Applying Normalisation Process Theory to a peer-delivered complex health intervention for people experiencing homelessness and problem substance use

Communications Medicine, Год журнала: 2025, Номер 5(1)

Опубликована: Янв. 10, 2025

Abstract Background The Supporting Harm Reduction through Peer Support (SHARPS) study involved designing and implementing a peer-delivered, harm reduction intervention for people experiencing homelessness problem substance use. Normalisation Process Theory (NPT) provided framework the study. Methods Four Navigators (individuals with personal experience of use and/or homelessness) were recruited hosted in six third sector (not-for-profit) services Scotland England (United Kingdom). Each worked participants to provide practical emotional support, aim reducing harms, improving well-being, social functioning quality life. NPT guided development and, process evaluation, which assessed acceptability feasibility this cohort who distinct, often unmet, health challenges. While mixed-methods data collection was undertaken, paper draws only on qualitative data. Results found that, overall, is feasible, acceptable to, participants, staff host settings. Some challenges encountered but these outweighed by benefits. particularly useful encouraging our team focus relationship between different aspects context(s) identify ways maximising ‘fit’. Conclusions To knowledge, first application cohort, specifically non-clinicians (peers) non-healthcare settings (homelessness services). Our helped us could be enhanced, key health/well-being underserved group.

Язык: Английский

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The Impact of Peer-Based Recovery Support Services: Mediating Factors of Client Outcomes

The Journal of Behavioral Health Services & Research, Год журнала: 2025, Номер unknown

Опубликована: Янв. 13, 2025

Abstract Research demonstrates a positive impact of Peer Based Recovery Support Services (PBRSS) facilitated by peer recovery specialists (PRS), who are people in from behavioral health conditions (e.g., substance use disorders [SUD] and mental conditions). This study investigated PBRSS, their on client outcomes use, health), the factors self-efficacy, perceived relationship with/helpfulness PRS) mediating between services while controlling for sociodemographic information age). Data were collected across 58 sites within 25 agencies providing PBRSS state located Northeastern USA. Cross-lagged panel models used to examine 12 longitudinal mediational sample N = 412. Models examined over two time periods (i.e., T1 T2). After alpha correction ( p .00417), most results nonsignificant. However, several findings indicated that constructs significantly related all self-efficacy at predicted T2), many point-in-time associations also significant number received was positively relationship/helpfulness PRS Better lower T2, receiving more better T2. Being older worse overall T2 some models. While no mediation found, this is important as it assists building with respect mechanisms which may effect change or not.

Язык: Английский

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Umbrella review of systematic reviews of peer support in substance use settings

Mental Health and Social Inclusion, Год журнала: 2025, Номер unknown

Опубликована: Янв. 22, 2025

Purpose The purpose of this umbrella review is to synthesise existing evidence on the effectiveness and implementation peer support in substance use settings, providing insights into its benefits, challenges implications for practice research. Design/methodology/approach preferred reporting items systematic reviews meta-analyses were used guide an review. Three databases searched: Academic Search Complete, Scopus Web Science, supplemented with bibliography searches. Articles included if they reviewed English language from inception 2024 reported contexts. Joanne Briggs Institute Critical Appraisal Checklist Systematic Reviews Research Syntheses was assess quality reviews. Findings are using a narrative synthesis. search yielded 4,062 articles, which 8 included, encompassing 177 ( N = 177) primary studies combined sample size 38,659 38,659) participants. Peer settings linked improved outcomes, including reduced severity, enhanced treatment engagement better social supports. Challenges identified inconsistent training, role definitions organisational barriers, such as stigmatising attitudes limited structural support. Most synthesis report results, no meta-analyses. appraisal categorised 25% high quality, moderate low critically quality. findings further highlighted need clearer strategies, standardised training recovery-oriented care models optimise effectiveness. In addition, randomised control trial method evaluating considered. Originality/value This uniquely synthesises diverse highlighting multidimensional benefits while addressing critical gaps strategies methodological approaches. It offers novel perspective optimising roles within models.

