Data_Sheet_2_Implementing a social innovation for community-based peer support for immigrant mothers in Sweden: a mixed-methods process evaluation.XLSX

IntroductionA South African social innovation based on peer support for mothers was contextualized in southern Sweden. The objective of the project was to support expectant women and mothers of young children in immigrant communities to access public services that would benefit maternal and child health. This study aimed to assess how the intervention was implemented, what the contextual barriers and facilitators were, and how the implementation was perceived by those who delivered and received it.
MethodsThe study used mixed methods with a convergent parallel design and followed the Medical Research Council guidance on process evaluations of complex interventions. Semi-structured interviews (n = 19) were conducted with peer supporters, client mothers, and key stakeholders involved in the intervention. The qualitative data were analyzed using content analysis. Quantitative data on peer supporters' activities were collected during contacts with client mothers and were presented descriptively.
ResultsThe five peer supporters had 1,294 contacts with client mothers, of which 507 were first-time contacts. The reach was perceived as wide, and the dose of the intervention was tailored to individual needs. Barriers to implementation included community mistrust of social services, norms on gender roles and parenting, and funding challenges. The implementation was facilitated by the organization's reputation, network, experience, and third-sector affiliation. Peer supporters tended to prioritize linking clients to other services over the educational components of the intervention, sometimes doing more than what was originally planned. Implementation strategies used included building trust, using multiple outreach venues, using internal support structures, and providing practical assistance as an entry point to comprehensive psychosocial support. The personal connection between peer supporters and clients was highly valued, and the building of relationships enabled them to address sensitive topics. Peer supporters sometimes experienced a blurred line between professional and personal roles.
ConclusionsPeer supporters used a variety of strategies to navigate identified barriers and facilitators. Trust was central both as a contextual factor and a strategy for implementation. It is valuable to maintain a balance between flexibility and adherence to the function of peer supporters. Further research is needed to evaluate the effects of the intervention.

引言：一项源自南非的母亲同伴互助社会创新项目，在瑞典南部完成了本土化适配。本项目旨在助力移民社区中的待产女性与低龄儿童母亲，获取有益于母婴健康的公共服务资源。本研究旨在评估该干预措施的实施情况、实施过程中的情境化障碍与促进因素，以及干预实施者与接受者对其的感知评价。
方法：本研究采用混合研究方法，结合收敛平行设计范式，并遵循英国医学研究理事会（Medical Research Council）针对复杂干预措施的过程评估指南。研究对参与该干预项目的同伴互助者（peer supporter）、服务对象母亲及关键利益相关者开展了19场半结构化访谈；采用内容分析法对定性数据进行编码分析，同时在与服务对象母亲的接触过程中，收集同伴互助者活动相关的定量数据，并以描述性统计方式呈现。
结果：5名同伴互助者累计与服务对象母亲完成1294次接触，其中首次接触为507次。项目覆盖范围被评价为广泛，且干预剂量依据服务对象的个体需求进行了个性化调整。实施障碍主要包括社区对社会服务的不信任、性别角色与育儿规范的限制，以及资金筹措难题。项目实施的促进因素包括执行机构的声誉、社会网络、实操经验以及第三部门的组织属性。同伴互助者更倾向于优先协助服务对象对接其他公共服务，而非项目预设的教育类干预内容，部分情况下其工作内容超出了初始规划范围。本次研究识别的实施策略包括：建立信任关系、设置多元外展服务点位、依托内部支持架构，以及以实用帮扶作为开展全面社会心理支持的切入点。同伴互助者与服务对象间的私人联结被高度认可，良好的关系建立使其能够探讨敏感议题。部分同伴互助者曾面临专业角色与私人角色边界模糊的困境。
结论：同伴互助者通过多元策略应对已识别的实施障碍并利用促进因素推进工作。信任既是影响项目实施的核心情境因素，也是重要的实施策略。在保持工作灵活性与坚守同伴互助者的核心职能之间维持平衡，具有重要实践价值。未来仍需开展进一步研究，以评估该干预措施的实际效果。