Peer engagement in harm reduction strategies and services: a critical case study and evaluation framework from British Columbia, Canada.

Alissa M Greer, Serena A Luchenski, Ashraf A Amlani, Katie Lacroix, Charlene Burmeister, Jane A Buxton
Author Information
  1. Alissa M Greer: BC Centre for Disease Control, 655 West 12th Avenue, Vancouver, British Columbia, V5Z 4R4, Canada. a.greer@utoronto.ca.
  2. Serena A Luchenski: The Farr Institute of Health Informatics Research, University College London, 222 Euston Road, London, NW1 2DA, United Kingdom.
  3. Ashraf A Amlani: BC Centre for Disease Control, 655 West 12th Avenue, Vancouver, British Columbia, V5Z 4R4, Canada.
  4. Katie Lacroix: BC Centre for Disease Control, 655 West 12th Avenue, Vancouver, British Columbia, V5Z 4R4, Canada.
  5. Charlene Burmeister: BC Centre for Disease Control, 655 West 12th Avenue, Vancouver, British Columbia, V5Z 4R4, Canada.
  6. Jane A Buxton: BC Centre for Disease Control, 655 West 12th Avenue, Vancouver, British Columbia, V5Z 4R4, Canada.

Abstract

BACKGROUND: Engaging people with drug use experience, or 'peers,' in decision-making helps to ensure harm reduction services reflect current need. There is little published on the implementation, evaluation, and effectiveness of meaningful peer engagement. This paper aims to describe and evaluate peer engagement in British Columbia from 2010-2014.
METHODS: A process evaluation framework specific to peer engagement was developed and used to assess progress made, lessons learned, and future opportunities under four domains: supportive environment, equitable participation, capacity building and empowerment, and improved programming and policy. The evaluation was conducted by reviewing primary and secondary qualitative data including focus groups, formal documents, and meeting minutes.
RESULTS: Peer engagement was an iterative process that increased and improved over time as a consequence of reflexive learning. Practical ways to develop trust, redress power imbalances, and improve relationships were crosscutting themes. Lack of support, coordination, and building on existing capacity were factors that could undermine peer engagement. Peers involved across the province reviewed and provided feedback on these results.
CONCLUSION: Recommendations from this evaluation can be applied to other peer engagement initiatives in decision-making settings to improve relationships between peers and professionals and to ensure programs and policies are relevant and equitable.

Keywords

References

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MeSH Term

British Columbia
Community Health Services
Harm Reduction
Humans
Peer Influence
Program Evaluation
Substance-Related Disorders