What influences the delivery of contact-based education interventions for mental health stigma reduction? Qualitative insights from the ground

Objective: This study offers a first-hand qualitative examination of how on-the-ground delivery processes shape the effectiveness of contact-based education interventions for reducing mental health stigma. We aimed to identify the delivery features, facilitators, and barriers influencing implementation and engagement, addressing a gap in stigma research that has largely prioritised outcomes over delivery processes.Method: We explored the perspectives of 18 intervention delivery staff using semi-structured focus groups. Data were analysed using reflexive thematic analysis to examine experiential accounts of delivery alongside broader contextual and structural influences on implementation.Results: Participants identified lived experience storytelling, peer-led delivery, relatable framing, and strategic pacing as central to effective delivery. Facilitators included supportive physical and temporal conditions, strong stakeholder alignment, optimal audience dynamics, and delivery team cohesion. Barriers included environmental and logistical disruptions, insufficient contextual audience information, stakeholder disengagement, systemic inequities, and team fatigue. Importantly, delivery tone, energy, authenticity, and relational engagement were viewed as equally, if not more, important than content in promoting meaningful engagement and stigma reduction.Discussion: Findings highlight delivery as a central mechanism of impact and inform the development of responsive, context-sensitive initiatives that are evidence-based in both content and delivery, grounded in lived experience, and adaptable to real-world settings.