Peer-led Program Research Articles

What About Nights, Weekends, and Wait Times? Adding an On-Demand Facilitated Telemedicine Buprenorphine Component to a Community-Based Peer Support Outreach Program.

In 2020, loosened federal regulations allowed for buprenorphine for opioid use disorder to be initiated via telemedicine. In response to these regulatory changes and growing racial inequities in overdose in St. Louis, MO, a local, peer-led outreach program incorporated a new rapid access (RA) to buprenorphine program. RA facilitated same-day buprenorphine access by conducting peer-facilitated telemedicine visits in community settings. This study used logistic regression to compare 1- and 3-month treatment and buprenorphine retention between clients in the RA and Traditional (ie, linkage to brick-and-mortar prescribers within 1-3 days) programmatic arms of a peer-led outreach program between December 2020 and June 2022. Propensity score matching allowed participants across groups to be matched on key factors (eg, sex, race, homelessness). Racial differences in program receipt/enrollment were also assessed through Chi-squared tests. Total program participation (N = 4139) included 1% (n = 52) in the RA program. Those in RA were more likely to be in treatment at 1 and 3 months and more likely to be on buprenorphine at 3 months compared to those in the Traditional group. The RA program included more White and fewer Black clients than expected. Four of the 8 reasons for non-enrollment differed by race, with Black individuals more likely to already have treatment secured but also more likely to decline the program or be unable to be contacted. This study is the first to demonstrate sustained benefits in treatment and medication engagement following same-day access to buprenorphine via community-based, peer-facilitated telemedicine. Lower-than-expected enrollment of Black individuals indicates a need for more culturally responsive implementation strategies for peer- and telemedicine-facilitated programs.

Impact of a community-based peer-led eHealth wheelchair skills training program: A randomized control trial.

To measure the effect of a community-based peer-led eHealth manual wheelchair (MWC) skills training program on community participation, wheelchair skills capacity and performance, wheelchair-specific self-efficacy, and health-related quality of life. Randomized control trial with wait-list control group. Community. Community-dwelling MWC users 18 year of age or older who propel using both arms (N=50). The 4-week MWC skills training intervention was comprised of three virtual sessions with a peer trainer and a self-directed eHealth home training app delivered via a computer tablet. Peer trainers were experienced MWC users who had received structured training for intervention delivery. Participants were provided with required equipment and encouraged to involve a care provider during home training. Peer trainers tailored the program to life activities participants identified as relevant. The control group were placed on a 4-week no intervention waitlist (reflecting typical clinical practice) and after post-intervention data collection were offered the training program. The primary outcome was community participation measured by the Wheelchair Outcome Measure (WhOM). Secondary outcomes included skill capacity and performance on the Wheelchair Skills Test-Questionnaire (WST_Q), self-efficacy on the Wheelchair Use Confidence Scale (WUCS); and health-related quality of life on the Short-Form 36 Health Survey Enabled (SF-36E). The intention-to-treat (n=50) primary analysis revealed a statistically significant Time*Allocation interaction for community participation (mean p = 0.046 and ηp2 = 0.09), increasing by 24%. Per-protocol (n=42) secondary analyses indicated significant improvements of 16.1% in the skill capacity (p=0.004), 11.4% in self-efficacy (p=0.017), and 7% relative improvement in quality of life (p=0.012). The findings indicate that an eHealth MWC training program incorporating peer and tablet app training components was effective in improving community participation, skill capacity, self-efficacy, and quality of life for a wide range of MWC users. An eHealth delivery format offers considerable potential from both an access and resource perspective.

