Accepted for/Published in: Journal of Participatory Medicine
Date Submitted: Jul 2, 2025
Date Accepted: May 3, 2026
Peer-Led Emotional CPR in Black, Indigenous, and People of Color Communities: A Convergent Mixed-Methods Study
ABSTRACT
Background:
Black, Indigenous, and People of Color (BIPOC) face disproportionately negative mental health outcomes, including rising suicide rates and persistent barriers to culturally responsive care. Systemic racism, historical trauma, and discrimination contribute to these disparities and foster mistrust of traditional mental health systems. Peer-led approaches, which center lived experience and shared cultural identity, offer a promising alternative by fostering trust, empowerment, and cultural safety. Emotional CPR (eCPR), a trauma-informed, peer-to-peer mental health education program, builds on the recovery model by equipping individuals with skills to emotionally connect and support others in crisis.
Objective:
This study examined the impact of eCPR, facilitated entirely by BIPOC trainers for BIPOC participants, on emotional well-being and related outcomes.
Methods:
Using a mixed-methods design, the study included 85 BIPOC participants (mean age = 42.7; 72% female; 45% Black, 30% Latinx, 15% Asian American/Pacific Islander, 10% multiracial/other) who completed pre- and post-intervention surveys. Two post-intervention focus groups (N = 17) were conducted to gather qualitative data. All sessions were facilitated by BIPOC trainers.
Results:
Quantitative findings showed significant reductions in loneliness (p = 0.025, d = 0.25) and increases in positive affect (p = 0.002, d = -0.37). However, declines were observed in empowerment (p = 0.026, d = 0.26), active-empathic listening (p = 0.018, d = 0.26), flourishing (p = 0.015, d = 0.27), and hope (p < 0.001, d = 0.41). No significant change was found in social connectedness. Qualitative themes included empowerment, emotional vulnerability, cultural trust, and challenges in sustaining connection and self-confidence after training.
Conclusions:
eCPR fostered short-term emotional gains and cultural safety but also surfaced challenges in sustaining empowerment and emotional skills. Increased self-awareness may have temporarily lowered confidence. Future programs should include follow-up sessions, peer mentorship, and extended practice to promote long-term emotional resilience among BIPOC participants Clinical Trial: n/a
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