Core competencies of peer workers who use pulse oximeters to supplement their overdose response in British Columbia

Abstract

Introduction Peer workers (those with lived/living experience of substance use) are at the forefront of overdose response initiatives in British Columbia, Canada. The onset of the coronavirus disease pandemic has significantly compounded the impact of the overdose crisis. Peer workers are integral in supporting people who use substances. However, despite the important work they do, peer workers often lack formalized credibility and do not have the same resources available to them as service providers without lived experience. The peer-led project titled the Peer2Peer Project implemented several support programs for peer workers, including providing pulse oximeters to peer workers to supplement their overdose response procedures. Materials and methods This study was a component of a larger evaluation of the pulse oximeter program at two organizations in BC. The study aims to highlight the competencies of peer workers who use pulse oximeters. Telephone interviews were conducted with seven peer workers who were given pulse oximeters. The transcripts were thematically coded using Covert et al.’s framework of core competencies of community health workers to compare our sample with other widely recognized professions. Findings We found that peer workers who used pulse oximeters described several core competencies in their work and these were aligned with Covert et al.’s core competencies for community health workers, including assessment, community health practice, communication, diversity and inclusion, professional practice, and disease prevention and management. Conclusion By aligning peer workers’ skills to those of community health workers, we create awareness on the competencies of peer workers in using oximeters to supplement overdose response and advocate for them to receive more recognition and respect within the workplace. Further, our findings act as groundwork for future research in identifying the professional proficiencies of peer workers.

Feeling safer: effectiveness, feasibility, and acceptability of continuous pulse oximetry for people who smoke opioids at overdose prevention services in British Columbia, Canada

“…For instance, from an equity lens, oximetry has been shown to be less reliable among people with darker skin tones [ 38 ] and therefore, additional measures to promote safe monitoring may be required for certain ethnic and racial minorities. Our study offers crucial lessons about participatory research strategies: meaningful partnerships with people with lived/living experience of drug use in all aspects of design and implementation [ 39 , 40 ] and capacity-building [ 27 , 41 ] were integral to our success. OPS sites guided necessary steps in study implementation to ensure that our oximetry protocol met the needs of participating OPS clients and staff.…”

“…We employed a participatory/community-based design, collaborating with people with lived/living experience of substance use throughout planning, implementation, analysis, and knowledge translation. We held three planning meetings to co-develop procedures and instruments with the Professionals for Ethical Engagement of Peers (PEEP), a BC Centre for Disease Control provincial peer advisory committee [ 27 , 28 ]. We engaged OPS staff to identify site-specific needs and facilitate implementation.…”

“…Peers reported that non-continuous finger pulse oximeters helped them to identify need for response and to clarify next steps, improving confidence in their decisions. Specifically, non-continuous finger pulse oximeters assisted peers to build competencies in client assessments (e.g., using data to decide on interventions), community health practice (e.g., advocating for clients’ needs), communication (e.g., distributing health information to community members), and professional practice (e.g., functioning as part of a health care team) [ 27 , 28 ]. Pulse oximetry has also been used in other settings by dedicated healthcare providers monitoring people who use opioids to determine the need for further interventions (e.g., supplemental oxygen, naloxone) [ 29 ].…”

Factors associated with obtaining prescribed safer supply among people accessing harm reduction services: findings from a cross-sectional survey

“…Finding may re ect the important role people working at OPS and DCS sites play in connecting clients to ancillary harm reduction and treatment services such as PSS. The role of people with lived and living experience of substance use in overdose response in BC must be acknowledged, where many DCS and OPS services rely on the expertise and leadership of people working in what are often termed "Peer worker" roles (41)(42)(43)(44). Studies have demonstrated that Peer workers rely on their informal roles and social networks to develop a sense of trust and safety that cannot be met by nonpeer staff (45).…”

Predisposing, enabling and reinforcing factors associated with opioid addiction helping behaviour in tri-state Appalachian counties: application of the PRECEDE–PROCEED model–cross-sectional analysis

“…These types of training have been shown to be an effective strategy to increase skills and helping behaviour in other populations, particularly when structured in a harm reduction context and when delivered in a peer-to-peer format 43. Peer-to-peer interventions are important strategies to address the overdose epidemic, as these programmes help to engage individuals in addressing the overdose epidemic and aid in rebuilding trust in the healthcare system 30 44. Public health professionals should consider implementing naloxone-based training, an important predisposing skill to address potential opioid-related overdoses, in communities substantially impacted by the overdose epidemic in order to equip all members of the community to intervene with bystander or peer-to-peer intervention.…”