BackgroundRecovery colleges (RCs) facilitate peer-supported communities where people with lived experience of mental disruption learn collaboratively, aiming to foster empowerment and personal recovery. While existing (qualitative) research relates RC attendance to positive outcomes, high-quality multi-college quantitative studies evaluating RC effectiveness are scarce.AimsWe examine the extent to which RC attendance impacts empowerment (primary outcome) and other recovery-related outcomes.MethodIn this nonrandomised clinical trial (May 2022 to January 2025), RC partakers from four Dutch RCs were compared with controls over 2 years, in annual data collections. Linear mixed model analyses were conducted to investigate interactions between group and time. Exploratory analyses investigated distinguishing characteristics of RC partakers. This study was embedded in a larger project and was pre-registered (clinicaltrials.gov: #NCT05620212). Academic and experiential researchers collaborated in the design, recruitment, and analysis.ResultsThe sample comprised 91 RC partakers and 182 matched controls. RC partakers faced severe or persistent mental health challenges and attended RCs in multiple capacities (e.g., student and visitor/volunteer). Outcomes were mostly stable over time and did not differ between groups. Hence, no group-specific changes over time were found, as shown by interaction terms that were not statistically significant (e.g., empowerment: estimate T1*RC= 0.02, 95% CI= -0.08-0.13, estimate T2*RC= -0.001, 95% CI= -0.11-0.11).ConclusionsDespite promising qualitative evidence of RC effectiveness, our study found no differences between RC partakers and matched controls in quantitative recovery-related outcomes over time. Factors of influence may be possible pre-study effects, unmeasured confounding, or limitations in how standardised questionnaires capture recovery experiences. Methodologically, the findings raise questions about the operationalisation of effectiveness in the context of personal recovery and flexible, co-created practices such as RCs. Importantly, while this study could not establish measurable effectiveness, this does not automatically imply that RC attendance cannot meaningfully contribute to recovery.Plain Language Summary TitleStudy evaluating if recovery colleges have effects on recovery by comparing survey scores of people who do vs. do not attend them across two years.
Introduction Over 50% of patients participating in cardiac rehabilitation (CR) experience poor sleep and/or, closely related, psychological stress. Although stress management interventions are generally available, they are typically underutilised in CR, and sleep remains an underaddressed component within CR. This is concerning, as poor sleep and stress not only reinforce each other but are also associated with poorer cardiovascular health and lower quality of life. Therefore, the primary aim of the OPtimising CArdiac REhabilitation by REfining Sleep and STress (RESST) study is to investigate the (cost-)effectiveness of adding a behavioural intervention targeted at improving sleep and managing stress during CR (RESST intervention) on sleep and psychological stress. Furthermore, the study aims to explore the (bidirectional) associations between sleep, stress and lifestyle behaviours.Methods and analysis This parallel-arm multicentre randomised controlled trial will include 200 CR patients across 3 major CR centres in the Netherlands who experience poor sleep and/or stress. Patients will be randomised in a 1:1 ratio to standard CR or standard CR with the RESST intervention. Standard CR is a structured programme combining exercise, lifestyle guidance and risk management. On top of standard CR, the RESST intervention consists of 5 in-person group sessions targeting sleep and stress and is based on Acceptance and Commitment Therapy and Cognitive Behavioural Therapy. Primary outcomes are accelerometer-assessed and self-reported sleep and perceived stress. Secondary outcomes include quality of life, psychosocial well-being, chronic stress biomarkers (hair cortisol and cortisone), momentary fatigue, momentary stress and physical activity. Linear mixed models will be used to assess changes in outcomes at 3-month (after intervention and/or CR completed) and 6-month follow-up. The momentary data collected with ecological momentary assessment and accelerometry will be analysed using multilevel linear mixed models to explore the (bidirectional) relationship between sleep, stress and other lifestyle components such as physical activity.Ethics and dissemination This study was approved by the ethics committee of Erasmus MC, Erasmus University Medical Centre, Rotterdam, the Netherlands (MEC-2024-0238). The findings will be disseminated through publications in peer-reviewed journals, presentations at academic conferences and professional and patient publications.Trial registration number NCT06505109.
