W3 Framework: Understanding The Role And Quality Of Peer Led Programs By People Who Inject Drugs In A National Hepatitis C Response

Author: Brown G, Byrne J, Kelsall J, Perry G

Theme: Models of Care Year: 2018

Peer-led responses for people who inject drugs (PWID) must navigate a rapidly changing
and highly stigmatised context around drug use. To achieve hepatitis C (HCV) treatment
goals among PWID will require major policy and practice shifts, and an even closer
partnership with peer led PWID organisations in this changing landscape. 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.
Description of model of care/intervention:
This collaborative study aimed to build a deeper understanding of the role, quality and
effectiveness of PWID peer programs in HICV prevention and care. 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 that drew on
complex systems theory 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.
We found four interrelated functions (engagement, alignment, adaptation, and influence)
which were key to the effectiveness of PWID peer-led programs. These functions provide a
framework to evaluate these programs and their partnership with health services. The paper
will describe the implications for PWID peer-led programs in a rapidly changing HCV
We need to evaluate peer led programs in the context of the broader system in which they
operate. To achieve outcomes for PWID, we need to not only invest in strengthening
community systems, but support the health and policy system to identify and draw on quality
PWID peer programs and leadership.
Disclosure of Interest
Graham Brown has received funding from the Australian Government Department of Health,
ViiV Healthcare International, and the Australian Federation of AIDS Organisations. Other
authors have received funding from Australian Government Department of Health and
jurisdictional Departments of Health. No pharmaceutical grants were received in the
development of this study

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