Peer delivery as an implementation strategy for evidence-based health and wellbeing interventions in acquired brain injury: a scoping review

People living with acquired brain injury (ABI), including stroke and traumatic brain injury, frequently experience ongoing challenges relating to wellbeing, social participation, identity, self-management, and adjustment following injury. Although a range of evidence-based and guideline-recommended health and wellbeing interventions have been developed to support rehabilitation and recovery, implementation into routine practice remains challenging and many individuals continue to experience unmet needs. Peer delivery has emerged as a potential implementation strategy for increasing access to evidence-based interventions. In this approach, individuals with lived experience of a condition contribute to the delivery of interventions for others with similar experiences. The use of peer facilitators may improve engagement, acceptability, relevance, reach, and sustainability of interventions while also creating meaningful opportunities for lived-experience involvement in healthcare services. However, despite increasing interest in peer-delivery approaches, limited understanding exists regarding how peer delivery has been applied within acquired brain injury populations, how peer facilitators are recruited and supported, and what implementation outcomes have been reported. The purpose of this scoping review is to map and synthesise the available evidence on peer delivery as an implementation strategy for delivering evidence-based health and wellbeing interventions to people with acquired brain injury. The review will focus on interventions delivered to people with non-degenerative acquired brain injuries, including stroke, traumatic brain injury, brain tumours, hypoxic brain injury, infectious causes of brain injury, and substance-related brain injury. Progressive neurodegenerative conditions such as Parkinson’s disease and dementia will be excluded. The review will examine the types of peer-delivery approaches that have been used, the evidence-based interventions delivered through peer facilitation, and the implementation processes used to introduce, integrate, and sustain peer-delivery approaches within rehabilitation and community-based services. Particular attention will be given to implementation science concepts, including implementation strategies, implementation frameworks, facilitator preparation and supervision, barriers and enablers to implementation, and implementation outcomes such as acceptability, appropriateness, feasibility, adoption, fidelity, reach, and sustainability. This review will be conducted using the Joanna Briggs Institute methodology for scoping reviews and reported in accordance with the PRISMA-ScR reporting guidelines. Published peer-reviewed literature will be identified through systematic searches of MEDLINE, Embase, PsycINFO, CINAHL, Scopus, and Web of Science. The expected outcomes of this project are: A comprehensive map of the existing literature relating to peer delivery in acquired brain injury. An overview of peer-delivery approaches and implementation strategies used across rehabilitation and community settings. Identification of implementation outcomes associated with peer-delivery approaches. Improved understanding of how peer facilitators are recruited, trained, supervised, and supported. Identification of barriers and enablers influencing successful implementation and sustainability. Identification of evidence gaps and priorities for future research and implementation. Evidence to inform the future development and implementation of peer-delivered health and wellbeing interventions for people with acquired brain injury, including stroke rehabilitation programs such as Take Charge After Stroke. The findings will contribute to implementation science knowledge and support the design of future peer-facilitated rehabilitation and wellbeing programs for people living with acquired brain injury.