The W3 Framework depicts the role of peer work in a public health response.
Using the W3 Framework can help:
- Peer workers plan and evaluate their work
- Mainstream health workers improve their own work’s impact through collaborating with peer-led responses
- Policymakers draw on peer expertise to develop more fair and effective health-related policies and laws to improve population health and wellbeing
- Researchers to understand peer work and the role of peers in a health response
Here is all the information you need to help you understand the W3 Framework.
Estimated reading time: 12 minutes
What is the W3 Framework?
The W3 Framework is a ‘systems map’ of peer work within an overall public health response.
By peer work, we mean the organised community response by members of marginalised, vulnerable, or ‘at-risk’ communities within an overall health response.
The map uses grey arrows to show how information and influence flow through peer-led responses between their communities and the broader health sector and policy environment. This helps us understand how the different parts of peer work interrelate. We can use this to help us plan or prioritise strategies, as well as evaluate quality and impact.
What are the parts of the W3 Framework?
The W3 Framework shows the different parts of the system using different shapes and colours.
- Shapes:
- Clouds are complex systems that exist within the W3 system
- Boxes are things that happen within the system, including elements of peer work and the W3 Functions
- Arrows are flows of knowledge and influence around the system
- Colours:
- Red represents peer organisations, programs, services, and workers
- Yellow represents both community and the W3 Function engagement
- Blue represents the broader health sector and policy environment and the W3 Function alignment
- Green represents the W3 Function adaptation
- Purple represents the W3 Function influence
Complex systems within the W3 Framework
There are two complex systems within the W3 Framework system:
Communities
Health sector and policy environment
Peer work is a part of both systems. Effective peer work is valued by, and has influence within, both systems. Therefore, although the two systems are shown as separate in the W3 Framework, in reality, they overlap.
In addition to peer work, communities also include diverse individuals, families, social networks, cultures, tensions, community spaces, and grassroots organisations and businesses with shared (or overlapping) backgrounds, experiences, identities, attitudes, and/or interests.
The health sector and policy environment includes peer work as well as government, health services, social services, other community organisations, research, politics, media, policies, laws, enforcement practices, and any other formal structure or system that can impact the health of communities.
Peer work
There are three core elements of peer work depicted in the W3 Framework (shown in red):
- Peer-based activities
- Practitioner learning
- Organisational knowledge, practices, and resources
Peer-based activities are the things peer organisations, programs, services, and workers do.
Practitioner learning is how peer workers gain skills and knowledge through their work and lived experience as peers.
Organisational knowledge, practices, and resources are everything an organisation can access and draw from to do its work, such as:
- The collective knowledge of all of its workers, past and present
- Formal policies, procedures, and guidelines
- Organisational culture
- Funding
- Physical space and materials
- Partnerships and allies
The W3 Functions
There are four W3 Functions:
- Engagement
- Alignment
- Adaptation
- Influence
Think of the W3 Functions as roles or purposes rather than as activities. They are umbrella terms that cover all and any related activities, attributes, and outcomes.
Engagement is about how the peer response interacts with and learns from its communities.
Alignment is about how the peer response interacts with, partners with, and learns from the broader health sector and policy environment.
Adaptation is about how the peer response changes the way it works to keep up with its changing environment.
Influence is about how the peer response achieves or mobilises change within their communities as well as within the health sector and policy environment.
The most effective peer work performs strongly across all four W3 Functions. It is important to think about how well all these roles or purposes are being fulfilled, not just about whether specific activities are happening.
Flows of knowledge and influence
The arrows represent the way knowledge and influence flow through the system. This is incredibly broad. It does not refer only to the knowledge of or influence on individual people but also to organisational-level, community-level, and sector-level knowledge and influence.
How do I ‘read’ the W3 Framework?
To ‘read’ the W3 Framework, follow the arrows around the map from one cloud or box or circle to the next. These pathways of arrows show you how knowledge and influence flow around the system.
