Health and mental health systems are increasingly employing community health workers and peer support specialists to expand service reach and effectiveness, yet role definitions and competency standards vary widely. Little is known about how to train or prepare these professionals to collaborate with health care teams, engage peers and community members, and address complex health and mental health needs. Tobacco use remains a leading cause of illness and death in the United States and disproportionately impacts people with low incomes and people with mental health conditions, including substance use disorders. Support for Tobacco Recovery Training (STaRT) was developed to provide brief but comprehensive training to support engagement in evidence-based tobacco treatment. This study describes STaRT's development and evaluates knowledge, reach, and satisfaction among graduates during its first 2 years. We developed STaRT using a community-engaged process with peer specialists, behavioral health professionals, and academic partners. The final program includes 8 self-paced online modules emphasizing recovery-oriented language, communication strategies, evidence-based treatment, and resource navigation. We collected demographics and a knowledge assessment at baseline, and a post-knowledge assessment and evaluation upon training completion. We used descriptive statistics to summarize demographics and evaluation items and a choropleth map of trainees demonstrates reach. We evaluated change in knowledge using a paired samples t-test. From November 2023 through October 2025, 256 trainees graduated from STaRT. Trainees were primarily women (83%) and worked across diverse settings, including public health, mental health, community health, and social service settings. Mean knowledge scores increased from 83% to 97% (P < .01). Trainees represented 46/105 counties, with reach ranging from 1 to 43 graduates/100 000 population. Program satisfaction was high (mean 4.6/5). STaRT is a feasible, scalable, and peer-informed training model that improves knowledge and expands the tobacco recovery workforce. Findings suggest strong potential for implementation and adaptation beyond Kansas.

Purpose Using an on-campus hotel and a faculty club as a case study, this research examines how hotels can foster community through club formation. It explores the benefits and challenges of such initiatives, with a focus on enhancing member well-being, strengthening social interaction, and creating mutually beneficial partnerships between hotels and faculty members. Design/methodology/approach A qualitative approach was employed, involving in-depth interviews with seven junior professors and six hotel managers, including the general manager and key department heads. Data were analyzed thematically to identify key opportunities, challenges, and strategic recommendations for establishing and managing faculty clubs within hotel environments. Findings Findings indicate that junior faculty often experience limited peer support and community engagement, which can be alleviated through participation in faculty-based clubs. Hotel managers recognize the value of leveraging existing facilities to support these initiatives. Faculty members benefit from improved well-being, expanded professional networks, and a stronger sense of belonging, while hotels gain increased revenue and deeper community connections. Evidence also shows that hotels already function as informal social hubs through activities such as fan groups and cooking clubs. Practical implications Hotels may deploy underutilized spaces to host affinity-based groupings that epitomize community engagement and generate prospective revenue streams. By aligning the offering of amenities with local resident needs, operators can strengthen their positioning as community-centered hubs, reduce seasonal dependencies and engender loyalty amongst local customers. Originality/value This study contributes to hospitality literature by highlighting how hotels can support community building while expanding their role in well-being and market development.

ObjectiveAdolescents living with HIV (ALHIV) face barriers to accessing sexual and reproductive health (SRH) services, negatively affecting their health and quality of life. These challenges are particularly pronounced in sub-Saharan Africa (SSA), where HIV prevalence, unintended pregnancies and child marriage remain high. This review aimed to map interventions designed to improve SRH access for ALHIV in SSA, applying Levesque’s framework to identify facilitators and barriers from supply-side and demand-side perspectives.DesignReview followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR).Data sourcesPubMed, EMBASE and Web of Science were searched, alongside institutional grey literature, for English and French language studies published between 2010 and 2024.Eligibility criteriaStudies were included if they focused on ALHIV aged 10–19 years in SSA, regardless of HIV acquisition mode and used experimental, quasi-experimental, qualitative or observational designs.Data extraction and synthesisTwo independent reviewers screened studies in Covidence, extracted data on study design, population, intervention components and delivery settings and mapped barriers and facilitators using Levesque’s framework. Findings were synthesised narratively.Resultsof 6835 records screened, 14 studies met inclusion criteria. Interventions ranged from comprehensive strategies addressing financial, infrastructural and psychological barriers to targeted approaches like education and stigma reduction, implemented across schools, clinics, communities and digital platforms. Most studies emphasised service acceptability, with 13 of 14 highlighting cultural relevance, while approachability, physical accessibility and affordability received less attention. Key barriers included fear of HIV disclosure and stigma, whereas facilitators, including peer support, community outreach and digital platforms, enhanced engagement, trust and comfort with SRH services.ConclusionImproving access to SRH services for ALHIV in SSA requires adolescent-friendly, integrated, context-specific interventions that combine stigma reduction, peer and community engagement, digital innovations and financial support to overcome barriers and improve SRH outcomes.Registration detailsOpen Science Framework (https://doi.org/10.17605/OSF.IO/7PBEW).

The lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) community represents a high-risk group for lung cancer given higher smoking rates. We evaluated implementation of a pilot patient navigation intervention for smoking cessation services combined with lung cancer screening (LCS) care for eligible LGBTQ+ adults. We completed a concurrent mixed-methods evaluation of the intervention to enhance adaptation and future scale. Forty-one LGBTQ+-identifying individuals who were eligible for LCS and currently smoking were enrolled, completed baseline surveys, and underwent the intervention for a 90-day period. Thirty-four participants completed post-intervention surveys and 15 were invited for semi-structured interviews. We conducted a thematic analysis of qualitative data, integrated with quantitative and qualitative survey data through joint displays, guided by the Health Equity Implementation Framework. We identified fourteen themes in three topical domains. Key themes related to Intervention Success included: flexible communication; iterative contact through a longitudinal relationship; improved confidence and comfort; multimodal and tailored elements. Themes related specifically to LGBTQ+ Care included: LGBTQ+-specific social challenges; the impact of historic discrimination; emphasis on non-judgmental care; and varied responses to LGBTQ+-specific tailoring. Themes related to Future Adaptations included: more education and information on the LGBTQ+-tailored approach; synergy with trusted primary care clinicians; upfront information on financial risks; community connection and peer support; and variable need for more intense support. LGBTQ+-tailored patient navigation is an acceptable and well-suited intervention to facilitate and integrate LCS care and smoking cessation. Further adaptation should include more education and incorporate components of community support.

Promoting mental health and psychological well-being from early childhood is a growing priority in global education policy. Bullying has emerged as a major threat to children's well-being, and while most school-based interventions begin in late childhood or adolescence, research suggests that bullying-related behaviors and peer exclusion emerge as early as preschool. Yet, to date, no bullying prevention program has been rigorously evaluated from the beginning of schooling. This study aims to fill this gap by evaluating Vivre Ensemble-Fri for Mobberi (VE-FFM), a comprehensive, developmentally tailored bullying prevention and social-emotional learning (SEL) program implemented in French primary schools from preschool through elementary school. We will conduct a two-arm cluster-randomized controlled trial involving 210 French public schools and approximately 5250 children, recruited at age 3 and followed for 7years. Schools will be randomly allocated to either the intervention group (VE-FFM) or a wait-list control group continuing with teaching-as-usual. VE-FFM is a universal, whole-school program targeting students, professionals, and families. It focuses on building inclusive peer communities and strengthening children's social-emotional skills through structured group discussions, well-being activities, and SEL workshops. Primary outcomes include bullying and peer victimization. Secondary outcomes include psychological well-being, mental health difficulties, empathy, social skills, academic performance, teacher-child relationship quality, school belonging, subjective unsafety, perception of school kindness, and teacher job satisfaction. Data will be collected at six timepoints using teacher- and child-rated measures. Implementation fidelity will be monitored through teacher logs and recorded classroom sessions. This trial is the first to evaluate the long-term impact of a bullying prevention and SEL program beginning at preschool level. By embedding the intervention into the full span of early schooling, VE-FFM may produce stronger and more lasting effects than shorter-term interventions implemented at later stages. Results will inform educational and mental health policy by providing evidence on the effectiveness of early, community-based approaches to preventing bullying and promoting mental well-being. DRKS; DRKS00037553. Registered on 2025/09/11.