The Michigan men’s diabetes project: perspectives on a peer-led diabetes self-management and support intervention for Black men with type 2 diabetes

BackgroundBlack men are more likely to be diagnosed with type 2 diabetes (T2D) compared to non-Hispanic White men, especially those over 55 years of age. Although there is ample evidence around the efficacy of peer-led diabetes self-management and support (PLDSMS) programs in improving diabetes health outcomes, Black men living with T2D experience several barriers to meaningful participation in peer-led programs and program developers face barriers to implementation. This qualitative study aimed to identify perspectives from collaborators on barriers and facilitators that impact the implementation of a PLDSMS intervention for older Black men with T2D.MethodsQualitative data were collected as part of the Michigan Men’s Diabetes Project. We used the Tailored Implementation in Chronic Diseases (TICD) Checklist to construct the semi-structured interview guide. TICD domains served as themes. Codes were later generated as a team (N = 3) from chunks of related text. Eight 1-on-1 semi-structured interviews (two researchers, three peer leaders, one community collaborator, two certified diabetes care and education specialists) were conducted between April 13–22, 2022 via Zoom. We engaged in thematic content analysis and used the rigorous and accelerated data reduction (RADaR) technique and Rapid analysis.ResultsThemes included guideline factors; individual collaborator factors; patient factors; professional interactions; incentives and resources; capacity for organizational change; and use of technology. Guidelines for implementing a PLDSMS program for Black men with T2D are lacking. For effective implementation, collaborators need interpersonal and session facilitation skills, flexibility, and cultural awareness. Although Black men with T2D may initially be apprehensive about participating in a PLDSMS program due to lack of knowledge, masculine norms, and stigma, these programs offer a safe space, a sense of brotherhood, and transparency. Having a physician champion is key in supporting organizational changes needed to implement PLDSMS programs in health systems, particularly as PLDSMS is not currently a billable service.ConclusionsThe PLDSMS program is culturally relevant in engaging older Black men with T2D. In addition to building trust among participants, successful development and implementation of a peer support program requires flexibility and tailored communication strategies. Findings can be used to inform future iterations of PLDSMS programs.

Youth-Friendly HIV Prevention: Tailoring Interventions for Young Populations

Youth-friendly HIV prevention is a crucial component of global efforts to combat the HIV epidemic, particularly among adolescents and young adults, who represent a significant proportion of new HIV infections. Tailoring HIV prevention interventions to the unique needs of young people—who often face distinct challenges such as limited access to healthcare, stigma, and developmental factors—has shown promising results. These interventions include age-appropriate education, peer-led programs, digital tools, and family engagement, which have been shown to enhance knowledge, encourage safe practices, and increase HIV testing and treatment adherence. This review explores these tailored approaches, examining their effectiveness and the critical role they play in empowering young populations to reduce HIV transmission. Adolescents and young adults face numerous risk factors that heighten their vulnerability to HIV, including experimental behaviors, socio-economic disparities, and lack of comprehensive sexual health education. Youth-friendly HIV prevention strategies focus on addressing these risks through culturally relevant, accessible, and non-judgmental interventions. Programs that incorporate peer education, digital platforms, and family involvement foster an environment in which young people feel supported in seeking information, guidance, and health services. Research demonstrates that when HIV prevention services are adapted to the specific needs and preferences of young people, they are more likely to engage, adopt safer behaviors, and reduce the stigma associated with HIV. Keywords: Youth-friendly services, HIV prevention, adolescents, tailored interventions, risk reduction

Development and Evaluation of a Strengths-Focused Peer-Led Support Program for Young University Mothers

The increasing enrollment of student parents, particularly mothers, in higher education highlights the crucial need for timely support. Compared to their non-parent peers, student mothers are more likely to encounter financial, logistical, and social barriers. In this study, we evaluated the feasibility and effectiveness of a strengths-focused, peer-led support program for young university mothers (YUM). YUM adapted an evidence-based life skills program previously designed for adolescent mothers. Seventeen mothers ( Mage = 24.59; SDage = 4.65) participated in the 7-week YUM program, and 17 mothers ( Mage = 24.12; SDage = 3.10) were in the control group. Following the intervention, YUM participants demonstrated significant decreases in stress and depression, significant increases in career and academic exploration, and satisfaction with social support compared to the control group. YUM participants also reported an increased sense of campus connectedness over time, although the change was not significantly different between the two groups. In their parenting self-efficacy, the two groups demonstrated no significant differences in the change over time. The qualitative findings from exit interviews indicated high levels of satisfaction and engagement among all YUM participants, suggesting that the program was well received and feasible. YUM participants saw the group as an emotional safe haven and appreciated the peer-led structure. Despite facing multiple challenges as college-going mothers, they expressed a desire for continued skill application and ongoing support on college campuses. The study’s strengths, limitations, and implications for pedagogical and counseling practices as well as for future research are further discussed.

