How participation in health promotion affects peer-experts and experts-by-experience from vulnerable neighborhoods: a...

Residents of vulnerable neighborhoods often experience economic hardship, poor health, and social exclusion. Health promotion in vulnerable neighborhoods is often unsuccessful due to residents' mistrust toward professionals and governmental institutions and misaligned interventions. Engaging experts-by-experience and peer-experts, people drawing on lived experience to support others, offers a promising means to overcome these hurdles. While this approach is gaining ground in the social domain, little is known about its impact on the experts themselves. Therefore, this study addresses the question: "What is the impact of being an expert-by-experience or peer-expert within the social domain on the expert-by-experience and peer-experts themselves?" Using Participatory Action Research, we conducted seventeen participatory observations and nine semi-structured interviews with two peer-experts, one expert-by-experience, and nine professionals in a Dutch city. A reflexive thematic analysis identified four impacts of the expert-by-experience and peer-expert role: (1) feeling connected-through mutual recognition and community engagement; (2) feeling valued-by contributing meaningfully and being respected; (3) personal growth-gaining self-reflection, self-acceptance, and self-confidence; and (4) acquiring transferable skills and future prospects-such as language skills, boundary-setting, and employment opportunities. Challenges included balancing pressures associated with role identity, financial insecurity, and boundary-setting. We conclude that, working as an expert-by-experience and peer-expert offers personal benefits, but also presents risks without adequate support. Reciprocal learning between peer-experts, as well as supportive environments, and focus on financial security are needed to ensure sustainability. Ultimately, integrating experiential knowledge may help health promotion initiatives building trust, address health inequities, and achieve lasting impact in vulnerable neighborhoods.