Development and description of Peers Actively Involved in Rehabilitation (PAIR): A co-designed peer support program for people with acquired brain injury

Background. Acquired brain injury (ABI) is a leading cause of long term disability in adults. In Canada, while advances in acute care and inpatient rehabilitation have improved survival, many people living with ABI experience persistent challenges following discharge. This can include reduced self efficacy, mental health difficulties, and decreased participation in daily life. Community based supports remain fragmented and difficult to access. Peer support, or mentorship provided by people with lived experience of ABI, has shown promise in improving outcomes in neurological and chronic conditions. However, peer support interventions for ABI are rarely described in sufficient detail to enable replication or implementation.Objective. To describe the development, theoretical foundations, core components, and delivery of Peers Actively Involved in Rehabilitation (PAIR), a structured, community based peer support intervention for adults living with ABI.Methods. This paper provides a detailed description of PAIR using the Template for Intervention Description and Replication (TIDieR), informed by principles from the Guidance for Reporting Intervention Development studies (GUIDED). Data sources include co creation with people with lived experience and community partners, feasibility research, intervention manuals, and operational procedures.Discussion. PAIR integrates lived experience knowledge into rehabilitation through structured peer support worker training, individualized matching, and flexible delivery embedded within community organizations. By transparently documenting development and delivery, this paper supports replication, adaptation, and future evaluation, and contributes to strengthening person centred, community based rehabilitation for adults living with ABI.