EE790 Cost-Effectiveness and Cost Utility Analysis of an eHealth Peer-Led Wheelchair Training Program Compared to the Existing Wheelchair Training Practice in Canadian Rehabilitation Centers: Economic Evaluation of a RCT

EE790 Cost-Effectiveness and Cost Utility Analysis of an eHealth Peer-Led Wheelchair Training Program Compared to the Existing Wheelchair Training Practice in Canadian Rehabilitation Centers: Economic Evaluation of a RCT

“Having Support at Work ‘Is Different’ and Important”: A Qualitative Study of Virtual Peer Discussion Groups With Medical School Faculty

Abstract Purpose In response to the need to support health care professionals during the COVID-19 pandemic, an innovative, peer-led discussion group program for medical school faculty, called CIRCLE (Colleague Involved in Reaching Colleagues through Listening and Empathy), was developed at Rutgers Health. This article describes results of a qualitative analysis of the participants’ experiences, explores virtual communication platform use during this peer support program, and identifies the program’s beneficial elements. Method CIRCLE was inaugurated in October 2020 at Rutgers New Jersey Medical School and Rutgers Robert Wood Johnson Medical School using evidence-informed topics. The inaugural CIRCLE peer-led discussion groups included 50 physicians who met twice monthly in groups of 5 to 8 between October 2020 and April 2021. Deidentified transcript data were iteratively reviewed using conventional content analysis, including familiarization, thematic framework creation, indexing, charting, mapping, and interpretation. Themes were grouped into 4 conceptual framework categories based on social support theory in the context of work-related stress: emotional, appraisal, informational, and instrumental support. Results Themes emerged based on the framework: emotional support (connecting on a deeper level, importance of support at work, COVID-19 made virtual connections needed), relevant appraisal support (feeling “not alone,” safe space to connect and share), informational support (sharing self-care strategies), and instrumental support (incentives to join are helpful but connection leads to engagement, some structure but “not too much” is important, virtual modalities are convenient and conducive to connection). Conclusions Benefits of peer discussion groups include deeper connections at work, reduced isolation, safe sharing, and exchange of information on self-care. Connection and balancing structure and autonomy were important to engagement. Virtual modalities were viewed as feasible, convenient, and conducive to connection. This article highlights the benefits and convenience of virtual peer-led discussion groups for medical school clinical faculty and provides evidence for content development of these programs.

Effectiveness of Peer-Led Education in Reducing HIV Transmission among Youths in Urban Areas: A Comprehensive Review

HIV transmission among urban youths remains a significant public health concern, driven by factors such as risky sexual behaviors, limited access to healthcare, and high social connectivity. Peer-led education has emerged as a promising intervention to reduce HIV transmission by utilizing the influence of social networks and delivering relatable, accessible information on HIV prevention. This review assessed the effectiveness of peer-led education programs in urban areas by examining their impact on HIV-related knowledge, behavior change, and HIV testing rates. Studies revealed that peer-led education significantly improves HIV knowledge, promotes condom use, and encourages HIV testing among urban youths, contributing to a reduction in high-risk behaviors. Additionally, the social and emotional benefits of peer-led education create supportive environments for discussing sexual health, reducing stigma, and fostering empowerment among participants. However, challenges such as variability in program quality, sociocultural barriers, and sustainability issues limit the long-term success of these interventions. To address these challenges, future strategies should focus on integrating digital health platforms, personalizing peer education, and employing rigorous program evaluation methods. The methodology for this review included a comprehensive analysis of existing literature, including randomized controlled trials, systematic reviews, and observational studies, to provide a holistic understanding of peer-led education’s effectiveness in reducing HIV transmission among urban youths. Keywords: Peer-led education, HIV prevention, Urban youths, Behavioral change, HIV transmission.

