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ID: HR19-733

Presenting author: Graham Brown

Presenting author biography:

Graham Brown is from the Australian Research Centre in Sex, Health and Society at La Trobe University. Graham has worked in HIV and Hepatitis C community based health promotion and research for over 20 years, and has a particular interest in the role of community based organisations and peer-led programs.

What Works and Why (W3) Project – a partnership with peer led organisations to demonstrate the value of participation of people who inject drugs in health services and policy

Graham Brown, Jude Byrne, Sione Crawford, Garri-Emma Perry

Issue:
Peer-led responses for people who inject drugs (PWID) must navigate a rapidly changing and highly stigmatised context around drug use. However, these peer-led programs often have difficulties in articulating their role, demonstrating their quality and community connection, and showing their effectiveness. This can lead to policy and health services resisting partnership and advice from PWID peer organisations.

Setting:
This project aimed to build a deeper understanding of the role, quality and effectiveness of PWID peer led programs. We used systems thinking methods to draw together the insights of over 90 peer staff from 10 Australian community and peer organisations. This involved a series of 18 workshops to elicit and diagram mental models (system maps) of how peer-led programs operate. We analysed the system maps to identify the underlying functions that a peer-led program needs to fulfil to be effective and sustainable in changing community and health service environments.

Key Arguments:
We found four interrelated functions (engagement, alignment, adaptation, and influence) which were key to achieving and sustaining meaningful involvement and influence of PWID in harm reduction and the HCV response. We have called this the W3 (What Works and Why) Framework. The paper will describe the implications for PWID peer-led programs, and the involvement of PWID, in a rapidly changing HCV landscape.

Outcomes and Implications:
The W3 Framework provides a way for peer-led PWID organisations to demonstrate the depth of their engagement with their community, the strength of their community insights, and their credibility and influence in health and policy systems. To achieve outcomes for PWID, we need to invest in strengthening community systems and support the health and policy system to draw on the expertise of quality PWID peer programs and leadership. The W3 Project lays out ways in which organisations can achieve and sustain this.