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The W3 Functions

The W3 Functions are the system-level functions that underpin effective peer work within a public health response.

There are four W3 Functions:

  • Engagement
  • Alignment
  • Adaptation
  • Influence

It is important to realise that the functions are all related. Therefore, to be as effective as possible, peer work needs all four functions to be occurring strongly. A peer response’s ability to do this is strongly affected by the overall health system and policy environment. Other organisations can be enablers or barriers to peer work.

This post explains each of the W3 Functions.

Estimated reading time: 8 minutes

What are the W3 Functions?

The W3 Functions are a key feature of the W3 Framework. Within the Framework, the W3 Functions are interrelated but distinct system-level functions that underpin peer work:

  • with a diversity of peers
  • Alignment between the peer response and the health sector and policy environment
  • Adaptation to emerging issues
  • Influence on peers and their communities and within the health sector and policy environment

Each of the W3 Functions is an umbrella term that covers a range of different activities, attributes, and outcomes. The more strongly the functions occur, the more effective the peer response and, ultimately, the overall public health response.

Engagement

Peer workers — and, by extension, their peer responses — have a strong and up-to-date understanding of their communities. As a result, they are finely attuned to their communities’ diverse and changing needs.

Peer responses are, therefore, part of the communities they work in. They feel the same tensions and the same challenges. They also play a role in community debate. Their communities trust that they are authentic and credible because of this.

Engagement, therefore, is not just about peer programs, activities, and services. It is also about how the peer response participates within its community on a deeper level.

Peer-to-peer interactions are central to effective engagement. Each interaction — whether it is part of their work or in their day-to-day lives — improves a peer worker’s skills and knowledge. This, in turn, leads to deeper and more authentic engagement.

Alignment

Alignment is about how peer work interacts with and learns from the broader health sector and policy environment.

As well as being part of their communities, peer responses are also part of the broader health sector and policy environment. Peer-led work within the health response is part of that response. A health-related peer program is a health program in its own right. In short, peer workers are health professionals.

As health professionals, peer workers pick up insights from the broader health sector and policy environment. This might be, for example, changes to:

  • Laws, policies, or policing strategies
  • Organisational partnerships within the sector
  • Epidemiology
  • Treatment availability and options
  • The services delivered by partner organisations
  • Access to health services

Peer responses draw on these insights to identify implications for their own community and/or work. In particular, they determine whether changes within the sector are likely to support or undermine their work or their community’s needs. They can then draw on peer insight to identify how best to respond.

When alignment is strong, the broader health sector recognises peer workers — not only as health workers but also as the experts on their own communities.

Strong alignment creates an environment in which peer and non-peer responses enhance each other’s work because:

  • Peer responses gain real-time insights into changes as they occur within policy and health system
  • Mainstream health responses and policymakers seek and act on the advice of peer responses
  • There is consistency between the needs of communities and the goals of the health sector and policy environment

Adaptation

Adaptation is about how peer work takes everything it learns through engagement and adaptation and uses that new knowledge to improve the way it works.

Of all the W3 Functions, adaptation is perhaps the most central to why peer responses are so important in a health response, and how they can have such strong, positive effects.

Communities and the health system and policy environment are complex systems. That is to say, they are constantly changing. Peer responses use their strong understanding of their communities to predict how changes might affect their community’s wellbeing. They can also pre-empt how their communities might react or respond to the changes. What’s more, they use these insights to adjust the way they work to either mitigate potential negative effects on their communities or to enhance positive ones.

Strong adaptation ensures that peer work:

  • Doesn’t become outdated
  • Maintains or increases its effectiveness
  • Takes advantage of positive changes
  • Minimises harmful effects that changes might have on their communities

Influence

Influence is about how well the peer work can achieve or mobilise change within the overall W3 Framework system.

Although Influence exists in the W3 Function as a single function, it is useful to think about it as having two parts:

  • Influence within the peer response’s community
  • Influence within the health sector and policy environment

Community Influence

Community influence is about how well the peer response can affect their community’s health, behaviour, knowledge, or attitudes (for example, through health promotion, harm reduction, or support services).

Peer responses derive their influence from the fact that they are part of their communities. In other words, they operate within communities instead of intervening on them.

Community influence is a strong reflection of a peer response’s engagement and cultural authenticity. This is particularly demonstrated by:

  • The level of trust communities have in the peer response
  • Whether communities see the peer response as culturally credible and authentic
  • Whether communities feel that the peer response is based on the reality of their shared experiences

Policy and health system influence

Policy and health system influence is about how the peer response achieves or mobilises change within the health sector and policy environment to make them more effective and equitable.

This includes influence on processes and outcomes; for example, changes to the way health services are run or changes to specific health department policies.

Insights from peer workers may be the broader sector’s only source of real-time knowledge about emerging issues. This places peer responses in a strong position to provide valuable strategic insights and guidance to funders, policymakers, health services, and researchers.

Policy influence is a strong reflection of a peer response’s alignment. It is particularly demonstrated by:

  • The strength of the peer response’s sector-wide partnerships
  • The peer response’s level of participation in the health sector and policy
  • The peer response’s ability to produce meaningful recommendations and strategic advice for the broader sector

On the other hand, influence is undermined by weak alignment and stigma within the health system and policy environment.

How do the W3 Functions relate to each other?

The W3 Framework represents the complex system in which peer work takes place. All the system’s parts are interrelated in any complex system. In this regard, the W3 Framework system is no different. The W3 Functions all impact each other, and they are all affected by each other.

This means that achieving strong performance in one function strengthens all of the others. By the same token, weak performance in any one function will weaken the others. We can use the W3 Framework can help us understand how this works.

Take engagement, for example:

  1. Strong creates a stronger understanding of community needs and issues.
  2. A peer response that is fully attuned to their community can more effectively adapt to their changing needs and priorities (improved adaptation).
  3. If the community feels that the peer response understands and is responsive to their needs, they place more trust in the response (improved community influence).
  4. Likewise, if the peer response has compelling evidence that they speak for and have a strong understanding of their community, they are in a strong position to influence the rest of the health sector and policy environment (improved policy and health system influence).
  5. Furthermore, consistently being a credible, trustworthy, and essential source of policy advice and information about their community improves a peer response’s sector-wide reputation and helps strengthen its partnerships (improved alignment).

Of course, this is just one (heavily simplified) example of how the W3 Functions are related. It is important to remember that you could start with any of the Functions and move around the Framework in a similar way.

Conclusion

The key takeaways from all of this are:

Firstly, in order to have the strongest positive impact possible, a peer response needs to pursue all the W3 Functions.

Secondly — and perhaps most importantly — for a health response to be as effective as possible, it needs to value peer responses. This includes creating an enabling environment for peer responses to achieve their full potential, as described by all the W3 Functions.

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