Background:Recovery colleges (RCs) facilitate peer-supported learning communities where people experiencing mental disruption work on recovery. How recovery processes unfold, especially within RCs, remains insufficiently understood. Objective:Using a narrative approach, this study scrutinized how recovery processes unfold for RC partakers within RCs and in their everyday lives, and what RC attendance means in those processes. Methods:This study's design, recruitment, data collection, analysis, and manuscript drafting were co-created with experiential researchers (ie, RC partakers). Following an interview study (N=26), a diary-interview study was conducted (N=5) between November 2022 and January 2023. RC partakers completed qualitative diaries for 1 or 2 months, every other day, and reflected on this diary period in an evaluative interview (conducted by an academic and an experiential researcher). Recovery narratives of 3 diary participants (Emma, Robin, and Norah) are presented. Results:For Emma, peer-to-peer contact within the RC helps rebuild a supportive social network and stimulates her to face her anxieties. Robin described how RC attendance offers new perspectives, invites her to trust her own judgments, and reconsider possibilities such as paid employment. Norah's narrative illustrates how RC partaking in various capacities supported a shift in her identity from feeling like a failure to seeing herself as a valuable contributor. Considering all narratives, a cross-case analysis foregrounded the value of experiential knowledge in the recovery processes of the RC partakers. Two mutually reinforcing learning processes were identified: learning by exchanging and learning by doing. It also became clear that the RC explicitly facilitated contexts in which these processes can unfold, as partakers experienced recognition, inspiration, hope, perspective, supportive structures, and social safety. Experiences stemmed from learning processes and acted as catalysts for further learning. Importantly, these processes were not linear: partakers also experienced challenges in their everyday lives and within the RC. Conclusions:Our findings underscore the value of RCs in landscapes of mental care and support as they explicitly facilitate space for exchanging experiences among peers and experimenting with new behaviors. We illustrate the importance of investigating supportive processes and contexts to understand how recovery unfolds. We also present practical implications for RC offerings and participatory health initiatives more broadly.
Background: Attending mutual-aid is associated with achieving better outcomes in people recovering from addictions. Because recovery becomes more stable over time, the benefits of mutual aid are likely strongest for those in early recovery. Methods: A sample of participants (N = 367) in recovery from problematic substance use completed a survey at baseline and then again 1 year later (Time 2; n = 311). Recovery Group Participation Scale (RGPS; Baseline) was median split into "high" and "low" scores, Commitment to Sobriety Scale (Baseline) and relapse (self-report; Time 2) were also collected. Results: For those in early recovery, 63% of the low RGPS group reported relapse, compared to 23% of the high RGPS group. Chi squared revealed that this difference was significant for those in early (<1 year) and sustained (1 to 5 years) recovery, but not for those in stable recovery (>5 years). Logistic regression showed that RGPS uniquely predicted the chance of relapse over and above its relationship with commitment to sobriety. Conclusions: The study provides evidence that greater involvement in addiction recovery groups is associated with better outcomes for those in earlier stages of recovery and highlights the need for greater availability of and referral to peer support groups, particularly for those in early recovery.
BackgroundIn recent years, implementation research has gained a renewed attention in the Netherlands. However, limited national funding for implementation research has mainly resulted in case- and context-specific descriptive data. To help prioritize research that holds high scientific value and practical relevance, this study aimed to identify gaps in both implementation science and implementation practice.MethodsA two-stage study was conducted combining multiple methods to collect data from implementation researchers working in the healthcare sector in the Netherlands. A two-round e-Delphi study was employed to identify research priorities amongst implementation researchers. In addition, a survey was conducted with practitioners to identify implementation knowledge gaps and needs in implementation practice.ResultsTwenty-six (55%) of the 47 invited researchers participated in Round 1 of the e-Delphi, leading to the identification of 31 research topics categorized into 7 themes. In Round 2, 22 of the 26 researchers (85%) completed the process, reaching consensus on 12 topics. These topics were grouped into six themes and linked to four areas of research: implementation, sustainability, scale-up, and de-implementation. The themes include: (1) understanding determinants, (2) matching strategies to determinants, (3) implementation strategies, (4) measuring implementation outcomes, (5) theories, models and frameworks, and (6) research designs. The survey of 74 practitioners revealed 230 implementation knowledge gaps, which were then triangulated with the e-Delphi results, highlighting specific research topics that emphasize implementation capacity and the need for pragmatic tools to enhance evidence-based implementation in practice.ConclusionsBy integrating insights from both implementation researchers and practitioners, the research agenda addresses topics that are relevant to both fields. Recommendations were made to advance the scientific field and improve implementation practice. This research agenda can guide research coordination and policymaking, aiming to consolidate research efforts in the Netherlands.