Язык: Английский

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Building Capacity for Community-Engaged Peer-Focused Research: Results From the IRIS Recovery Research Fellowship

Health Promotion Practice, Год журнала: 2025, Номер unknown

Опубликована: Фев. 25, 2025

Engaging peers and other substance use service providers in research increases the relevance impact of findings, including ways to further integrate into recovery workforce. Academics also have much learn about peer by engaging professionals with lived experience collaborative research. Despite these benefits, there been few intersectoral, peer-focused initiatives dedicated building skills through hands-on scientific inquiry. Grounded community-based participatory research, IRIS Recovery Research Fellowship aimed develop connectedness, commitment workforce integration, trust skills, practice-driven studies. Learning sessions coaching were provided a cohort 17 peers, agency staff, academics. Evaluation was conducted using mixed methods. Pre- post-test surveys measured change over time paired-sample t-tests. Thematic analysis used for open-ended responses Rivers Life drawings. All fellows completed studies while contributing position paper on integration. Results indicated statistically significant gains qualitative an array skills. The fellowship "drove home value necessity peers," leading increased advocacy enhanced services. Additional related professional development opportunities are needed build capacity providers, researchers ground inquiry recovery, interdisciplinary groups engage These activities will help practice evidence base, support employers effectively workforce, strengthen

Язык: Английский

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“Sometimes I’m interested in seeing a fuller story to tell with numbers” Implementing a forecasting dashboard for harm reduction and overdose prevention: a qualitative assessment

BMC Public Health, Год журнала: 2025, Номер 25(1)

Опубликована: Март 7, 2025

The escalating overdose crisis in the United States points to urgent need for new and novel data tools. Overdose tools are growing popularity but still face timely delays surveillance availability, lack of completeness, wide variability quality by region. As such, we innovative identify prioritize emerging high-need areas. Forecasting offers one such solution. Machine learning methods leverage numerous datasets that could be used predict future vulnerability at regional, town, even neighborhood levels. This study aimed understand multi-level factors affecting early stages implementation an forecasting dashboard. dashboard was developed with statewide harm reduction providers increase data-driven response resource distribution level. part PROVIDENT (Preventing OVerdose using Information Data from EnvironmeNT), a randomized, community trial, conducted where facilitated three focus groups organizations enrolled larger trial. Focus group participants held titles as peer outreach workers, case managers, program coordinators/managers. We employed Exploration, Preparation, Implementation, Sustainment (EPIS) Framework guide our analysis. framework multi-level, four-phase analysis unique within human services environment assess exploration preparation phases influenced launch intervention. Multiple themes centering on organizational culture resources emerged, including limited staff capacity interventions repeated exposure stress trauma, which limit intervention uptake. Community-level included burden collection funding efforts build stronger networks dashboarding allocation. Using allowed us contextual Additional investments may required create optimal setting integration

Язык: Английский

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Four decades of overdose prevention centres: lessons for the future from a realist review

Harm Reduction Journal, Год журнала: 2025, Номер 22(1)

Опубликована: Март 20, 2025

Abstract Background Overdose prevention centres (OPCs) are spaces where people can consume previously obtained illicit drugs under the supervision of staff who intervene to prevent and manage overdose. They have been provided in Europe elsewhere for nearly 40 years, initially response epidemic HIV/AIDS. We learn from their operation history inform future developments harm reduction services. Methods carried out a realist review 391 documents, reported according RAMESES I guidelines, synthesis these documents. Results present full programme theory OPCs, with diagrammatic logic model, how contexts mechanisms OPCs combine produce various outcomes service users communities different settings. Three specific causal pathways were evidenced through which particular groups housing status, gender identity ethnicity, local drug markets, frequency use, legal political contexts, stigma as overlapping contextual factors. Key OPC interventions include provision safe hygienic consumption space, education, timely overdose response, protection scene gender-based violence. These trigger underlying safety, trust, social inclusion, engagement, autonomy, empowerment when supported health care other services, including detoxification opioid agonist treatment. The combinations create important individual users, they live in, wider society. also describe that lead unintended, adverse outcomes. Conclusion This provides useful information policy makers, practitioners, researchers on implement evaluate maximise benefits; an task context ongoing public crises poisoning deaths North America UK, possibility increasing synthetic opioids elsewhere.