Peer Community In and Peer Community Journal: a two-step diamond OA process giving research communities back control of publishing

ABSTRACT In the early days of COVID-19, organizations experienced widespread lockdowns and cancellations of in-person activities as countries tried to mitigate the virus’ spread. Universities canceled classes and graduations, while human service agencies suspended in-person client contact and field supervision, which influenced the transition of Spring 2020 social work graduates into employment. This phenomenological study, based in the United States, explored how field supervisors and graduates in a midwestern and southeastern state responded to the disruptions and navigated the resulting uncertainty. Six supervisors from human service agencies and 13 graduates were interviewed. Thematic analysis showed that field supervisors’ desired qualities for future social work interns and new hires were evolving in the midst of disrupted service delivery. Graduates also shifted their early career expectations and developed a professional social work identity outside of formal employment by finding ways to connect social work values to community activities and peer relationships. We discuss implications for social work programs and practicums in supporting early career social workers through times of disruption and uncertainty by teaching new service delivery models and by nurturing supportive collegial relationships between new social workers.

Building a Career in a Hospice and Palliative Medicine Research: Advice for Early Investigators.

The coping strategies and needs of caregiving burnout among family caregivers of elderly stroke survivors.

Remote patient monitoring (RPM) and telehealth improve hypertension management but remain underutilized in resource-constrained settings. The Advancing Long-term Improvements in Hypertension Outcomes through a Team-based Care Approach (ALTA) intervention integrates RPM and virtual health coaching into routine care across a large urban FQHC network and has improved blood pressure outcomes. Explore contextual and mechanistic factors shaping ALTA's implementation outcomes from the perspective of intervention deliverers. Following 1 year of ALTA implementation, we conducted a realist-informed qualitative evaluation to examine factors influencing intervention uptake using semi-structured interviews and focus groups conducted from September to November 2023. Practice leadership, clinicians, and staff. Participants were recruited through convenience sampling. Transcripts were analyzed using a stepwise deductive and inductive coding approach. Deductive codes were drawn from Proctor's taxonomy of implementation outcomes. Themes were developed using context-mechanism-outcome (C-M-O) configurations. Analysis of 32 semi-structured interviews and four focus groups with a total of 46 intervention deliverers revealed five primary C-M-O-oriented themes: (1) Appropriateness, determined by perceptions of fit, drives acceptability. (2) Demanding workflows raise concerns around ALTA's additional burden, influencing perceptions of appropriateness. (3) Intervention challenges are mitigated by practice facilitation and team-based problem-solving, enhancing acceptability, feasibility, and fidelity. (4) Repeated exposure promotes workflow optimizations, fostering intervention penetration over time. (5) Staff desire insight into ALTA's impact, and communication about intervention progress increases motivation and buy-in. Five of Proctor's implementation outcomes emerged most prominently: appropriateness, acceptability, feasibility, fidelity, and penetration. Notably, these outcomes were interdependent, with one acting as an important contextual factor or mechanistic element for another. This evaluation highlights important contextual factors, mechanisms, and interconnected outcomes underlying implementation of ALTA. Shared understanding and peer learning, workflow optimization, and communication of outcomes with frontline staff improve reach, equity, and sustainability of RPM-enabled interventions for hypertension management in FQHCs. ClinicalTrials.gov NCT03713515, date of registration: October 19, 2018, https://classic. gov/ct2/show/NCT03713515.

