Implementation components and delivery structures of adolescent peer navigation as a workforce model: a scoping review

BACKGROUND: Adolescents face persistent barriers to accessing health services, particularly among vulnerable populations such as those living with HIV, adolescent mothers, and youth experiencing mental health or substance use challenges. Peer navigation has emerged as a promising strategy to address these gaps by leveraging shared lived experience to support engagement across health and social systems. However, existing literature has primarily focused on intervention effectiveness, with limited attention to how these programs are implemented. This scoping review aims to characterize the implementation architecture of adolescent peer navigation programs globally, with a focus on peer eligibility, training, supervision, and support systems. METHODS: Following PRISMA-ScR guidelines, we systematically searched four databases for studies published between 2005 and 2025. Twenty-one programs met inclusion criteria. Data were extracted using a standardized, piloted template capturing study characteristics, peer navigator characteristics, training and supervision, navigator roles and responsibilities, health services and domains addressed, delivery modalities, and program focus. Given heterogeneity across studies, data were synthesized narratively using descriptive tables and iterative thematic coding. Two reviewers independently reviewed extracted data, developed and refined codes through discussion, and identified recurring implementation components and patterns to characterize program typologies and inform a conceptual model of adolescent peer navigation. RESULTS: Across studies, peer navigation programs shared core design elements, including selection based on lived experience, structured training, supervision, and multidimensional roles spanning psychosocial support, health education, and service navigation. However, substantial variability was observed in how these components were operationalized. Training and supervision were widely implemented but inconsistently specified, and few studies examined peer navigator well-being or workforce sustainability. Programs were predominantly clinic-based and concentrated in countries in Africa, with emerging hybrid and community-based models. CONCLUSIONS: Adolescent peer navigation is best understood as a flexible workforce and service delivery model rather than a standardized intervention. Strengthening reporting and standardization of implementation components is critical to support replication, optimization, and scale-up.