Using Alma to Alleviate Tristeza Maternal: Preliminary Outcomes of a Peer-Led Behavioral Activation Program Among Latina Mothers

Spanish-speaking Latinas in the United States encounter significant barriers when seeking culturally responsive treatment for perinatal mental health disorders, resulting in treatment disparities and elevated rates of mental health symptoms. To address these challenges, peer-delivered support may be one promising strategy. This study examined the efficacy of Alma, a peer-delivered behavioral activation (BA) program comprising 6-8 sessions.Participants (N = 126) were Spanish-speaking Latina mothers experiencing elevated depressionsymptoms during the perinatal and early parenthood period. Participants were recruited through three community partner sites across rural and urban settings.Participants reported high satisfactionwith the program and experienced decreases in depressionsymptoms, anxietysymptoms, and perceived stress. Importantly, significant clinical improvements occurred early in the program, indicating a rapid relief of symptoms. This symptom reduction was associated with improvements in putative mechanisms of BA including activity level and environmental reward. Limitations of this study include participant attrition and the absence of a control group. Together, the findings indicate that Alma is a promising program to address depressed mood, anxiety, and stress among Spanish-speaking Latina mothers during the perinatal/early parenthood period, offering accessible and culturally responsive mentalhealth support. Moreover, by meeting the mental health needs of Spanish-speaking Latina mothers, Alma holds promise for mitigating mental health disparities in underserved communities.

Acceptability, feasibility and preliminary efficacy of the Peer-led Hub-and-Spoke Community Aphasia Group program

ABSTRACT Background Several programs addressing the long-term impacts of aphasia after stroke show promise. However, barriers restrict their implementation at scale. Hub-and-spoke models of care operate in several health contexts to reduce the health care costs associated with health professionals providing all direct services, and to improve the reach of services to communities at distance from the main service. We developed the Peer-led Hub-and-Spoke Community Aphasia Group (Peer-led HS CAG) program to address staff and service availability barriers. The Peer-led HS CAG organises service through a “Hub” of allied and mental health professionals, led by a speech pathologist, who provide consultative and occasional direct services to the aphasia group. The “spokes” are volunteers with and without aphasia, trained and supported by the “Hub” staff to facilitate groups in the community. Aims We aimed to investigate the feasibility, acceptability, and preliminary efficacy of the Peer-led HS CAG program to address long-term impacts of aphasia. Methods & Procedures In a Phase I, proof of concept, mixed methods design we utilised: (1) a pre-post observational quantitative design; (2) an embedded qualitative study using semi-structured in-depth interviews of group facilitators and participants. Four health professionals from speech pathology, psychology, art therapy, and music therapy formed the Hub. Four volunteers were trained as group facilitators over two, half-day sessions prior to the group programs commencing. The 12-week group programme was delivered twice in a community setting, consisting of weekly 2-hour sessions. Seven people with aphasia attended: four in programme one, three in program two. The group program consisted of four compulsory topic sessions and eight “members choice” sessions. Seven close others attended four of the twelve program sessions: two with their family members with aphasia; two with specific “hub” staff input. During the remaining eight weeks of the program close others chose whether to meet independently. Outcome measures were taken at four time points: 6 weeks pre-program; immediately pre-program; immediately after-program; 6-week follow up. Outcomes & Results Four participants showed clinically meaningful gains in communication-related quality of life and three in functional communication immediately post-program or at 6-week follow up. Qualitative interviews confirmed the feasibility and overall acceptability of the program. Close others requested additional sessions specific to their needs. Conclusions The Peer-led HS CAG program is a feasible and acceptable way to address the current lack of community aphasia groups. Future phase II and III research should explore the efficacy and costs of this model.