Food insecurity (FI) is a pressing issue for adults with Severe Mental Illness (SMI), with evidence showing a higher prevalence in this group compared to the general population. However, routine screening for FI in adults with SMI within healthcare settings is currently lacking. Research has indicated that lack of access to adequate food may affect medication adherence and overall health outcomes in this population. This study explored how FI screening can be integrated into routine healthcare practices, co-produced with individuals with lived experience of SMI, in order to improve early identification, enhance acceptability, and support implementation within mental health services. A mixed-methods exploratory study was conducted between April and June 2025 within one NHS mental health Trust in North East England. Semi-structured interviews were undertaken with peer-support workers with lived experience of SMI (n = 4), and an anonymous online survey was completed by mental health professionals across disciplines (n = 40). Interview data were analysed thematically, and survey data were analysed using descriptive statistics and content analysis of open-text responses. Peer-support workers identified missed opportunities in healthcare where FI could have been addressed, and expressed preferences for flexible, non-stigmatising screening methods. Barriers included time constraints, stigma, and lack of training, while solutions focused on embedding screening within care planning and leveraging trusted relationships. Survey findings showed that most professionals acknowledged the importance of FI screening, especially during initial assessments and routine care. However, only 33% reported routinely screening for FI. Participants supported short, compassionate screening tools and highlighted the need for training, validated tools, and referral pathways. Findings highlight the urgent need to normalise FI screening as a routine aspect of mental healthcare. Both professionals and peer workers highlighted that FI impacts mental and physical health and recovery. Flexible tools and relationally delivered screening, especially by peer workers, nurses, and community teams, were seen as most acceptable.

Community engagement and empowerment to address health inequalities: A rapid evidence review.

Vascular liver diseases (VLDs) predominantly affect young adults and require lifelong monitoring. The health-related quality of life (HRQoL) of patients with VLDs is deteriorated, with high levels of fatigue and depressive symptoms, but their lived experience and unmet needs remain unknown. To fully integrate the patients' perspective and generate actionable insights, we conducted a qualitative peer-research study. Twelve peer researchers conducted interviews with patients in France, Spain, Switzerland, and the Netherlands. Analysis proceeded in three phases: individual inductive thematic analysis independently made by peer and academic researchers, followed by an international workshop to build a shared thematic framework. Third, directed content analysis, informed by the shared framework, was made by an academic researcher. From 27 interviews, five themes were identified, mapping the disease's impact on quality of life from diagnosis onward, and throughout the patient journey. First, the diagnosis trajectory was characterised by 'uncertainty and biographical disruption'. Then, long-term symptoms were described as impacting daily life through the experience of 'chronic uncertainty, loss of ability and social exclusion'. Participants' accounts also reflected the social impact of VLDs, which resulted in 'renegotiating roles, ties and identities'. All along the care journey, their healthcare experience could be marked by 'relational and institutional gaps shaping illness experience'. Finally, 'the sense of belonging to a community of peers' was highlighted as a potential but lacking resource. Living with a rare VLD involves uncertainty, unpredictable fatigue, stigma, and social disruption, alongside efforts to maintain dignity and autonomy. While patients can demonstrate resilience, this does not negate ongoing needs. Improving quality of life requires addressing not only symptoms such as fatigue, anxiety or sexual dysfunction but requires guidance on physical activity, nutrition or occupational and financial challenges. Ten patients and two caregivers were involved as peer researchers throughout the study, ensuring that priorities, interpretations, and conclusions reflected patient-defined concerns. All peer researchers contributed to the design, data collection and analysis activities. Due to professional and health constraints, about half of the PRs could only participate in the first local analysis phase. PRs were financially compensated.

This study examines how internal communication and perceived fairness are associated with the emergency decision-making competency (EDMC) of grassroots civil servants, a core capability in public performance and crisis governance. Integrating crisis sensemaking, high-reliability organizing, social information processing, and fairness heuristic theory, the study develops an individual-level framework in which leader–member communication effectiveness (LMCE) is linked to EDMC directly and indirectly through organizational peer communication support (OPCS), while organizational justice (OJ) conditions the strength of this relationship. Drawing on survey data from 1,966 grassroots civil servants across 136 counties in 16 prefecture-level cities in Shandong, China, the study finds that LMCE is positively associated with EDMC. OPCS accounts for a substantial share of this association, indicating that effective leader communication is linked to stronger emergency decision-making partly through a more supportive peer communication environment. OJ further strengthens the positive LMCE–EDMC relationship, and the association is more pronounced among non-leaders. By integrating communication quality, peer support, and perceptions of fairness into a single empirical model, this study extends public administration research on frontline crisis capability. It identifies concrete organizational levers to strengthen grassroots emergency governance in practice.

