A Brief Overview of the Peer Engagement Principles and Best Practices

Key findings related to emerging/promising principles for engaging PWLLE:

• PEERS AS EXPERTS – expertise is valued by recognizing peer’s interest, placing emphasis on their voices, and providing fair and equitable compensation.
• EQUITY – peers experience barriers, discrimination and differences in relationships, compensation and health due to the social positionality of people who use drugs in our society. Promoting equity requires acknowledging these factors and addressing them, and restructuring power differences in decision making.
• DIVERSITY – peers are not all the same and have a range of different voices and experiences that need to be heard.
• TRANSPARENCY – acknowledging successes and failures. Providing evidence and rationale for decision-making, revealing power dynamics, and providing honest and forthcoming explanations for processes and outcomes.
• ACCOUNTABILITY – peer engagement practitioners must take responsibility for their decisions and actions and provide rationales for them.
• SHARED DECISION-MAKING POWER – recognizing and addressing differences in power in decision-making tables is key to the success and validity of voices in peers’ engagement work.
• INCREASING CAPACITY – key to concrete skills, knowledge, goals and confidence in peer engagement.

Key findings related to emerging/promising practices for engaging PWLLE:

• Engage with Several Peers – 2+ is recommended for best practice and will bring a range of perspectives.
• Informed recruitment processes can be supported by peer-based organizations, other peers and providers. Identifying as a peer in some regions may be difficult where drug use is highly stigmatizing. Anonymity and confidentiality are important during this process.
• Clear expectations of knowledge, collaboration, and discussion with all – peers and other team members alike; including what engagement goals are, role expectation, how voices will be heard and used.
• Partnering with peer-based organizations run by peers are important to recognize a range of voices.
• Equitable pay – peers should be paid the same as others (non-peers) doing similar work. Cash stipend is considered best practice; however, discuss with peers what their financial situation is, including barriers, and what works best for them.
• Develop capacity – Capacity building should take a strengths-based approach by identifying and bolstering the strengths peers and other staff bring to the team. Training opportunities include those related to cultural safety, trauma informed care, compassionate engagement, and other skills-based training. Such training promotes sustainability and future employment opportunities.
• Overcome Barriers – Common barriers for people who use drugs include location, travel, childcare, substance use or opioid agonist therapy, and literacy. However, do not make assumptions as to which barriers peers face or how they should be navigated (or by whom).
• Work with Peer mentors as navigators – Peer mentors are people who have previously engaged with providers. Using this experiential knowledge, mentors support peers in ways that non-experiential staff cannot.
• Meaningfully Disengage – There can be an intense feeling of loss and isolation among peers and providers at the end of an engagement project. Connecting with peers’ support networks can assist peers in this transition period.
• Evaluate and Share Outputs.

Key findings on policy: Engaging with peers when designing health and policy solutions can help to mitigate equity issues through capacity building and empowerment.

Key Findings Related Implementation Approaches: Have ongoing flowing communication with peer during the implementation of engagement, in case elements need to be revised, or added. Be committed to provide support, be flexible where needed.