By Residents, for Residents: Evaluating a Community-Led Peer Health Education Program in Australian Social Housing Communities.

Introduction: Socially disadvantaged and marginalised groups experience significant barriers to accessing healthcare compounded by the complexity and lack of integration between health services. Social housing residents face persisting health inequities linked to poverty, stigma and chronic conditions. International evidence suggests tailored, community-based initiatives can advance health and equity by building capacity, trust and engagement, notably through peer-based roles. However, there is little detailed literature on the mechanisms that support successful implementation and impacts across both community and health systems. Description: The paper describes the implementation and evaluation of a community-driven and co-designed peer-to-peer health education program in social housing communities in Australia. We use a mixed-methods, realist-informed methodology to assess the program's effectiveness and identify success factors at individual, program and organisational levels. Discussion: An important lesson is that a strength-based and community-led model is effective in areas of entrenched disadvantage and can have greater reach than other health promotion approaches. The program's flexibility, holistic remit, and focus on sharing power and trust-building were crucial for its success. Conclusion: Peer and community-based initiatives are becoming an increasingly important component of integrated care programs. Valuing the process as well as the outcomes and providing long-term timeframes and ongoing resources are critical to sustain change.