The effectiveness of secondary-school based interventions on the future physical activity of adolescents in Aotearoa New Zealand: a modelling study.

Secondary schools are important settings for promoting varied physical activity (PA) opportunities for adolescents to promote PA throughout life. However, research on the effect of secondary school-based interventions on future PA is limited. This study examined the potential impact of secondary school-based interventions on the determinants of future PA participation of Aotearoa New Zealand (NZ) adolescents using simulated modelling. We used data from a nationally representative sample of secondary school students (n = 5035) aged 12-17 between 2017 and 2020 in NZ. We modelled four secondary school-based interventions and their projected impact on five determinants of future PA. Modelled interventions were the technological augmentation of physical education (TAPE), a peer-led PA mentoring programme (PL), physically active learning (PAL) and the inclusion of a natural environment play area (NE). Total weekly PA increased the most from the NE intervention (+ 0.2h/week), followed by TAPE (+ 0.08h/week), PAL (+ 0.05h/week) and PL (-0.06h/week). Current number of PA settings increased the most in NE (+ 1.75 settings/week), followed by TAPE (+ 1.29 settings/week), PAL (+ 1.21 settings/week) and PL (+ 0.73 settings/week). Current number of PA types increased the most in NE (+ 1.57 types/week), followed by PL (+ 1.05 types/week), TAPE (+ 0.34 types/week) and PAL (+ 0.15 types/week). Physical literacy scores increased the most from PL (+ 3.6%), followed by PAL (+ 3.3%), TAPE (+ 0.43%) and NE (+ 0.12%). Social support scores increased the most from PAL (+ 5%), followed by PL (+ 1.9%), TAPE (+ 1.46%) and NE (+ 0.57%). On average, all interventions benefitted determinants of future PA participation to a small degree. Results show differing magnitudes of the intervention effect by determinant, indicating the complexities surrounding the promotion of PA adherence. Future interventions could be improved through detailed consultation alongside, and involving, adolescents and stakeholders within schools. Researchers should also prioritise the collection of longitudinal PA data and explore its connection with sociodemographic differences between adolescents.

Peer-led intervention for individuals with major depression: study protocol for a randomized controlled trial (SUPEERMood)

BackgroundMajor Depressive Disorder (MDD) is one of the most disabling mental health problems worldwide. The Recovery Model emphasizes peer support to empower individuals with MDD, improve self-management, and patients' quality of life. Despite the demonstrated efficacy of peer-led interventions, further research is needed due to methodological limitations and variability in interventions across studies. Therefore, the objective of this trial is to evaluate the effectiveness of an adjuvant peer-led intervention for the reduction of depressive symptoms in individuals diagnosed with MDD attended in primary care mental health units.MethodsA controlled, parallel, randomized clinical trial will be conducted. The intervention group (n = 35) will receive 6 weeks of peer-led sessions based on a peer support program drive whilst supervised by nurses, while the control group (n = 35) will use a mobile Health (mHealth) application for emotional wellness based on CBT for 6 weeks. Measurements will be collected at baseline, at 6 weeks, at 6 and 12 months after the intervention to evaluate post-intervention effects. The primary outcome is the reduction of depressive symptoms through the Beck Depression Inventory (BDI-II) after the intervention. Secondary outcomes will involve measures such as adherence to psychiatric treatment, quality of life, adherence to mediterranean diet, alcohol consumption and physical activity.DiscussionWe hypothesize that this peer-led intervention, in contrast to the mHealth, will show improvement in BDI-II score reduction of 6 points after six weeks, 6 and 12 months. Standardized peer-led programs can benefit patients and professionals in terms of efficacy and feasibility of clinical treatment of depression, healthy habits, self-care and quality of life. In addition, they can provide recovery and relapse reduction, improved psychosocial support, minimization of intensive care use, and support for patient autonomy through self-management.Trial registrationThe trial protocol is prospectively registered with ClinicalTrials.gov under protocol registration number NCT06398561. Date of registration: May 01, 2024. Recruitment is ongoing.

