Background
Peer support refers to support provided by individuals with lived experience of a disease to those facing similar challenges, encompassing emotional, informational, and experiential dimensions. Despite growing recognition of its added value, peer support remains insufficiently integrated into oncology units, leaving several patient with needs unmet across the cancer care trajectory. The PAROLE-Onco programme, developed in Québec, introduced trained accompanied patients (APs) into oncology teams as complementary actors within patient-centred care. PaRole OncO France (PROOF) aims to transfer this evidence-based intervention into the French context through a co-designed, implementation-oriented approach that embeds experiential expertise into routine oncology services.
Objectives
The primary objective was to adapt, implement, and evaluate a structured peer support intervention in French oncology settings. Specifically, the programme aims to:
(1) Transfer the original PAROLE Onco model to the French health system through participatory co-design;
(2) Assess early implementation processes and outcomes;
(3) Explore the perceived effects and added value of peer support for patients, APs, and care teams.
Methods
The PROOF research is grounded in implementation science and participatory action research (PAR) principles. It is conducted in 2 phases:
Phase 1 (co-design, 2024–2025) involved patients, APs, clinicians, researchers, and hospital managers in participatory workshops to tailor APs role definitions, referral pathways and supervision processes.
Phase 2 (prospective implementation and evaluation study, 2025–2027) uses a convergent mixed-methods design to assess the implementation of peer support across ten oncology units. Implementation outcomes (acceptability, feasibility, appropriateness, fidelity) and contextual determinants are examined using the Consolidated Framework for Implementation Research (CFIR). Data include quantitative indicators (APs trained, number and modalities of encounters, patient profiles) and qualitative interviews with patients, APs, and healthcare professionals. Rapid-cycle evaluation is conducted to support iterative adaptations and strengthen implementation in real time.
Results
Twenty-four workshops involving 69 stakeholders resulted in the co-design 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.
Early implementation has now begun across the four participating oncology units. Seventeen APs have been trained and integrated into routine activities, and 92 patients have been referred and included to date. Initial deployment shows strong engagement from clinical teams and successful integration of peer support into care pathways.
Conclusion 
PROOF illustrates how participatory research and implementation science can translate an evidence-based peer support intervention into public health action within oncology services. Early results demonstrate feasibility, acceptability, and added value for patient support and service organisation. By embedding experiential knowledge within care pathways, the programme contributes to more democratic, patient-engaged, and responsive health systems.