Using Intervention Mapping to Develop ‘ROSE’: An Intervention to Support Peer Workers in Overdose Response Settings

Abstract

Background: Peer workers (those with lived/living experience of substance use working in overdose response settings) are at the forefront of overdose response initiatives in British Columbia (BC). Working in these settings can be stressful, with lasting social, mental and emotional impacts. Peer workers have also been disproportionately burdened by the current dual public health crises characterized by the onset of the COVID-19 pandemic and rise in illicit drug overdose deaths. It is therefore critical to develop supports tailored specifically to their realities.Methods: We used the steps outlined in the Intervention Mapping (IM) framework to identify needs of peer workers and design an intervention model to support peer workers in overdose response settings. Eight peer-led focus groups were conducted at the pilot sites and other community settings to identify peer workers’ needs and transcripts were analyzed using interpretive description. The strategies within the intervention model were informed by the organizational development theory as well as by the lived/living experience of peer workers. Results: The support needs identified by peer workers were categorized into three key themes and these formed the basis of an intervention model titled ‘ROSE’; R stands for Recognition of Peer Work, O for Organizational Support, S for Skill Development and E for Everyone. The ROSE model aims to facilitate culture change within organizations, leading towards a more equitable and just workplace for peer workers. This, in turn, has the potential for positive socio-ecological impact. Conclusions: Centering lived/living experience in the Intervention Mapping process led us to develop a framework for supporting peer workers in BC. The ROSE model can be used as a baseline for other organizations employing peer workers.