Co-designing peer-to-peer support in oncology: A participatory study on the development of the PaRole OncO France model

OBJECTIVES: Accompanying Patients (APs) are individuals with lived experience of cancer who provide emotional, informational, and navigational support to patients. However, peer-to-peer support interventions in oncology remain inconsistently developed and rarely integrated into clinical practice in France. This study aims (1) to co-design a context-sensitive peer-to-peer support intervention for oncology units, (2) to identify institutional enablers and barriers to implementation, and (3) to develop tailored implementation pathways using implementation science frameworks. METHODS: A multi-site participatory study was conducted in nine oncology units across four French healthcare institutions. Eight patient partners were involved as co-researchers contributing to study design, facilitation of co-design workshops, and iterative model refinement. A structured co-design methodology guided four interactive workshops per unit. Data were collected through workshop materials, observation notes, and co-researcher reflections, and analyzed thematically using the Consolidated Framework for Implementation Research (CFIR) framework, and the resulting intervention was described using the Template for Intervention Description and Replication (TIDieR). RESULTS: Twenty workshops involving 60 stakeholders (APs, healthcare professionals and managers) resulted in the co-construction of a peer-to-peer support model aligned with local care structures. Three key outputs emerged: (1) a shared definition of the APs role, including expected psychosocial competencies and training needs; (2) identification of institutional enablers and barriers to implementation, such as leadership support, physical environment constraints, and role legitimacy; and (3) tailored implementation pathways, including onboarding, supervision, and integration into care processes. The resulting PaRole OncO France (PROOF) model was designed to be adaptable while preserving core components. CONCLUSION: This study demonstrates the feasibility and value of co-designing a peer-to-peer support intervention in oncology, grounded in lived experience and local context. PRACTICE IMPLICATIONS: The PROOF model offers a replicable framework for integrating APs into cancer care teams. Findings provide actionable guidance for institutions seeking to implement sustainable, patient-partnered peer-to-peer support programs.