Let’s look at one short pathway as an example:
Peer-based activities → Practitioner learning → Adaptation → Peer-based activities (→ Practitioner learning and so on and so forth)
The general story this pathway tells is:
Peers work with their communities and with other services and organisations (peer-based activities). As they work and gain experience, they improve their understanding of their work (practitioner learning). As they gain experience and understanding, they get better at meeting the diverse and changing needs of clients and sector partners (adaptation). This contributes to the overall improvement (also adaptation) of the peer work as a whole (peer-based activities).
We hope this quite simple and generic story helps illustrate how you can use the W3 Framework to help you describe and make sense of real-life events and scenarios.
Some things to remember when using the W3 Framework
Keep in mind the following things to help you think about the system mapped by the W3 Framework.
Other organisations in the policy and health system can be enablers or barriers to peer work achieving the W3 Functions
The W3 Framework is a system map, and a defining feature of a system is that every element in a system impacts the way the system works.
Therefore, whether the peer response works well is not only about the quality of the peer work. It is also about the quality of the mainstream services and policies.
For example, if mainstream services tolerate or perpetuate stigma towards vulnerable and marginalised communities, peer work is more likely to be ignored within the policy and health system.
On the other hand, peer work is more likely to be leveraged if mainstream services are allies who challenge stigma, demonstrate confidence in peer advice, and advocate for the peer-led response’s position.
It is important to look at the feedback loops
To use systems-thinking jargon: because all the flows are of the same stock, and because they all indicate increases in that stock, they are all reinforcing feedback loops.
Put another way, the arrows are all flows of knowledge and influence.
If the element at the start of the arrow is working well, the flows of knowledge or influence coming from it will be stronger. On the other hand, if the element at the start of the arrow is not working well, the flows of knowledge and influence will be weaker.
Strong flows of knowledge and influence improve or strengthen the element at the end of the arrow. Likewise, weak flows of knowledge or influence decrease the potential effectiveness of the element at the receiving end.
It is possible to pick any two elements in the W3 Framework and find a pathway that goes from one, through the other, and back to the first one again. This means that the whole system becomes stronger when things are working well. Conversely, the whole system becomes weaker when they are not.
When finding loops between two elements, you’ll notice that some are long and convoluted while others are quite short. We can use this to start to understand when some elements or flows of knowledge or influence may have greater, faster, or more far-reaching impacts than others.
Video walk-through of the W3 Framework
Video walk-through transcript
Introduction (0:00)
Hi. I’m Daniel from the Understanding What Works and Why Project (or W3 Project) at the Australian Research Centre in Sex, Health and Society. In this presentation, I’m going to walk you through the W3 Framework for learning and evaluation.
Developing the W3 Framework (0:14)
We used concepts and methods from complex systems to articulate program theories for three different programs using peer-based approaches to respond to HIV and hepatitis C.
The W3 Framework takes a helicopter view of the common themes across all three programs. To develop it, we asked the question: What are the functions that any peer-based program would need to fulfill in order to remain effective and sustainable in a continually changing environment?
The systems in the W3 Framework (0:40)
The diagram shows the program in between two clouds. The clouds represent separate but overlapping complex adaptive systems. On the left, the community system refers to the communities, networks, and cultures the program seeks to engage with. On the right, the policy system includes the health system, legislators and policy makers and funders, clinical disciplines, social research and surveillance, and so on.
A key thing to note about these systems is that they are constantly changing. Outcomes in each system reflect the interaction of enormous numbers of very diverse players. As a result, we never have a complete picture of what’s going on or how they work. Programs’ effectiveness depends on keeping up with the changes, but they only ever receive partial signals about what’s happening.
In other words, a program’s effectiveness depends on capturing as many insights as it can from practice, and then using those insights to refine mental models of:
- The structure of the systems in its environment
- How they work
- How they are changing
Flows of knowledge and influence (1:42)
The diagram I’m about to show you maps out the flows of knowledge and influence that are crucial to the program being effective and sustainable in this kind of environment.