Youth-led community street sport in practice: balancing programme intentions and peer leadership

ABSTRACT Peer-led sport programmes can provide supportive social relations and opportunities for role modelling and identification. These features can support the inclusion of groups who usually do not participate in sport activities and provide an environment that fosters personal and social development. However, it is important to assess the implementation of peer-led activities to understand whether such potentials are fulfilled. Therefore, we investigated the quality of delivery of peer-led street sport activities implemented by the street sport organisation GAME. The study combined quantitative and qualitative observations. Peer leader practices were assessed quantitatively with 40 observation items scored on a Likert scale. In addition, qualitative observations could be noted on the observation form. We conducted 49 observations at 15 different peer-led street sport activities delivered in low-resource neighbourhoods. We compared peer leader practices with the intentions of the programme as described in the programme logic model and explored influences on delivery in the physical and social setting. Quantitative data showed that pedagogical competencies (‘role modelling’, ‘body language’ and ‘conflict management’) scored highest for quality of delivery. Sport instruction elements, particularly the categories ‘technique’ and ‘instruction’, scored lower. The qualitative analysis suggested that programme features and structure as well as the (mostly outdoor) community setting influenced the possibility of peer leaders for implementing the programme as intended. Peer leaders were often observed to function as role models, mostly in a prosocial manner, although role modelling was also observed to not support programme intentions. The study provided insight into some of the challenges in and potentials inherent to peer-led sport activities in the setting of low-resource neighbourhoods where youth peer leaders are responsible for implementation.

American Legion Participation Among Incarcerated Veterans

ABSTRACT In the social sciences, belongingness is among the individual core social needs. Institutionalization is a powerful mediator in the individual search for belongingness, as it establishes agency among group members. Using a conceptual framework that borrows from theories of institutionalization and group membership, we examine the lives of incarcerated military veterans and their choices in group affiliation during incarceration, especially in the context of American Legion posts behind bars. We use interview data from 43 incarcerated veterans to interpret patterns of belongingness, group trust, and group affiliation as developed within and across institutions. Five themes related to American Legion involvement emerged: (1) brotherhood and camaraderie; (2) serving others and the community; (3) creating a routine and improving quality of life; (4) creating community; and (5) leadership and conflict. Research on belongingness, group membership, and participation in peer-led prison programs is critical for improving knowledge on prison adaptation. It also provides a foundation for innovative approaches to post-release integration and desistance from crime among justice-involved veterans.

Effectiveness of Harm Reduction Interventions in Chemsex: A Systematic Review.

A systematic review of the scientific literature related to harm and risk reduction strategies and the effectiveness of chemsex interventions. Between January 2024 and May 2024, the articles were retrieved from the electronic databases Pubmed, Web of Science, Scopus, PsycInfo, Cochrane, Dialnet, CUIDEN, and SciELO. The review protocol was registered in the PROSPERO database (registration number CRD42024508953). The inclusion criteria were as follows: (I) original studies published in peer-reviewed journals, (II) studies exploring harm reduction interventions for chemsex, and (III) studies reflecting the efficacy of harm reduction interventions for chemsex. Two reviewers independently selected articles by title, abstract, and full paper review and extracted data. Two authors described the selected studies and assessed their methodological quality. The systematic review comprised six scientific papers that met the selection criteria and were obtained from five countries. Although a limited number of studies were included, it was observed that they presented a medium-high methodological quality. Programs evaluated interventions to reduce harm from chemsex, such as a web-based intervention that improved self-efficacy to refuse risky behaviors and accept HIV testing. The studies suggested that peer-led programs can be effective, especially with facilitators who have experienced chemsex dependence. Harm reduction strategies in chemsex are effective and should be promoted by health professionals. Interventions should be accessible, personalized, and non-judgmental to provide appropriate care and support, ensuring a comprehensive and effective public health response.

