Participant and Staff Experiences in a Peer-Delivered HIV Intervention with Injection Drug Users

Kostick, Kristin M.; Weeks, Margaret R.; Mosher, Heather

doi:10.1525/jer.2014.9.1.6

Cited by 5 publications

(4 citation statements)

References 31 publications

(41 reference statements)

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“…Clinic leadership team members also discussed potential risks for patients engaging in health advocacy in the community with out-of-treatment drug users (Kostick, Weeks & Mosher 2014). Of significant concern was the need to address core component #2.…”

Section: Resultsmentioning

confidence: 99%

“…In-depth interviews facilitated examination of staffs’ and patients’ ethical concerns for maintaining patient safety during outreach (Kostick, Weeks & Mosher 2014). These interviews also revealed the personal benefits and challenges patients perceived of peer intervention delivery as they became bridges between drug users in the clinic and in the community.…”

Section: Discussionmentioning

confidence: 99%

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Translation of the Risk Avoidance Partnership (RAP) for Implementation in Outpatient Drug Treatment Clinics

Weeks

Kostick

et al. 2015

Journal of Psychoactive Drugs

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Background Scientific literature increasingly calls for studies to translate evidence-based interventions into real-world contexts balancing fidelity to the original design and fit to the new setting. The Risk Avoidance Partnership (RAP) is a health promotion intervention originally designed to train active drug users to become Peer Health Advocates. Objectives A theoretically driven approach was used to adapt RAP to fit implementation in outpatient methadone treatment clinics and pilot it with clinic patients. Methods Ethnographic observations and process tracking documented the RAP translation and pilot experience, and clinic and community characteristics relevant to program implementation. Clinic administrators, staff, and patients were interviewed on their values, capacities, interest in RAP, perceived challenges of implementing RAP in drug treatment clinics, and experiences during the pilot. Results Findings indicated that RAP core components can be met when implemented in these settings and RAP can fit with the goals, interests, and other programs of the clinic. Conclusions Balancing fidelity and fit requires recognition of the mutual impacts RAP and the clinic have on each other, which generate new interactions among staff and require ongoing specification of RAP to keep abreast of clinic and community changes. Collaboration of multiple stakeholders significantly benefited translation and pilot processes.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Translation of the Risk Avoidance Partnership (RAP) for Implementation in Outpatient Drug Treatment Clinics

Weeks

Kostick

et al. 2015

Journal of Psychoactive Drugs

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“…These include relationship dilemmas and other stressors on fieldworkers, who are often seen as ‘gatekeepers’ to resources or resented for their paid research positions and face raised expectations from study participants and local communities (Molyneux et al, 2009; Kamuya et al, 2013; Kamuya et al, 2014). Suggestions for supporting frontline research workers and strengthening human subjects protection include providing customized ethics training that draws upon past challenges of fieldworkers working in similar contexts to incorporate local examples, role-play, and immediate feedback (Kamuya et al, 2014; Kostick et al, 2014). Given the particularities of each study and the evolving nature of dilemmas encountered in the field, such training should be continuous and include regular debriefing sessions and observations in the field by supervisors to keep them apprised of the conditions in which CRs are conducting research activities.…”

Section: Discussionmentioning

confidence: 99%

Supporting the role of community members employed as research staff: Perspectives of community researchers working in addiction research

True¹,

Alexander

Fisher

2017

Social Science & Medicine

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Community researchers are laypersons who conduct research activities in their own communities. In addiction and HIV research, community researchers are valued for their insider status and knowledge. At the same time, their presence on the research team raises concerns about coercion and confidentiality when community researchers and participants know each other personally, and the work of navigating between the worlds of research and community leads to moral distress and burnout for some community researchers. In this paper, we draw upon the concept of ‘moral experience’ to explore the local moral worlds of community researchers in the context of addiction research. In February and March, 2010, we conducted focus groups with 36 community researchers employed on community-based addiction studies in the United States to elicit perspectives on ethical and moral challenges they face in their work and insights on best practices to support their role in research. Community researchers described how their values were realized or thwarted in the context of research, and their strategies for coping with shifting identities and competing priorities. They delineated how their knowledge could be used to inform development of research protocols and help principal investigators build and maintain trust with the community researchers on their teams. Our findings contribute to current understandings of the moral experiences of community members employed in research, and inform policies and practices for the growing field of community-engaged research. Funders, research organizations, and research ethics boards should develop guidelines and standards to ensure studies have key resources in place to support community researchers and ensure quality and integrity of community-engaged work. Investigators who work with community researchers should ensure channels for frontline staff to provide input on research protocols and to create an atmosphere where challenges and concerns can be openly and safely discussed.

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“…Past research with non-migrant populations has demonstrated the importance of peer-led or community-based models for enhancing the responsible conduct of community- and policy-relevant research. [ 44 , 46 , 103 , 106 , 110 , 112 , 113 ] As this issue has rarely been critically examined with respect to the engagement of highly mobile migrant populations in research, future efforts to identify appropriate models for the democratization of knowledge production and exchange among marginalized migrant populations remain needed (e.g., how to ensure meaningful community engagement in the design, conduct, and dissemination of research; feasibility of peer designs for mobile groups).…”

Section: Discussionmentioning

confidence: 99%

Enhancing the Ethical Conduct of HIV Research with Migrant Sex Workers: Human Rights, Policy, and Social Contextual Influences

et al. 2016

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BackgroundMigrant sex workers are often highly marginalized and disproportionately experience health and social inequities, including high prevalence of HIV, sexually transmitted infections, and human rights violations. In recent years, research involving migrant sex workers has increased, yet many knowledge gaps remain regarding how best to protect research participant rights and welfare. Our objective was to identify key challenges and opportunities related to the responsible conduct of HIV research with migrant sex workers.MethodsFocus groups and interviews conducted with 33 female sex workers ≥18 years old at the Guatemala-Mexico border from June 2013–February 2014 were analyzed. Participants were recruited through community outreach by a local HIV prevention organization to sex work establishments such as bars, hotels, street corners, and truck stops.ResultsKey themes influencing research engagement for migrant sex workers included researcher mistrust and fear related to research participation, rooted in the social isolation frequently faced by recent migrants; intersecting concerns related to immigration status, fear of criminalization, and compliance with sex work regulations; and perceived benefits and risks of HIV/STI testing for migrants (e.g., immigration implications, stigma) represent potential barriers and opportunities for the responsible conduct of research involving migrant sex workers.ConclusionsResults highlight the intersection between the human rights vulnerabilities of migrant sex workers and barriers to research participation, including social isolation of migrants and policy/legal barriers related to immigration and sex work. Findings illustrate the need for researchers to develop population-tailored procedures to address fears related to immigration and criminalization, and to reinforce positive and non-stigmatizing relationships with migrant sex workers. Community-led efforts to reduce stigma and foster community organization and supports for migrant sex workers are recommended, as are broader policy shifts that move away from punitive legal approaches towards approaches that safeguard and prioritize the human rights of migrant sex workers.

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Participant and Staff Experiences in a Peer-Delivered HIV Intervention with Injection Drug Users

Cited by 5 publications

References 31 publications

Translation of the Risk Avoidance Partnership (RAP) for Implementation in Outpatient Drug Treatment Clinics

Translation of the Risk Avoidance Partnership (RAP) for Implementation in Outpatient Drug Treatment Clinics

Supporting the role of community members employed as research staff: Perspectives of community researchers working in addiction research

Enhancing the Ethical Conduct of HIV Research with Migrant Sex Workers: Human Rights, Policy, and Social Contextual Influences

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