We looked at peer-based programs working on three different levels from:
- Peer service provision in a needle and syringe program
- Peer health promotion targeting sexually adventurous men who have sex with men
- Peer leadership and policy advocacy in a coalition of people living with HIV/AIDS organisations
You can see those in the red box.
Most evaluations only look at two things. They look at quality process in the activities and some limited measures of impact on the community. To us, that sounds a bit one-off, like the end of the line. And in the W3 Project, we’re interested in ongoing cycles of influence.
W3 Functions (2:34)
Influence (2:34)
As you can see in the golden box, influence is the first of four key functions in the W3 Framework. We define those functions as ‘things that need to be happening for a program to be effective and sustainable in a continually changing community and political environment’.
Our framework builds on past research that looks at how to improve monitoring and evaluation in programs, reflective practice by practitioners, and the practices that make up a learning organisation. So, you can see there that peer-based activities feed into practitioner learning, and from there into organisational knowledge, practices, and resources on the diagram.
Adaptation (3:13)
These support our second key function, which is adaptation.
In this project, we have a particular focus on looking for signs of programs changing their approach according to revised mental models based on insights obtained from practice. In fact, we’re quite tough about this. If the program doesn’t change, it can’t say it has learned anything.
Engagement and influence on community (3:38)
The other big difference about this framework is the value that we place on peer-based programs as sources of knowledge about what’s happening in the rapidly changing and highly diverse communities they engage with. The quality of engagement flows through to peer activities and then onwards to influence on the community.
In the diagram, you can see the arrows show that the quality of engagement flows through to peer activities and, from there onwards, to affect influence on the community. In other words, if engagement quality is low, no matter how great your activities are, your influence will also be poor.
As communities are continually changing, a program needs to use insights obtained from engagement and practice to inform practitioner learning. And a key step that’s often missed is capturing those insights as assets for organisational knowledge.
Influence on policy and the sector (4:37)
We found that insights acquired through practice learning and peer skill can inform the program’s participation in policymaking and advocacy within the sector. In this respect, peer insights can sustain influence not just on the community but also on the policy system as well.
Alignment (4:56)
Finally, programs also need to pick up insights about what’s going on in the policy system. The policy system includes things like surveillance and social research. So, changing knowledge in those fields might be fed into adaptation of peer-based activities. But it also includes policymaking and advocacy by other players in the sector, and insights about those activities might be fed into strategic planning for the future of the program.
Long-term influence on communities through influence on the policy system (5:28)
Lastly, there’s a dotted line showing that changes in the policy system also impact on the community system. But that can take a very long time. So, for programs involved in peer leadership and policy advocacy, the community may not recognise these changes as a product of their work. That’s why quality and visibility of engagement and direct community influence may be more important to the program having legitimacy in the community it’s working with.
Using the W3 Framework (5:55)
It’s possible to use this framework in a variety of ways.
One way is to use it as a framework for inquiry. The diagram is at a very high level of abstraction and every program in the real world will have different ways of doing things to accomplish these functions. So, the definitions here on this screen act as prompts for evaluators to make inquiries about how these particular functions are carried out in a program that they’re working with.
The other way to use it is as a framework for developing indicators for monitoring quality improvement and adaptation over time. Does the program maintain up-to-date mental models of the diversity of needs, experiences, and identities in its target communities? What would it look like this were happening? And what different sources of data and insights from practice might inform our confidence that this is actually happening?
Where to next?
To sum up, the W3 Framework shows you where and how peer work fits into an overall public health response. Understanding how to look at peer work through the W3 Framework can help you build stories to explain what you might see in your work or your community.
Now that you have a basic understanding of the parts of the W3 Framework and how to interpret them, you are ready to start using it to help:
- Improve your understanding of peer work
- Conduct more robust evaluations of peer work
- Improve the overall quality and impact of public health responses