Self-directed versus peer-supported self-management for mental and sexual wellbeing after acquired brain injury: protocol for a feasibility randomised controlled trial

Abstract Background Acquired brain injury (ABI) can lead to biopsychosocial changes such as depression, low self-esteem, and fatigue can cause, and be caused by, sexual issues affecting relationships and wellbeing. Given the relationship between sexual wellbeing and mental health, it is feasible that supporting sexual wellbeing will benefit psychological wellbeing. However, neurorehabilitation is inconsistent and often inadequate across the UK, and psychological, sexual, and social support is lacking. Research shows that self-management and peer-support programmes can improve quality of life, self-efficacy, and psychological wellbeing after brain injury. This protocol describes a feasibility randomised controlled trial (RCT) of a digital self-management programme to support mental and sexual wellbeing (known as HOPE4ABI), co-designed with and for people with ABI. Methods This mixed-methods feasibility RCT has two parallel trial arms of the 8-week digital HOPE4ABI self-management programme. Eligibility criteria includes: age > 18 years, sustained an ABI > 3 months prior to trial entry, access to internet enabled device, and ability to engage with the intervention. Referrals to the study website will be made via National Health Service (NHS), social media, and partnering organisations. Sixty eligible participants will be randomised at a ratio of 1:1 to peer-supported (n = 30) or self-directed (n = 30) HOPE4ABI programme. Primary feasibility outcomes include recruitment and retention rates, engagement, adherence, and usage. Secondary outcomes relate to standardised measures of quality of life, sexual wellbeing, and mental wellbeing. Participants and peer-facilitators will be interviewed after the course to assess acceptability across both trial arms. Discussion This feasibility trial data is not sufficiently powered for inferential statistical analyses but will provide evidence of feasibility of a full RCT. Quantitative trial data will be analysed descriptively, and participant screening data representing age, ethnicity and gender will be presented as proportions at group level. This data may indicate trends in reach to particular demographic groups that may inform future recruitment strategies to widen participation. Progression to a definitive trial will be justified, if predetermined criteria are met, relating to recruitment, retention: engagement, and acceptability. Trial Registration ISRCTN46988394 registered on 1st March 2023.