Doing community-based research during dual public health emergencies (COVID and overdose)

Abstract

Meaningful engagement and partnerships with people who use drugs are essential to conducting research that is relevant and impactful in supporting desired outcomes of drug consumption as well as reducing drug-related harms of overdose and COVID-19. Community-based participatory research is a key strategy for engaging communities in research that directly affects their lives. While there are growing descriptions of community-based participatory research with people who use drugs and identification of key principles for conducting research, there is a gap in relation to models and frameworks to guide research partnerships with people who use drugs. The purpose of this paper is to provide a framework for research partnerships between people who use drugs and academic researchers, collaboratively developed and implemented as part of an evaluation of a provincial prescribed safer supply initiative introduced during dual public health emergencies (overdose and COVID-19) in British Columbia, Canada. The framework shifts from having researchers choose among multiple models (advisory, partnership and employment) to incorporating multiple roles within an overall community-based participatory research approach. Advocacy by and for drug users was identified as a key role and reason for engaging in research. Overall, both academic researchers and Peer Research Associates benefited within this collaborative partnerships approach. Each offered their expertise, creating opportunities for omni-directional learning and enhancing the research. The shift from fixed models to flexible roles allows for a range of involvement that accommodates varying time, energy and resources. Facilitators of involvement include development of trust and partnering with networks of people who use drugs, equitable pay, a graduate-level research assistant dedicated to ongoing orientation and communication, technical supports as well as fluidity in roles and opportunities. Key challenges included working in geographically dispersed locations, maintaining contact and connection over the course of the project and ensuring ongoing sustainable but flexible employment.

Primus Inter PARES: First among equals—practical strategies for young adult PAtient RESearch partners (PARES) by young adult PARES

“…This ensures that the collaborative spirit endures beyond the project's lifespan. The exclusion of diverse groups and the presence of systemic discrimination [4,15,35,42] are challenges we tackle with our Unity in Diversity approach. This strategy ensures the intentional inclusion of underrepresented groups in our research team, study, process and narrative, fostering a setting that celebrates diverse strengths and contributions while actively working against discrimination and stigma.…”

“…The proliferation of complex frameworks within the academic domain frequently manifests as a formidable barrier rather than an inviting landscape for prospective researchers, partners and participants [4,37,48,56,63,64]. This metaphorical "academic fortress, " as some of us prefer to call it, hinders the openness and approachability necessary to engage with POR.…”

“…A common issue in POR is the difficulty of sustaining long-term engagement [ 4 , 48 ]. Our Community Continuum strategy addresses this by creating a culture of mutual support and continuous collaboration through mentorship, capacity-sharing and community and relationship building.…”

Walk With Me: reducing harm and confronting the toxic drug poisoning crisis in small British Columbia cities through community engaged research

“…CER positions marginalized and often-overlooked community actors as experts on their own living environments, with significant expertise to contribute to policy discussions, equal to state actors and others who normally have a 'seat at the table' [5,17]. Such research is grounded in collaboration and engagement with those who are most affected by community crises (in our case, the TDPC, and its overlap with poverty, homelessness, and other 'wicked' societal issues), and seeks to ensure their equitable participation, with the goal of producing research results that can address the TDPC and bring awareness and action for change [5,18,19].…”

“…Indeed, as team member Christopher, who identifies as a PWLLE, shares, our team takes on "a great deal of responsibility to ensure that the voice and the work of the research […] doesn't exist to extract from community but rather to serve it. " As other researchers have noted, CER promotes equity by involving communities as Peer researchers who participate in decision-making, co-design the research and set priorities, and decide how the results will be presented to the public and policymakers [18]. Moreover, CER is critically important in advancing decolonial work that walks with Indigenous Peers and communities in respectful, reciprocal ways to "reflect and honour [their] experience" and lead to robust research outcomes that may not have been possible without their involvement [18,28,29].…”