Comparison of bone health among pre-menopausal and post-menopausal females in rural Eastern India: A pilot study.

The aim of this study was to identify the at-risk female population (pre- and post-menopausal), identify the risk factors for low bone mineral density (BMD) and assess the knowledge of the subjects regarding osteoporosis by Osteoporosis Knowledge Assessment Tool (OKAT) in both the groups and to determine areas for early intervention in a predominantly rural and tribal area of Eastern India. This was a cross-sectional hospital-based study conducted in a predominant tribal and rural area of Eastern India. Females who were pre- and post-menopausal without a prior diagnosis of osteoporosis were included in the study. Factors affecting osteoporosis and quantified knowledge regarding the disease. A total of 388 females were included in the study (pre-menopausal = 190 and post-menopausal = 198). Although no significant difference was noted in the age at menarche between both the groups, a gradual significant shift in the age at menarche was noted in the younger females (p = .031). The mean OKAT score in the pre-menopausal and post-menopausal group was 9.5 ± 3.4 and 9.2 ± 3.5, respectively. 80% of females in the pre-menopausal group had normal T-scores whereas only 25% of the females in the post-menopausal group had normal T-scores. Targeted educational programs which influence the preventive health behaviour in general and osteoporosis knowledge in particular would bridge this gap. Peer-led community intervention programs which focus on behaviour change with respect to lifestyle and diet modification in the younger population should be the step ahead to reduce the prevalence of the disease.

Effect of a peer-led prevention program (P2P) on smoking in vocational high school students: Results from a two-school-year cluster-randomized trial.

The aim of this work was to measure the impact of P2P (i.e. peer-to-peer), a peer-led smoking prevention intervention, on daily smoking prevalence of adolescents over 2 school years. A cluster-randomized controlled trial was performed over a 16-month follow-up (trial status: closed to follow-up). P2P was implemented 1-3 and 13-15 months after baseline. Assessments took place at baseline and 4, 10 and 16 months after baseline. The research team, assessors and adolescents were blinded to the study-arm assignment only at baseline. Fifteen vocational high schools in France were randomized into two clusters, using a 1:1 allocation ratio per French department (n intervention = 7, n control = 8). Participants comprised a sample of 2010 students in year 11 (i.e. 15-16 years) in vocational high schools. A total of 437 students could not be assessed at baseline (absent or left school), yielding a total sample of 1573 students (n intervention = 749, n control = 824). The P2P programme trained voluntary students to become peer educators and design smoking prevention actions for their schoolmates in the intervention group (n = 945 students), compared with a passive control group (n = 1065 students). The primary outcome was change from baseline in the prevalence of self-reported daily smoking (i.e. at least one cigarette per day) at 16 months. The 'time × group' interaction indicated that, compared with the control group, the intervention group had statistically significantly fewer daily smokers after 16 months [odds ratio (OR) = 0.33, 95% confidence interval (CI) = 0.20, 0.53]. Similarly, compared with the control group, the intervention group had statistically significantly fewer daily smokers after 4months (OR = 0.50, 95% CI = 0.30, 0.82) and 10months (OR = 0.60, 95% CI = 0.37, 0.98). No adverse events of P2P2 were reported. A cluster-randomized trial found evidence that the peer-led P2P (peer-to-peer) smoking prevention intervention reduced the uptake of daily smoking among high school students in France over 16 months.

The Michigan Men's Diabetes Project Randomized Clinical Control Trial: A Pilot/Feasibility Study of a Peer-Led Diabetes Self-Management and Support Intervention for Black Men With Type 2 Diabetes.

