title: Tuberculosis peer educators: personal experiences of working with socially excluded communities in London.
abstract: METHODS
  Peer education is a relatively unexplored intervention for tuberculosis (TB) control, particularly among socially excluded communities. In London, peer educators are used to raise awareness of TB and promote uptake of radiological screening among people using homeless and/or drug and alcohol treatment services.
  
  
  OBJECTIVE
  To understand the motivation and personal impact of being a peer educator on people with experience of anti-tuberculosis treatment, homelessness and addiction.
  
  
  METHODS
  In-depth semi-structured interviews with peer educators were recorded and transcribed, and then analysed using a grounded theory approach to identify themes. Reflexivity and thick description were used to support transparency of findings.
  
  
  RESULTS
  Becoming a peer educator supports individuals in making sense of past experiences and renewing their sense of self. The role places value on personal experience and the communication approach this supports. The project environment is an important motivator, providing the peer with structure, social support and respect.
  
  
  CONCLUSIONS
  Being a peer educator with experience of homelessness and addiction can be beneficial and empowering and help long-term recovery. Peers are an underused resource for strengthening TB control among socially excluded populations. There is a need for further research into the contribution of peers to TB control, including analyses of economic effectiveness.
authors.affiliation: School of Medicine, Kings College London, London, UK.
authors.forename: L A
authors.initials: LA
authors.lastname: Croft
authors.affiliation: Department of Primary Care and Population Health, University College London, London, UK.
authors.forename: A C
authors.initials: AC
authors.lastname: Hayward
authors.affiliation: Department of Primary Care and Population Health, University College London, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Story
mesh_terms: D000437:Alcoholism / Q000453:epidemiology; D003142:Communication; D003625:Data Collection; D005260:Female; D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006703:Ill-Housed Persons; D006801:Humans; D008131:London; D008297:Male; D008403:Mass Screening / Q000379:methods; D009042:Motivation; D010379:Peer Group; D012934:Social Isolation; D012944:Social Support; D019966:Substance-Related Disorders / Q000453:epidemiology; D014376:Tuberculosis / Q000175:diagnosis / Q000517:prevention & control* / Q000628:therapy