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Existing support strategies have shown limited benefit. The Impact de la Pair-Aidance \u00c9tudiante sur la Sant\u00e9 Mentale des internes de M\u00e9decine de premi\u00e8re ann\u00e9e (PAESSM) study will evaluate whether embedding Mental Health First Aid (MHFA)-trained peer supporters within a first-year residency cohort is associated with improved mental well-being and reduced psychological distress over 12 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>PAESSM is a non-randomised controlled mixed-methods quasi-experimental study in Lyon, France involving the two Lyon medical schools. Two contemporaneous cohorts will be followed for 12 months: first-year residents exposed to a structured peer-support programme and second-year residents receiving usual support resources without a structured peer-support network. About 430 residents are eligible in each cohort, with anticipated enrolment of approximately 260 per group. In the intervention cohort, around 10% of first-year residents will complete certified MHFA training and act as peer supporters. Online questionnaires will be administered at baseline and at 3, 6, 9 and 12 months. The primary outcome is 12-month mental well-being measured by the Warwick-Edinburgh Mental Well-Being Scale. Secondary outcomes include anxiety and depression symptoms, suicidal ideation, job strain and help-seeking behaviours. The primary analysis will use longitudinal targeted maximum likelihood estimation adjusted for prespecified baseline covariates and informative censoring. Sensitivity analyses will include mixed-effects models and complete-case analyses. A qualitative sub-study will explore peer supporters\u2019 experiences and implementation processes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical approval was obtained from the Comit\u00e9 de Protection des Personnes Nord-Ouest IV (Ref: 2025-A01549-40). In accordance with French legislation applicable to minimal-risk research, formal written informed consent was waived and participants will provide documented non-opposition before inclusion. Findings will be disseminated through peer-reviewed publications, conference presentations and communication with institutional stakeholders and residents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT07161284\">NCT07161284<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-120352","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T11:45:29Z","timestamp":1785325529000},"page":"e120352","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Peer support based on Mental Health First Aid for medical residents in Lyon, France: protocol for a 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