Abstract
Objectives
Globally, engaging people who have used drugs, or peers, in decision-making has been increasingly touted as a best practice approach to developing priorities, programs, and policies. Peer engagement ensures decisions are relevant, appropriate, and effective to the affected community. However, ensuring that inclusion is accessible and equitable for those involved remains a challenge. In this study, we examined the perspectives of people who use or have used illicit drugs (PWUD) on peer engagement in health and harm reduction settings across British Columbia (BC), Canada.
Methods
The Peer Engagement and Evaluation Project used a participatory approach to conducting 13 peer-facilitated focus groups (n = 83) across BC. Focus group data were coded and analyzed with five peer research assistants. Themes about the nature of peer engagement were generated. From this analysis, peer engagement barriers and enablers were identified.
Results
Barriers to peer engagement included individual, geographical, systemic, and social factors. Issues related to stigma, confidentiality, and mistrust were intensely discussed among participants. Being “outed” in one’s community was a barrier to engagement, particularly in rural areas. Participants voiced that compensation, setting, and the right people help facilitate and motivate engagement. Peer networks are an essential ingredient to engagement by promoting support and advocacy.
Conclusion
PWUD are important stakeholders in decisions that affect them. This cross-jurisdictional study investigated how PWUD have experienced engagement efforts in BC, identifying several factors that influence participation. Meaningful engagement can be facilitated by attention to communication, relationships, personal capacity, and compassion between peers and other professionals.
Résumé
Objectifs
À l’échelle mondiale, le dialogue avec les personnes ayant consommé de la drogue (les « pairs ») à la prise de décisions est de plus en plus considéré comme une pratique exemplaire pour l’élaboration de priorités, de programmes et de politiques. Le dialogue avec les pairs mène à des décisions pertinentes, appropriées et efficaces dans la communauté touchée. Il demeure toutefois difficile d’assurer l’accessibilité et l’équité de l’intégration des personnes en cause. Dans cette étude, nous avons examiné les points de vue de personnes consommant ou ayant consommé de la drogue (PCACD) au sujet du dialogue avec les pairs dans les milieux de la santé et de la réduction des méfaits en Colombie-Britannique, au Canada.
Méthode
Ce projet de participation des pairs et d’évaluation a fait appel à une démarche participative pour mener 13 groupes de discussion animés par des pairs (n = 83) en Colombie-Britannique. Les données des groupes de discussion ont été codées et analysées avec cinq pairs adjoints à la recherche. Des thèmes sur la nature du dialogue avec les pairs sont ressortis. L’analyse a permis de cerner les éléments qui entravent ou qui favorisent le dialogue avec les pairs.
Résultats
Les éléments qui entravent le dialogue avec les pairs étaient des facteurs individuels, géographiques, systémiques et sociaux. La stigmatisation, la confidentialité et la méfiance ont été des questions chaudement discutées entre les participants. Le fait d’être révélé dans son propre milieu comme étant consommatrice ou consommateur de drogue constituait un obstacle au dialogue, surtout en zone rurale. Les participants ont exprimé l’avis que la rémunération, le lieu et les « bonnes personnes » facilitent le dialogue et motivent les gens à s’impliquer. Les réseaux de pairs sont un ingrédient essentiel du dialogue, car ils favorisent l’entraide et la défense des intérêts.
Conclusion
Les PCACD sont d’importants acteurs dans les décisions qui les concernent. Cette étude à l’échelle intergouvernementale a porté sur la perception par des PCACD vivant en Colombie-Britannique des démarches visant à les faire participer; plusieurs facteurs influant sur le dialogue ont été recensés. Un dialogue sérieux peut être favorisé par une attention à la communication, aux relations, aux capacités individuelles et à la compassion entre les pairs et les autres professionnels.
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Notes
After discussing the term “peer,” the team decided to remove it from the RA job title (and this paper) as the team felt it may result in being treated differently than those identified as non-using members of the team. Rather, the word “peer” is only used in the context of highlighting the experiential knowledge that is contributed through this role.
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Greer, A.M., Amlani, A., Burmeister, C. et al. Peer engagement barriers and enablers: insights from people who use drugs in British Columbia, Canada. Can J Public Health 110, 227–235 (2019). https://doi.org/10.17269/s41997-018-0167-x
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DOI: https://doi.org/10.17269/s41997-018-0167-x