Development and validation of the Meaningful Engagement Evaluation Tool (MEET) for dual diagnosis peer-led programs: a co-designed approach

Purpose Increasingly, the value of peer-led programmes to support individuals with co-occurring mental health and substance use disorders (dual diagnosis) is acknowledged. However, there is a lack of validated tools to assess meaningful engagement in these programmes. This study aims to develop and validate the Meaningful Engagement Evaluation Tool (MEET) to measure engagement in dual-diagnosis peer-led support groups systematically. Design/methodology/approach Using a co-designed approach, MEET was developed in collaboration with consumers, peer facilitators and clinicians. The tool consists of two scales – one for consumers and one for facilitators – measuring four key engagement domains: hope and motivation, social connection, recovery strategies and safe space. The study was conducted across six public health service sites, with survey data collected from 410 consumers and 384 facilitators. The quantitative analysis assessed internal consistency, while qualitative responses were thematically analysed. Findings MEET demonstrated strong internal consistency (Cronbach’s alpha = 0.82 for consumers, 0.88 for facilitators). Participants reported high engagement, with qualitative themes highlighting the role of lived experience in fostering connection and recovery. Item responses encountered ceiling effects. Research limitations/implications This study demonstrated that the MEET is a reliable tool for assessing engagement in peer-led dual-diagnosis programmes; however, several limitations were identified. Quantitative data showed ceiling effects, limiting discrimination between high engagement levels. The predominantly mental health-based sample and limited inclusion of alcohol and drug services constrain generalisability. Broader validation, refinement of item wording and enhanced scale sensitivity are needed. Findings highlight MEET’s potential for improving programme evaluation, with future research recommended to optimise measurement precision and test applicability across diverse peer-led settings. Practical implications The MEET provides mental health and alcohol and other drug (AOD) services with a co-designed, reliable tool to evaluate meaningful engagement in peer-led dual-diagnosis programmes, capturing dimensions such as hope, social connection, recovery strategies and safe space. Its use can guide service improvement, highlight the value of lived experience facilitation and strengthen evidence for peer work within integrated care models. By providing structured, participant-centred feedback, MEET supports quality improvement, programme funding justification and alignment with recovery-oriented practice. Future refinements to increase sensitivity will enhance its utility, enabling services to better tailor interventions, demonstrate impact and promote engagement across varied clinical and community settings. Social implications The MEET reinforces the social value of peer-led dual-diagnosis programmes by evidencing their role in fostering inclusion, trust and mutual support among people with lived experience. By capturing participants’ perceptions of hope, connection and safety, it highlights how such programmes reduce stigma, promote empowerment and build recovery capital through shared experiences. Widespread use of MEET can strengthen recognition of peer work as a legitimate and impactful component of mental health and AOD services, supporting policy shifts towards recovery-oriented care. Ultimately, this tool can help embed lived experience perspectives into service design, enhancing social cohesion and equity in health systems. Originality/value The MEET is a reliable and valid measure of engagement in peer-led dual-diagnosis programmes. Future research should further refine MEET and assess its applicability across diverse recovery settings.