Язык: Английский

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“You take care of people, people will take care of you”: Moral Economies and an Unpredictable Drug Market

PLoS ONE, Год журнала: 2025, Номер 20(4), С. e0320423 - e0320423

Опубликована: Апрель 2, 2025

Introduction Fentanyl is the leading cause of opioid-related overdose deaths in United States. Given exogenous market shock fentanyl and subsequent transition illicit opioid supply, our analysis sought to explore social relational experiences people who use opioids (PWUO). Methods We conducted qualitative interviews with 30 PWUO (n = 30) Los Angeles, CA from July 2021 April 2022. To be eligible for this study, participants had report being 18 years age or older any self-reported opioid, cannabis, injection drug within past days. used constructivist grounded theory analyze contexts that contribute lived surrounding behaviors networks. Results Within an unpredictable contaminated by fentanyl, reported: 1) avoiding withdrawal symptoms sharing financial material resources networks, 2) securing cultivating known, predictable ties prioritize safe/ safer supply opioids, 3) mitigating risk fatality using peer groups. Conclusions Our findings emphasize while support plays a critical role safety moral economies PWUO, structural changes are needed address additional harms unregulated supply. Harm reduction interventions such as test strip naloxone distribution, well medication disorders may improve safety. However, fentanyl-contaminated increasing distribution pharmaceutical-grade prevention programs effectively burden withdrawal, overdose,

Язык: Английский

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Substance Use Stigma and Community Drug Checking: A Qualitative Study Examining Barriers and Possible Responses

International Journal of Environmental Research and Public Health, Год журнала: 2022, Номер 19(23), С. 15978 - 15978

Опубликована: Ноя. 30, 2022

Background: Community drug checking is an emerging response to the overdose crisis. However, stigma has been identified as a potential barrier service use that requires investigation. Methods: A qualitative study explored how best implement services wider population including those at risk of overdose. secondary analysis 26 interviews with users examine may be and strategies address this. Substance Use Stigma Framework was developed guide analysis. Results: Drug operating in context structural produced by criminalization. People fear criminal repercussions, anticipate when accessing services, internalize resulting shame avoidance services. perceived hierarchy substance creates results between sites associated certain drugs. Participants frequently recommended located more public spaces still maintain privacy. Conclusions: Criminalization societal views on can deter use. Strategies mitigate include employment people lived living experience from diverse backgrounds; yet private locations preserve anonymity; normalization while decriminalization could root causes stigma.

Язык: Английский

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The wages of peer recovery workers: underpaid, undervalued, and unjust

Critical Public Health, Год журнала: 2024, Номер 34(1), С. 1 - 12

Опубликована: Апрель 18, 2024

Peer-based recovery support services are evidence-based practices used to achieve long-term recovery. Fundamental these peer workers, who use their lived experience of form trusting, supportive relationships with individuals initiating self-directed journeys mental health or substance However, workers report low salaries and workplace environments that cause unnecessary stress, burnout, compassion fatigue, suboptimal service provision. We compare mean state worker wages prevailing living by utilizing a wage calculator assembling data on offers from national job-posting platform in the US. Our results suggest significant insufficiency. Among single-worker households children, exceeds every state. conclude guidance public researchers practitioners address social justice implications

Язык: Английский

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Navigating transitions into, through, and beyond peer worker roles: insider insights from the Supporting Harm Reduction through Peer Support (SHARPS) study

Harm Reduction Journal, Год журнала: 2024, Номер 21(1)

Опубликована: Окт. 28, 2024

Abstract Background Peer workers are individuals who draw on their personal experiences in a professional capacity to support clients. Existing research the role of peer mental health, homelessness, and substance use services has primarily focused impact client outcomes. This paper describes development as they transition into, through, beyond this role. Utilising data from Supporting Harm Reduction through Support (SHARPS) study, where Navigators supported people experiencing homelessness challenges, explores sense-making involved an intensive worker role, adaptation organisational culture, engagement with opportunities for advancement. Methods Semi-structured interviews three were conducted by two SHARPS study researchers at four time points 2018 2019 corresponding beginning, middle, end intervention. These analysed along entries Navigators’ reflective diaries. Analysis followed multi-stage approach thematic analysis utilising both inductive deductive processes. The reflections have also been incorporated into recommendations. Results foundational training provided before taking up helped ensure readiness build confidence. illuminated dynamics supporting complex health social challenges. Integrating diverse environments, adapted new expectations consistently advocated harm reduction psychologically informed approaches, sometimes encountering resistance other professionals. Establishing effective relationships participants professionals was essential dealing challenges such overcoming biases navigating systemic obstacles. benefitted specially designed career progress which enabled successful transitions study. Conclusions Pre-work training, coupled adherence key principles, integrate effectively organisations. Quality vital achieving outcomes growth Navigators. findings important employing underscore importance commitment continuing development.

Язык: Английский

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