Background Gender-affirming surgery (GAS) is a vital component of transgender healthcare, yet post-surgical well-being is shaped by more than surgical outcomes alone. Empirical research on post-GAS healthcare experiences in India remains limited despite policy advancements supporting transgender rights. Objective To examine healthcare-related and social factors associated with post-surgical well-being among transgender women in Tamil Nadu, India. Methods A convergent mixed-methods design was employed with 200 community-recruited transgender women who had undergone at least one GAS procedure at least six months prior. Snowball sampling was conducted through community organizations and peer referral networks. Validated Likert-scale instruments (α = .80–.88) assessed healthcare accessibility, perceived quality of care, cultural sensitivity, and social support as predictors of post-surgical well-being. Seven semi-structured interviews were analyzed using reflexive thematic analysis. Results All four predictors were significantly associated with post-surgical well-being (all p < .01): social support (r = .66), cultural sensitivity (r = .64), perceived quality of care (r = .62), and healthcare accessibility (r = .50). The regression model explained 41% of variance (R 2 = .41), with social support (β = .28), perceived quality of care (β = .25), and cultural sensitivity (β = .22) as the strongest predictors. The identified qualitative themes were: bureaucratic vulnerability, linguistic invalidation, spatial exclusion, financial dependency, and chosen-family resilience. Conclusion Post-surgical well-being is shaped by the interplay of structural healthcare accessibility, gender-affirming clinical environments, and community-based support. This study provides contextually grounded evidence from South Asia and highlights the need for culturally competent, inclusive healthcare systems to support equitable recovery outcomes following GAS.

The global rise in aging populations has introduced challenges such as increased social isolation and weakened intergenerational relationships. Intergenerational programs (IGPs) offer some promising strategies to address these issues by encouraging interactions between the older and younger generations by fostering mutual learning, support, and understanding. This study evaluated the feasibility and impact of a community-based intergenerational program in rural Maharashtra, India, with a particular focus on improving the overall well-being of the elderly individuals. A mixed-methods approach was used to evaluate the implementation of community-driven IGP strategies in 18 villages via qualitative methods (in-depth interviews, focus group discussions, force field analysis, spider web analysis, and most significant change stories) and quantitative assessments (quality of Life, generativity, social capital and self-care assessment tools) across 3 years. Stratified random sampling was used to recruit 520 participants across two elderly age groups (60-70 years and > 70 years). The qualitative data revealed that IGPs improved intergenerational relationships, enhanced communication and appreciation for joint family structures. The key facilitators included community engagement, peer trainers, cultural events, and active involvement from local leaders. Barriers included conflicting agricultural responsibilities, health issues, and limited intergenerational interaction due to mobile use. In the 60-70 years age group, the quality of Life scores was 70.6 at baseline and 68.5 by year 3, the generativity scores was 32.3 at baseline and 28 by year 3, and the social capital scores was 48.3 at baseline to 48.4 by year 3. In the > 70 years age group, the quality of Life score ranged from 66.9 at baseline to 65.4 by year 3, and the generativity scores was 31.8 at baseline and 26.1 at year 3. The social capital score was 45.2 at baseline and 45.5 by year 3. The self-care score was 127 for the 60-70 years age group and 125 for the > 70 years age group at baseline, and 106 for the 60-70 years age group and 103 for the > 70-years age group by year 3. Child-caregiver interactions for the 60 to 70 year-old age group (8.61 at baseline and 9.13 by year 3) and for the > 70-year-old group (9.23 at baseline to 7.74 by year 3). Community based intergenerational project offer a promising approach to address social isolation and promote well-being in elderly individuals while also enhancing intergenerational connections and community resilience.

