Treatment spillover or diffusion of treatment onto control group sites
We recognize that treatment spillover or diffusion of treatment onto control group sites may be a threat to internal validity [We also acknowledge the limitations in the implementation of the reduction/cessation intervention. Utilizing peer educators limits the degree of customization and breadth of services and support provided to participants in the R/C and R/C+RE arms. Though some customization is possible depending on participant needs, the curriculum is standardized and simplified. Though the PEs do not have clinical expertise or training and, thus, are limited in the degree of support they can provide, efforts to incorporate peers may empower residents and further advance community engagement efforts.