The Peer Effect Is "Utterly Profound": A Social-ABI-lity Pilot Study of a Multicomponent, Peer-Moderated Social Media Skills Intervention for People With Acquired Brain Injury.

Purpose: People who have an acquired brain injury (ABI) experience challenges in using social media. However, rehabilitation clinicians report feeling inadequately prepared to support them in its use. We aimed to evaluate the outcomes of a multicomponent, peer-moderated social media skills intervention for people with ABI.

Method: This study utilized a mixed-methods, pre-post intervention design. Two people with ABI were invited to be research co-investigators and participated as peer moderators. A total of seven adults with an ABI were recruited to participate in the intervention and completed a short self-guided course about social media skills (social-ABI-lity course) and then took part in a private, peer-moderated Facebook group over an 8-week period (social-ABI-lity Facebook group). Data were analyzed with mixed methods, collected via observation of group activity, weekly surveys, social media use and quality of life questionnaires (pre-intervention, postintervention, and after 3 months), and postintervention interview.

Results: Small improvements in social media skills were observed, although no significant changes were noted on quantitative measures for quality of life or confidence and enjoyment of Facebook use. Following a thematic analysis of interview data and incorporating reflections from peer moderators, we generated eight themes: loss, isolation, return, confidence, choice, identity, connection to community, and the "peer" effect. The intervention was identified as being feasible, acceptable, and engaging for all, with the role of the peer moderators perceived as being highly relevant and relatable by the participants. The peer moderators reported a positive influence on their confidence and sense of self-identity following the intervention.

Conclusions: The intervention was feasible and acceptable, with peer moderators also benefitting from their involvement. Future research is warranted to determine the fidelity and efficacy of this intervention on a larger scale and to develop clinical resources to support goal setting and individualized approaches to support people with ABI to use social media safely and meaningfully.