Petrina is the W3 Project Research Officer at La Trobe University's Australian Research Centre in Sex, Health and Society (ARCSHS). Before stepping into research, she worked for nearly 10 years in health promotion, primarily for community-based organisations. She is deeply committed to peer-led, person-centred, rights-based approaches to health.

Background

Peer-led organisations for people who use drugs (PWUD) are critical to improving the health of their community and advocating against detrimental laws and policies. However, evaluations of peer-led work often do not demonstrate the full scope of their impact, such as community-level impact or influence on health systems. Consolidating this evidence across organisations may provide deeper insight.


Methodology

The W3 Framework (https://w3framework.org) provides a conceptual model to support peer-led organisations to demonstrate their full impact and value. We drew on the W3 Framework to pool data from PWUD-led organisations in Australia to create a consolidated evidence base.

Working with partner organisations, we located evidence for a set of collaboratively developed evaluation indicators. Evidence was assembled in NVivo. Analysis drew from framework synthesis and textual narrative synthesis methodologies.


Results

Our findings indicate that PWUD-led organisations have strong processes and impact across all areas of the W3 Framework (engagement with community; collaboration with relevant sector partners; adaptation to change; and influence on communities, health systems, and policy environments).

Despite the level to which the health sector values and relies on their work, PWUD-led organisations continue to face considerable systemic and structural barriers, including criminalisation, stigma, discrimination, and lack of resources. These barriers impact their capacity both to undertake and to document and evaluate their work.


Conclusion

This work is the first consolidated evidence base of the broader value of PWUD-led work. The results can support PWUD-led organisations in their work with communities, and in their negotiations with sector partners and funders. From this work, we have gained a clearer understanding of:

•The impact and role of PWUD-led organisations within Australia’s public health response
•How to identify and use alternative, non-traditional forms of evidence to demonstrate impact
•Insights and guidance for the investment and scale-up of peer programs in priority populations