Meaningful engagement of people living with HIV who use drugs: methodology for the design of a Peer Research Associate (PRA) hiring model

Abstract

BackgroundCommunity-based HIV, harm reduction, and addiction research increasingly involve members of affected communities as Peer Research Associates (PRAs)—individuals with common experiences to the participant population (e.g. people who use drugs, people living with HIV [PLHIV]). However, there is a paucity of literature detailing the operationalization of PRA hiring and thus limited understanding regarding how affected communities can be meaningfully involved through low-barrier engagement in paid positions within community-based participatory research (CBPR) projects. We aim to address this gap by describing a low-threshold PRA hiring process.ResultsIn 2012, the BC Centre for Excellence in HIV/AIDS and the Dr. Peter AIDS Foundation collaborated to develop a mixed-method CBPR project evaluating the effectiveness of the Dr. Peter Centre (DPC)—an integrative HIV care facility in Vancouver, Canada. A primary objective of the study was to assess the impact of DPC services among clients who have a history of illicit drug use. In keeping with CBPR principles, affected populations, community-based organizations, and key stakeholders guided the development and dissemination of a low-barrier PRA hiring process to meaningfully engage affected communities (e.g. PLHIV who have a history of illicit drug use) in all aspects of the research project.The hiring model was implemented in a number of stages, including (1) the establishment of a hiring team; (2) the development and dissemination of the job posting; (3) interviewing applicants; and (4) the selection of participants. The hiring model presented in this paper demonstrates the benefits of hiring vulnerable PLHIV who use drugs as PRAs in community-based research.ConclusionsThe provision of low-barrier access to meaningful research employment described herein attempts to engage affected communities beyond tokenistic involvement in research. Our hiring model was successful at engaging five PRAs over a 2-year period and fostered opportunities for future paid employment or volunteer opportunities through ongoing collaboration between PRAs and a diverse range of stakeholders working in HIV/AIDS and addictions. Additionally, this model has the potential to be used across a range of studies and community-based settings interested in meaningfully engaging communities in all stages of the research process.Electronic supplementary materialThe online version of this article (doi:10.1186/s12954-016-0116-z) contains supplementary material, which is available to authorized users.

Hiring, training, and supporting Peer Research Associates: Operationalizing community-based research principles within epidemiological studies by, with, and for women living with HIV

“…Previous research has identified key challenges to PRA training within the context of a CBR study, including limited financial resources and a significant time commitment required to sustainably support trainees [43, 51, 52]. We were fortunate to learn from this work to develop and implement a PRA hiring and training process.…”

Achieving meaningful participation of people who use drugs and their peer organizations in a strategic research partnership

“…Previous literature has identified good practice methods to the meaningful involvement of PWUD in policy, health services, and research (such as [1, 8, 19, 39–42]). However, much of this literature has focused on good practice engagement strategies and their benefits, with much less emphasis on the system level factors that may enhance or constrain meaningful involvement [6, 13].…”

“…Enhancing the meaningful involvement of PWUD and their peer organizations in research and policy has been an ongoing endeavor for decades [1] with literature discussing good practice as well as barriers and enablers [8, 25, 39–42, 52]. However much of this literature has focused on engagement strategies and research methodology, with much less emphasis on identifying system level factors that may enhance or constrain meaningful involvement [6, 13].…”

Building New Approaches to Risk Reduction With Social Networks and People Who Smoke Illegal Drugs From Participatory Community-Based Research

“…In addition, although traditional methods facilitate inferential statistics on the larger population from which the sample is drawn, there are many limitations of the methods that have raised a lot of discussion in the academic community (Broadhead, 2008; Lansky & Mastro, 2008; Ouellet, 2008; Scott, 2008). For example, there have been concerns related to tokenistic involvement of marginalized participants and associated underground economy, risk of violence, coercion, or false reporting (Closson et al, 2016; Logie, James, Tharao, & Loutfy, 2012; Richardson, Wood, & Kerr, 2013; Scott, 2008).…”

“…Since the main successive component of the traditional social network methodology’s sampling strategy has been focused on “peers” or “seeds,” mainly based on the notion that such individuals are better able to locate and access the hard-to-reach populations than outreach workers or experienced researchers, we believe that better outcomes can be achieved if peers or people with lived or current experiences of illegal drug use not only act as a referral point but also be invited to partake in the research design, implementations, data collection, data entry, and dissemination of findings in the community (Brizay et al, 2015; Greene, 2013; Jagosh et al, 2012; Wright, 2015). In fact, there is growing interest by health researchers to give greater roles to people affected by the health problems under study (Boyd, 2013; Boyd, Murray, & MacPherson, 2017; Closson et al, 2016; Cropper et al, 2010; Greer et al, 2016; Wright, 2015).…”