title: Peer engagement in harm reduction strategies and services: a critical case study and evaluation framework from British Columbia, Canada.
abstract: Engaging people with drug use experience, or 'peers,' in decision-making helps to ensure harm reduction services reflect current need. There is little published on the implementation, evaluation, and effectiveness of meaningful peer engagement. This paper aims to describe and evaluate peer engagement in British Columbia from 2010-2014.
  
  
  
  A process evaluation framework specific to peer engagement was developed and used to assess progress made, lessons learned, and future opportunities under four domains: supportive environment, equitable participation, capacity building and empowerment, and improved programming and policy. The evaluation was conducted by reviewing primary and secondary qualitative data including focus groups, formal documents, and meeting minutes.
  
  
  
  Peer engagement was an iterative process that increased and improved over time as a consequence of reflexive learning. Practical ways to develop trust, redress power imbalances, and improve relationships were crosscutting themes. Lack of support, coordination, and building on existing capacity were factors that could undermine peer engagement. Peers involved across the province reviewed and provided feedback on these results.
  
  
  
  Recommendations from this evaluation can be applied to other peer engagement initiatives in decision-making settings to improve relationships between peers and professionals and to ensure programs and policies are relevant and equitable.
authors.affiliation: BC Centre for Disease Control, 655 West 12th Avenue, Vancouver, British Columbia, V5Z 4R4, Canada. a.greer@utoronto.ca.|School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada. a.greer@utoronto.ca.
authors.forename: Alissa M
authors.initials: AM
authors.lastname: Greer
authors.affiliation: The Farr Institute of Health Informatics Research, University College London, 222 Euston Road, London, NW1 2DA, United Kingdom.
authors.forename: Serena A
authors.initials: SA
authors.lastname: Luchenski
authors.affiliation: BC Centre for Disease Control, 655 West 12th Avenue, Vancouver, British Columbia, V5Z 4R4, Canada.
authors.forename: Ashraf A
authors.initials: AA
authors.lastname: Amlani
authors.affiliation: BC Centre for Disease Control, 655 West 12th Avenue, Vancouver, British Columbia, V5Z 4R4, Canada.|Society of Living Illicit Drug Users, 857 Caledonia Street, Victoria, British Columbia, V8T 1E6, Canada.
authors.forename: Katie
authors.initials: K
authors.lastname: Lacroix
authors.affiliation: BC Centre for Disease Control, 655 West 12th Avenue, Vancouver, British Columbia, V5Z 4R4, Canada.
authors.forename: Charlene
authors.initials: C
authors.lastname: Burmeister
authors.affiliation: BC Centre for Disease Control, 655 West 12th Avenue, Vancouver, British Columbia, V5Z 4R4, Canada.|School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada.
authors.forename: Jane A
authors.initials: JA
authors.lastname: Buxton
mesh_terms: D001955:British Columbia; D003153:Community Health Services; D040261:Harm Reduction; D006801:Humans; D000067074:Peer Influence; D015397:Program Evaluation; D019966:Substance-Related Disorders / Q000517:prevention & control*
keywords: Community engagement; Harm reduction; Health equity; Peer engagement; Process evaluation; Public participation; Substance use