a novel peer support intervention to promote resilience after stroke. Health & Social Care in the Community 25(5), 1590-1600.
| Crossref | Google Scholar |

Sanders EB-N, Stappers PJ (2008) Co-creation and the new landscapes of design. CoDesign 4(1), 5-18.
| Crossref | Google Scholar |

Sansonetti D, Fleming J, Patterson F, Lannin NA (2022) Conceptualization of self-awareness in adults with acquired brain injury: A qualitative systematic review. Neuropsychological Rehabilitation 32(8), 1726-1773.
| Crossref | Google Scholar |

Schmidt J, Lannin N, Fleming J, Ownsworth T (2011) Feedback interventions for impaired self-awareness following brain injury: A systematic review. Journal of Rehabilitation Medicine 43(8), 673-680.
| Crossref | Google Scholar |

Schulz CH (1994) Helping Factors in a Peer-Developed Support Group for Persons With Head Injury, Part 2: Survivor Interview Perspective. The American Journal of Occupational Therapy 48(4), 305-309.
| Crossref | Google Scholar |

Schwartzberg SL (1994) Helping Factors in a Peer-Developed Support Group for Persons With Head Injury, Part 1: Participant Observer Perspective. The American Journal of Occupational Therapy 48(4), 297-304.
| Crossref | Google Scholar |

Schwarzer R, Jerusalem M (1995) Generalized self-efficacy scale. Measures in HealthPsychology: A User’s Portfolio. Causal and Control Beliefs [1] 35-37.
| Google Scholar |

Shalaby RAH, Agyapong VIO (2020) Peer support in mental health: Literature review. JMIR Mental Health 7(6), e15572.
| Crossref | Google Scholar | PubMed |

Silva MA, VandenBussche Jantz AB, Klocksieben F, Monden KR, Rabinowitz AR, Cotner BA, Dillahunt-Aspillaga C, Nakase-Richardson R (2021) Unmet Rehabilitation Needs Indirectly Influence Life Satisfaction 5 Years After Traumatic Brain Injury: A Veterans Affairs TBI Model Systems Study. Archives of Physical Medicine and Rehabilitation 102(1), 58-67.
| Crossref | Google Scholar |

Stagg K, Douglas J, Iacono T (2019) A scoping review of the working alliance in acquired brain injury rehabilitation. Disability and Rehabilitation 41(4), 489-497.
| Crossref | Google Scholar |

Stoner CR, Orrell M, Spector A (2015) Review of Positive Psychology Outcome Measures for Chronic Illness, Traumatic Brain Injury and Older Adults: Adaptability in Dementia? Dementia and Geriatric Cognitive Disorders 40(5–6), 340-357.
| Crossref | Google Scholar |

Struchen MA, Davis LC, Bogaards JA, Hudler-Hull T, Clark AN, Mazzei DM, Sander AM, Caroselli JS (2011) Making Connections After Brain Injury. Journal of Head Trauma Rehabilitation 26(1), 4-19.
| Crossref | Google Scholar |

Sun B, Wang N, Li K, Yang Y, Zhang F (2024) The mediating effects of hope on the relationships of social support and self-esteem with psychological resilience in patients with stroke. BMC Psychiatry 24(1), 340.
| Crossref | Google Scholar |

Thabane L, Ma J, Chu R, Cheng J, Ismaila A, Rios LP, Robson R, Thabane M, Giangregorio L, Goldsmith CH (2010) A tutorial on pilot studies: the what, why and how. BMC Medical Research Methodology 10(1), 1.
| Crossref | Google Scholar |

Toglia J, Lee A, Steinberg C, Waldman-Levi A (2020) Establishing and measuring treatment fidelity of a complex cognitive rehabilitation intervention: The multicontext approach. British Journal of Occupational Therapy 83(6), 363-374.
| Crossref | Google Scholar |

Tsow R, Pollock C, Mehta S, Turcott A, Kang R, Schmidt J (2024) A Look at Traumatic Brain Injury Community Programs in British Columbia: Barriers and facilitators of implementation. Brain Injury 38(7), 539-549.
| Crossref | Google Scholar |

Wobma R, Nijland RHM, Ket JCF, Kwakkel G (2016) Evidence for peer support in rehabilitation for individuals with acquired brain injury: A systematic review. Journal of Rehabilitation Medicine 48(10), 837-840.
| Crossref | Google Scholar |

Yan J, Xie S, Johnson JA, Pullenayegum E, Ohinmaa A, Bryan S, Xie F (2024) Canada population norms for the EQ-5D-5L. The European Journal of Health Economics 25(1), 147-155.
| Crossref | Google Scholar |

Zhang S, Li J, Hu X (2022) Peer support interventions on quality of life, depression, anxiety, and self-efficacy among patients with cancer: A systematic review and meta-analysis. Patient Education and Counseling 105(11), 3213-3224.
| Crossref | Google Scholar |