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Peer-led recovery groups for people with psychosis in South Africa (PRIZE): protocol for a randomized controlled feasibility trial

Asher, Laura; Rapiya, Bongwekazi; Repper, Julie; Reddy, Tarylee; Myers, Bronwyn; Hanlon, Charlotte; Petersen, Inge; Brooke-Sumner, Carrie

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Clinical Associate Professor

Bongwekazi Rapiya

Julie Repper

Tarylee Reddy

Bronwyn Myers

Charlotte Hanlon

Inge Petersen

Carrie Brooke-Sumner



The available care for people with psychosis in South Africa is inadequate to support personal recovery. Group peer support interventions are a promising approach to foster recovery, but little is known about the preferences of service users, or the practical application of this care model, in low and middle-income countries (LMIC). This study aims to assess the acceptability and feasibility of integrating peer-led recovery groups for people with psychosis and their caregivers in South Africa into existing systems of care, and to determine key parameters in preparation for a definitive trial.


The study is set in Nelson Mandela Bay Metropolitan district of the Eastern Cape Province, South Africa. The design is an individually randomised parallel group feasibility trial comparing recovery groups in addition to treatment as usual (TAU) with TAU alone in a 1:1 allocation ratio. We aim to recruit 100 isiXhosa-speaking people with psychosis and 100 linked caregivers. TAU comprises anti-psychotic medication-focused outpatient care. The intervention arm will comprise seven recovery groups, including service users and caregiver participants. Recovery groups will be delivered in two phases: a 2-month phase facilitated by an auxiliary social worker, then a 3-month peer led phase. We will use mixed methods to evaluate the process and outcomes of the study. Intervention acceptability and feasibility (primary outcomes) will be assessed at 5 months post-intervention start using qualitative data collected from service users, caregivers and auxiliary social workers, along with quantitative process indicators. Facilitator competence will be assessed with the GroupACT observational rating tool. Trial procedures will be assessed, including recruitment and retention rates, contamination, and validity of quantitative outcome measures. To explore potential effectiveness, quantitative outcome data (functioning, unmet needs, personal recovery, internalised stigma, health service use, medication adherence and caregiver burden) will be collected at baseline, 2 months and 5 months post-intervention start.


This study will contribute to the sparse evidence on the acceptability and feasibility of peer-led and recovery-oriented interventions for people with psychosis in LMIC when integrated into existing care systems. Results from this feasibility trial will inform preparations for a definitive trial and subsequent larger scale implementation.

Trial registration

Registered at Pan-African Clinical Trials Register on 28th February 2022. PACTR202202482587686.


Asher, L., Rapiya, B., Repper, J., Reddy, T., Myers, B., Hanlon, C., …Brooke-Sumner, C. (2023). Peer-led recovery groups for people with psychosis in South Africa (PRIZE): protocol for a randomized controlled feasibility trial. Pilot and Feasibility Studies, 9, Article 19

Journal Article Type Article
Acceptance Date Dec 16, 2022
Online Publication Date Feb 1, 2023
Publication Date 2023
Deposit Date Jan 9, 2023
Publicly Available Date Jan 20, 2023
Peer Reviewed Peer Reviewed
Volume 9
Article Number 19
Public URL
Publisher URL