Peer navigation for young people in tertiary paediatric health services: A rapid review

Importance: Peer-based interventions have been highlighted as a promising way of improving patient outcomes across diverse health services. While previous reviews have examined peer-based programs in specific health services (e.g., mental health, cancer) or with specific populations (e.g., people with HIV), no previous reviews have investigated peer-based programs with a dedicated peer provider role (e.g., peer navigator) for adolescents receiving care in tertiary health services.Objective: To describe characteristics of adolescent-focused peer-based programs in paediatric tertiary care or youth health services, and synthesise the available evidence on the feasibility, acceptability, effectiveness, barriers and facilitators of these programs.Methods: MEDLINE, Embase, and Web of Science were searched for empirical studies published between January 1st, 2015 to May 2nd, 2025. Eligible articles described programs with a dedicated peer role for adolescents under 26 years of age receiving care in a tertiary paediatric or youth health service. A narrative synthesis of the extracted data was conducted to group data into relevant themes.Findings: Fifteen studies with a total of 751 participants were included across 16 articles (8 qualitative, 3 quantitative non-randomised, 2 randomised controlled trials, and 3 mixed methods). One-third of studies (n=5; all qualitative designs) met all quality criteria. There was significant heterogeneity in the peer-based interventions in terms of health contexts (e.g., HIV, oncology, disability), format (one-on-one, group or hybrid), delivery (face-to-face, online, or pre-recorded video), and characteristics of peer roles (group facilitation, one-on-one sessions, referrals, appointment attendance, training, supervision and embeddedness within clinical teams). Most adolescents and service providers deemed interventions to be feasible and acceptable. Peer roles were seen as a key source of social support and role modelling which facilitated adolescents’ health-related learning, self-management and comfort in participating in health care or group interventions. Key barriers included technical issues (e.g., virtual delivery), non-cohesive group dynamics, poor understanding of peer navigator roles among clinicians, and irrelevant or non-tailored program content. Facilitators included comprehensive training and supervision for peer navigators and flexible, adolescent-centred program delivery and recruitment strategies. Quantitative evidence for the effectiveness of peer interventions was mixed; however, qualitative reports highlighted improvements in psychosocial wellbeing.Conclusions and Relevance: Peer-based programs with a dedicated peer role appear to feasible and acceptable to adolescents and service providers, although not without barriers to implementation. More high-quality research is necessary to clarify the effectiveness of these programs for adolescents receiving care in tertiary care or youth health services.