Assessing community (peer) researcher’s experiences with conducting spirometry and being engaged in the ‘Participatory Research in Ottawa: Management and Point-of-care for Tobacco-dependence’ (PROMPT) project

Abstract

Plain summaryThis article examines the overall experiences of community researchers in their involvement with the ‘PROMPT’ project for smoking cessation, which targeted community members who were homeless or at-risk for homelessness. More specifically, four community members, representing the study population were involved in the project as researchers. They were asked to complete surveys at both the beginning and end of each research training session to better understand their learning as it related to using a key instrument for this project, a spirometer, to measure project participants’ lung function. Spirometry is typically performed by trained healthcare providers. Community researchers were also interviewed to explore what their experiences were like working as a researcher with their own at-risk community. Although the researchers felt that the training was sufficient, more research is needed to evaluate training effectiveness among community researchers in delivering acceptable quality lung function testing using a spirometer. Upon analyzing the small group discussion and survey results, we found that the community researchers had an overall positive experience with both the project, and the training that was provided to equip them with the knowledge, tools, and resources they needed to successfully work in a research project of this kind. They also faced challenges that are common in such community-based projects, such as the power differential between the researchers with a healthcare background and themselves who have lived experience with the issue at hand.Abstract Background The Ottawa Citizen Engagement and Action Model (OCEAM) used a Community Based Participatory Action Research (CBPAR) approach by involving the most at-risk urban population. Community (peer) researchers participated in every step of the study despite the multiple challenges. Objective To assess the community researchers’ training and experiences in a CBPAR project, PROMPT: Participatory Research in Ottawa: Management and Point-of-care for Tobacco Dependence. Method Four community researchers were recruited, representative of the PROMPT project’s target population with current or past poly-substance use; smoking tobacco; and/or being homeless or at-risk for homelessness. The community researchers participated in all phases of PROMPT, including study design, development of questionnaires, participant recruitment, administering consent forms and questionnaires, as well as hand-held spirometry after rigorous training. To assess their knowledge and comfort level with spirometry testing after standardized training, questionnaires were administered pre- and post-training. In turn, to assess their overall experience, interviews were conducted at the end of study completion. Results All community researchers underwent small-group training sessions including presentations, discussions and hands-on practice adapted from standardized training material prepared for health care professionals. Spirometry training was included in all sessions. Se...

Provision of peer support at the intersection of homelessness and problem substance use services: a systematic ‘state of the art’ review

“…There were two other papers looking specifically at IPS -a qualitative study looking into the experiences of peer providers and recipients and their opinion of what makes IPS effective in homelessness recovery [34]; and a mixed methods Qsort study investigating the opinions of experts on what makes peer support effective with people who are homeless [35]. The remaining studies included: a quantitative pilot intervention of peer-led support for homeless youth [79]; a feasibility study of involving vendors of The Big Issue (a magazine sold by individuals who are homeless or at risk of homelessness that provides them with opportunities to earn an income) to become peer educators for people who are homeless to reduce drug related harms [55]; a study protocol for peer-led intervention for people who are experiencing homelessness and problem substance use [81]; a report from an independent evaluation of the Homeless Health Peer Advocacy Service programme on the impact on client's health, cost, and impact on the peers themselves [27]; a commentary on the need for more safe/supervised consumption sites and other overdose prevention interventions across a range of housing sites to minimise overdose risk [83]; a longitudinal evaluation of a Housing First peer support model [36]; an evaluation of the effects of peer delivered permanent supportive housing on health and mental health of an ethnically diverse population [51]; an evaluation of a group intensive peer support model of case management in a supported housing programme for homeless veterans [67], and four studies relating to smoking cessation peer interventions in poly-substance using individuals experiencing homelessness ( [47,48,54,80]).…”

“…Eleven of the included papers looked at the challenges that those in peer support roles can face ( [34,43,47,55,57,59,65,70,[88][89][90]). Five key themes emerged: vulnerability; authenticity; boundaries; stigma; and a lack of recognition of value of peers and these are now discussed.…”

“…Similarly, Wright and colleagues [43], in their qualitative exploration of peer provision of take home naloxone (THN), saw a clear theme of willingness to administer THN in an emergency situation but many peers worried about being charged with unintentionally causing death. Charron et al [47] assessed community researcher training and experience in the PROMPT project (the same intervention as [48]) and noted that peers felt accountable as project leaders, as illustrated in this quotation from one of the peers: 'Service providers can just go back to the office but as a peer you can't hide from your own community' ( [47], p.7).…”

“…Stigma was explicit in two papers ( [47,90]). Chapman et al [90] concluded that stigma, and the perception of stigma, regarding employing workers with lived experience of problem substance use/homelessness remained a problem in the workplace and included labelling, stereotyping, and experienced or internalised discrimination.…”

Patients’ engagement in primary care research: a case study in a Canadian context

“…A fundamental question where primary care research and health systems research is concerned is who researchers should seek to engage with. For disease-specific research such as arthritis [ 5 ], urinary tract infections [ 4 ], cancer or diabetes [ 6 ], it makes sense to engage patients with lived experience of the condition in question, and similarly for population-specific research, such as that involving the homeless [ 7 ] or adults with intellectual disabilities [ 8 ]. However, in primary health care and health systems research it is more difficult to know which patients to engage with, since these domains encompass the entire population.…”