Black men are disproportionately affected by type 2 diabetes (T2D) and experience higher diabetes-related complications than non-Hispanic White men. To address the complex barriers in diabetes self-management for Black men, we implemented a 3-month peer-led and empowerment-based Diabetes Self-Management Education (DSME) and Support (DSMS) intervention in Metro Detroit. Twenty-five Black men ≥55 years of age with self-reported T2D were randomized to the intervention group (n=12)-10 hr of DSME and 9 hr of DSMS-or enhanced usual care (EUC) group (n=13)-10 hr of DSME. Peer leaders (n = 3) were trained by certified diabetes care and education specialists (CDCESs) to cofacilitate the support sessions. Outcomes (hemoglobin A1c [HbA1c], diabetes self-care activities, and diabetes distress) were assessed preintervention and postintervention. In the intervention and EUC groups, mean HbA1c decreased by 0.20% (p = .52, SD = 0.99) and 0.13% (p = .68), respectively. General diet (p = .03, M change: 1.32, SD = 1.71) and blood glucose monitoring (p < .05, M change: 0.50, SD = 0.74) scores improved among those in the intervention group. General diet scores also improved in the EUC group: mean change: 1.77, p = .08, although changes were not statistically significant. Changes in diabetes distress scores differed based on the number of sessions attended, with a significant decrease in those attending 7 to 12 sessions (n = 7), >50%, (p = .003, M change: -5.71, SD = 3.20). Implementing a peer-led DSMS program for Black men was feasible, adopted, and led to positive changes in outcomes. Scaling up the intervention and assessing sustainability is warranted.

Implementation and sustainability of student peer-led physical activity programs in a school community

PurposeThis study sets out to investigate the elements of the collaborative culture required for the successful implementation and sustainability of programs in schools. It draws on a case study of a student peer-led physical activity (PA) program implemented within the complex and dynamic environment of school communities in New Zealand. The article outlines four key components needed to effectively implement and impact long term sustainability of a program within the school context.Design/methodology/approachThis qualitative case study examines the implementation of a new peer-led PA program introduced across eight New Zealand schools. Data were collected from semi-structured interviews with senior leaders, teachers and parents and analyzed through a complexity theory lens.FindingsEffective and sustainable program implementation requires a strategic, collaborative approach through actively engaging with and resourcing four key interacting components: student choice, voice and agency; collective responsibility; shared understanding of purpose; and curriculum coherence.Originality/valueThis research offers a pragmatic approach to developing collaborative school communities that can effectively implement change by highlighting key areas of focus that policymaker, school leaders and program designers can plan for.

Hungarian adaptation of the Honest Open Proud program

IntroductionThe Honest, Open, Proud (HOP) program is an effective peer-led group program to support people with mental health problems in their disclosure to manage self and public stigma. The HOP program will be integrated into the National Anti-stigma Program in Hungary, which was initiated in 2020.ObjectivesOur goal was to develop the Hungarian version of the HOP program. We conducted the following measures to achieve our aim.MethodsThe adaptation process was conducted using community-based participatory research (CBPR) between September 2022 and January 2023. Over ten sessions, a group of eight individuals, consisting of both males and females with varying mental health conditions (mean age = 39.6 ± 8.5), participated in the online-led CBPR. The adaptation process was systematically documented, and regular supervision was provided.ResultsThe program comprises three lessons and a follow-up section. We have translated the text of the manual and workbook into Hungarian and adjusted the tone, language, locations, and examples as per the Hungarian context. Although our adaptation process did not involve changes to the content and implementation strategies, we will perform structural modifications and adjustments to ensure the content is suitable for the predefined number of sessions and Hungarian participants.ConclusionsThe HOP could be feasibly implemented in the National Anti-stigma Program in Hungary; both online and in-person programs are planned. Given the lack of such a program in Hungary, it will likely be warmly welcomed and strongly supported for the benefit of people with mental health problems.Disclosure of InterestD. Őri Grant / Research support from: Fulbright Association supported research, P. Corrigan: None Declared