Gynaecological cancers and their treatment can alter sexual functioning, intimacy, and relationship dynamics, yet these concerns are frequently difficult to raise in clinical encounters and everyday support networks. This study examines how sexuality is articulated and collectively interpreted in online peer communities by analysing sex-related discussions in three Reddit forums focused on cervical, endometrial, and ovarian cancer. After web-scraping posts in RStudio, a reflexive thematic analysis was conducted to identify recurring patterns in how participants describe sexual concerns, seek guidance, and construct shared understandings of ‘normal’ sexual change in the context of illness. Four themes were developed: (1) sexual pain and distress; (2) body image and sexual selfhood; (3) seeking peer advice and lateral expertise; and (4) relational strain. Together, the findings identify Reddit as a venue for collective meaning-making about sexuality under illness conditions, highlighting how lay communities generate practical and interpretive resources that complement, and at times extend beyond, clinical framings of sexual recovery.

Perceived social status (PSS), a subjective measure of social position, has been associated with multiple health outcomes. Elevated levels of stress, depression, and anxiety are all prevalent among dental students, but the role of PSS among this population remains unknown. This study investigates relationships between PSS and mental health among dental students. In fall 2023, an online survey was distributed to all actively enrolled pre-doctoral dental students at the University of Iowa College of Dentistry and Dental Clinics (UICOD) (N=326). Questions included demographic characteristics, perceived stress, perceived anxiety, and PSS relative to peer community (UICOD) and society. Adjusted response rate was 25% (n=83). Mean societal PSS (range: 1-10) was 6.4 (SD: 1.3), and mean UICOD PSS (range: 1-10) was 6.0 (SD: 1.7). Both perceived stress (r = -0.32, p = 0.003) and perceived anxiety (r = -0.25, p = 0.020) demonstrated a significant linear relationship with UICOD PSS but not with societal PSS. In adjusted regression models, severe anxiety (b = 1.78, p < 0.011), high stress (b = -1.29, p = 0.044, and moderate stress (b = -0.85, p = 0.028) were significantly associated with lower UICOD PSS. Dental students perceive their social status as lower relative to peers than to society. Severe anxiety and moderate to severe stress are significantly correlated with PSS relative to dental student peers. These findings underscore the importance of understanding how PSS impacts mental health in highly competitive educational environments.

Transition from working life to retirement can challenge mental wellbeing due to loss of identity, meaning, daily structure, and social connections. This study aimed to gather expert perspectives to inform the design of Retirement Companion, a digital solution that supports mental health during the transition to retirement. An online survey was conducted with 16 experts from psychology, academia, healthcare, social work, and human resources. Qualitative analysis was used to identify key themes related to mental health challenges, design requirements, and adoption factors. Experts highlighted the core challenges such as loss of routines, self-worth, meaning, and social connections. Recommended features included the display of comprehensive information, tools for social connectedness, meaning-focused activities, personalized routines, peer communities, and tools for self-reflection. The findings provide actionable design guidance for creating evidence-based and supportive digital interventions for mental health support in the transition to retirement.

Purpose This paper aims to examine how peer communication can help foster motivation in self-managed groups. Design/methodology/approach To better understand this framework, the authors use two well-supported theories – Motivating Language Theory to provide a framework for understanding peer communication and Substitutes for Leadership Theory to explain the focus on coworkers. Findings Examining these two theories together has resulted in a practical, theory-based guide for how employees can use peer communication to improve workplace results in self-managed organizations. Research limitations/implications Peer Motivating Language (PML) extends motivating language to peer contexts. Empirical evidence remains limited, especially longitudinal research in self-managed teams. Future studies should examine boundary conditions, underlying mechanisms, and potential downsides, using multi-level and experimental designs to better understand PML’s long-term impact on motivation and performance. Practical implications Organizations with self-managed teams can strengthen motivation by intentionally fostering PML. This includes raising awareness of peer influence, embedding communication norms, integrating PML into onboarding and training, and reinforcing it through check-ins and reward systems. By formalizing peer communication expectations and aligning them with culture and incentives, organizations can sustain engagement and cohesion without relying on hierarchical supervision. Originality/value This framework shifts motivation from leader-centric to peer-driven dynamics, offering a structured, research-based explanation of how everyday coworker communication sustains motivation in self-managed organizations.