Accelerating Best Practices in Peer Support Around the World

Program Development Guide

Starting a Peer Support Program

Chapter Navigation

1. Starting a Peer Support Program

2. Developing Peer Support Protocols

3. Collaborating with Existing Peer Support Programs in the Community


Starting a Peer Support Program

Starting a peer support program involves thinking about the kinds of support that people need, and how your programs can address those needs. Doing so requires attention to the needs and strengths of your organization, the target population you aim to serve, the peer supporters and what they need to provide support, and ideas about what peer support would look like in your setting. The following two sections provide an overview of the essential phases in developing and managing a peer support program, as well as information about adapting a peer support program from a previously successful one.

Program Development and Management

As illustrated in Figure 2 below, starting or strengthening a peer support program often goes through four phases, including:

  1. Community and Organizational Readiness – such as assessing needs, obtaining stakeholders’ buy-in, and securing resources.
  2. Program Developmentplanning peer support interventions, developing protocols, and recruiting and training peer supporters.
  3. Program Implementation – reaching and engaging program participants, and monitoring and supporting peer supporters.
  4. Evaluationdocumenting the process, and identifying indicators and tools to evaluate outcomes/impact.

All phases are critical to Program Sustainability. However, attention should also be paid to behavioral, programmatic and policy-related aspects order to better sustain a program. This guide is organized in the way that walks you through these phases and provides examples and resources to help you start or enhance a peer support program.


Figure 2. Four phases of program development and management

Figure 2. Four phases of program development and management


For specific guidance for developing a peer support program addressing a particular disease or condition, please refer to the example manuals in Resource section.


Peers for Progress Evaluation Grantee Project Summary Tables: Intervention Design Tables summarize how each Peers for Progress grantee project has designed their peer support interventions for diabetes.
The Peer Support Resource Manual by British Columbia Ministry of Health Service This manual describes formal and informal structures of peer support programs for adults with mental illnesses.
The Chronic Illness Alliance Peer Support Network’s Best Practice Framework This online manual covers major aspects of developing and managing a volunteer-based, chronic illness peer support program.
The Peer Mentoring Program Manual by the Mt. Sinai School of Medicine This manual provides comprehensive guidelines on how to start up a peer support program for individuals with brain injury and their families.
Building an Effective Peer Support Program by CIL-NET a program of the IL-NET national training and technical assistance project This online manual provides centers of independent living with practical tools and strategies on how to develop a peer support program.
Peer Specialist Toolkit: Implementing Peer Support Services in the VHA Developed by two Mental Illness Research, Education, and Clinical centers (MIRECC), this toolkit provides guidelines on how to implement peer support for mental health services in the Veterans Health Administration.
Live Learn and Share – A Diabetes Peer Support Group Guide for the Black Caribbean Community This guide provides step-by-step guidance and resources for people living with diabetes on how to start a diabetes peer support group.
Peer Support for HIV Treatment Adherence by the Harlem Adherence to Treatment Study This manual for program managers and supervisors provides resources for developing a peer support program on HIV care and treatment adherence.
Rural Assistance Center’s Community Health Worker Toolkit This toolkit is designed to help evaluate opportunities for developing a CHW program and provide resources and best practices developed by successful CHW programs.
Building a Foundation for Recovery: A Community Education Guide on Establishing Medicaid-Funded Peer Support Services and a Trained Peer Workforce This SAMHSA publication is a resource kit for implementing federally funded peer support services that help drive recovery and system transformation.
Cancer Support Groups: A Guide to Setting Up Peer Facilitated Supports Developed by Cancer Council Australia, this guide provides resources for setting up a peer facilitated support group for people affected by cancer.
Cancer Support Groups: A Guide to Setting Up And Maintaining A Group Developed by Health Issues Center for Cancer Australia, this guide is specifically designed for community members who are interested in leading face-to-face cancer support groups, leaders of existing groups, and health professionals.


Adapting Peer Support

It is common for program managers to initiate a peer support program by adapting an existing program that has demonstrated success. Adaptation is the modification of an evidence-based intervention without competing with, contradicting, or removing its core elements or internal logic (Winwood et al., 2008). An adapted peer support program will have a higher likelihood of success when it maintains fidelity to established peer support frameworks (i.e. four key functions) while modifying program components to fit the target population, increase cultural competency, address the needs of the community, and allow integration with the local health system.

In general, various adaptation guidelines share the following steps (see Figure 3):

  1. Assess the needs of target population and settings
  2. Determine core areas that need adaptation and ways to address them
  3. Pretest your strategies, products and/or interventions
  4. Modify or revise your strategies, products and/or interventions based on the feedback from pretesting
  5. Proceed with full implementation and then evaluation

When adapting an existing program, the key is to continually modify or revise your approaches based on the needs and characteristics of your program participants and settings. In fact, Continuous Quality Improvement (CQI) is applicable to all peer support programs regardless they are starting from the ground up, or adapting an existing model.


Figure 3. Framework for Adaptation

Figure 3. Framework for Adaptation


What are Key Points to Developing a Successful Peer Support Program?

There’s no single ingredient that is required or guarantees success, but these components often comprise successful peer support programs.

  • Maintain frequent contact (long-term and ongoing support).
  • Develop and maintain linkages with health systems and primary care providers.
  • Encourage regular care, healthy eating, physical activity and medicine adherence; share experiences and advice for those activities; and assist in completing those activities.
  • Provide support in coping with day-to-day stressors.
  • Assist in developing problem-solving, decision-making, and coping skills.
  • Take into account the individual, social and cultural characteristics of the patient.
  • Consider individual rights, privacy, and the limits on the role of the peer supporter.
  • Encourage peer supporters to contact health care providers if they are unable to answer specific questions or provide assistance to patients. Peer supporters must acknowledge the boundaries of the care that they can provide and should refrain from giving medical advice or diagnoses.

Through research and global networking, Peers for Progress has identified a few success factors for designing and managing a peer support program:

  • Keep it simple – Remember that peer support is meant to be from “people like me”
  • Avoid too many details of training – Remember, key is knowing, listening, and being available
  • Ongoing support and information for peer supporters are key


The National Cancer Institute’s RTIPs’ Guidelines for Choosing and Adapting Programs Provides guidelines and checklist for program adaptation
The National Cancer Institute’s Using What Works Train-the-trainer course on adapting evidence-based programs to fit your needs
Capacity for Health website Website containing a list of resources to help adapt evidence-based interventions and public health strategies, including CDC’s ADAPT-ITT Model.


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