Implementing a trauma-informed intervention for homeless female survivors of gender-based violence: Lessons learned in a large Canadian urban centre.

Gender-based violence is associated with an elevated risk of physical and psychological harm for girls and women. This study examines service user and provider experiences of a trauma-informed, peer-facilitated group psychosocial intervention (Peer Education and Connection through Empowerment [PEACE]) targeting female-identified youth experiencing homelessness and gender-based violence. Participants were recruited among service users and providers of the intervention, delivered in Toronto, Canada. We conducted 19 semi-structured interviews between May and October 2017, engaging 12 service users and 7 additional stakeholders (including social service providers, peers and program administrators). We elicited participant perspectives on the acceptability of the intervention and key enablers of successful implementation and engagement of the target population. Qualitative transcripts were analysed using thematic analysis. Service users, including survivors of sexual exploitation, forced marriage and honour crimes, described satisfaction with and acceptability of the intervention. A number of factors were perceived by service users and providers as contributing to the intervention's successful implementation, including a focus on service user needs, program quality, flexibility and accessibility and strong inter-and intra-agency networks. Introducing peers as mentors led to challenges that could be mitigated through peer mentor education and training to maintain healthy boundaries and enhance peer mentor retention. The need for clear guidelines on the management of trauma disclosures in community settings and a systems-wide approach to service provider and administrator training in the effective integration of peer support services also emerged as important areas for future development. A group-based, trauma-informed and peer-supported psychosocial intervention was acceptable to service users and providers and successfully engaged female-identified survivors of gender-based violence who were also experiencing homelessness. Findings add to the scant knowledge base on interventions to support this population and identify important areas for future research.