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The W3 Project, Stage 2 (2016-2019)

In Stage 2 of the W3 Project, we partnered with two peer-led organisations to pilot the W3 Framework.

Working together with peer staff from organisations led by people living with HIV and people who use drugs, we developed processes and tools to implement the W3 Framework in their practice.

This post explores how we did this and highlights some of the key things we learned.

The image shows the original banner from the W3 Project website. The background is a blurred image of a crowded streetscape. W3 Project is written in white letters in a black box. Underneath is a red line. Under the red line, it says, “Understanding what works and why in peer-based and peer-led programs in HIV and hepatitis C”.

Background to Stage 2 of the W3 Project

In the first stage of the W3 Project, we worked with 10 community and peer-led organisations to improve our understanding of the peer response to HIV and hepatitis C. Through this work, we developed a new quality and evaluation framework for peer-led programs: the W3 Framework.

In the W3 Project’s second stage, we wanted to continue supporting community and peer-led organisations to:

  • Demonstrate their quality and impact
  • Adapt their programs to the rapid changes occurring in HIV and hepatitis C
  • Increase their value-add to the overall sector response
  • Strengthen the evidence base to guide investment in community-based and peer-led health promotion programs

With this purpose in mind, our plan was to trial and refine the W3 Framework in practice. Most importantly, we hoped to translate what we learned in Stage 1 into on-the-ground tools and strategies that:

  • Enhanced the evidence base for peer-led programs
  • Were sustainable within the resources available to community organisations

Objectives

Stage 2 of the W3 Project had 2 primary objectives.

Working with staff working in peer-based HIV and hepatitis C prevention programs, we wanted to:

  • Develop, trial, and refine tools to strengthen peer-led programs’ monitoring and evaluation practices
  • Assess how relevant, useful, and sustainable the tools were for real-world use

Methods and results

We partnered with two peer-led organisations in Victoria:

  • Harm Reduction Victoria, led by people who use drugs (PWUD)
  • Living Positive Victoria, led by people living with HIV (PLHIV)

Together with organisation staff, the W3 Project Team drew on the W3 Framework to develop clear indicators for peer-led programs. In order to do this, we needed to sit down with staff from all levels of the organisation and really analyse their programs and how they work.

Through many hours of discussions and workshops, we explored the answers to questions like:

  • What does achieving the W3 Functions actually mean for us? (In other words, what does engagement actually look like for our program? What do strong alignment, adaptation, and influence mean in our work?)
  • How do we know when our program is achieving them?
  • What information do we currently have that can help show when our program is achieving them?
  • Do we collect (or have access to) information that would help us show our impact even though we don’t use it for that purpose?

The answers to these questions helped us build a better understanding, not only of how we could apply the W3 Framework to specific programs, but also how we could use it to help programs improve their evaluation processes.

The tools and processes that we first created and used during this time form the basis of the W3 Framework Guide, and our essential guides to evaluating peer work and improving peer responses.

Below, we describe some of the more important and interesting things we did and learned while working with two peer-led programs:

  • Harm Reduction Victoria’s Peer Networker Program
  • Living Positive Victoria’s Phoenix

Harm Reduction Victoria’s Peer Networker Program

Harm Reduction Victoria’s Peer Networker Program recruits, trains, and supports people who inject drugs to be ‘peer networkers’. Peer networkers play an important role in improving their community’s safety. They do this by providing clean needles and syringes to their friends and other community members. They can also teach their peers about safer drug use and ‘model’ safer injecting practices.

Understanding engagement

To enhance our understanding of engagement through the Peer Networker Program, we revised the data sheets and analysing the geographic and gender diversity of who the program reaches compared to other needle and syringe programs.

Strengthening policy and health system influence

To strengthen the voice of people who use drugs and enhance the advice to the rest of the sector, we have been trialling the collection of current peer insights and feedback from the different networks in the Peer Networker Program.

Living Positive Victoria’s Phoenix

Living Positive Victoria’s Phoenix is a workshop for anyone with a recent diagnosis of HIV. For many, this time shortly after receiving a positive HIV diagnosis feels extremely isolating and overwhelming.

In the Phoenix workshops, PLHIV and HIV specialists provide information and support in a safe space to help people process their diagnosis and plan for a happy and healthy future.

Capturing peer insights to enhance adaptation

The Phoenix workshops result in rich peer discussion and problem solving. After each workshop, peer facilitators come together to debrief and reflect. These reflexive discussions — particularly those about emerging issues and the quality of the peer experience during the workshop — provide key moments of insight and learning for the peer workers.

Despite their clear value, however, these insights were not being captured for sharing within or beyond the program. In response to this gap, we developed a brief facilitator feedback tool to tap into and capture the expertise and experience of peer facilitators. Because this tool was for facilitators, it had the added benefit of not placing any extra burden on workshop participants.

Understanding community influence

Through our conversations with PLHIV peer workers, we realised that a lot of their work aims to improve client quality of life. However, there was no simple way for them to track or measure this for their evaluations.

This led to our collaboration with a range of PLHIV peer organisations (including Living Positive Victoria) and ViiV Healthcare to develop, validate, and trial the PozQoL Scale, a short quality of life scale for people living with HIV.

Outcomes

You can find out more about the outcomes of applying the W3 Framework at Harm Reduction Victoria and Living Positive Victoria in our W3 Project impact analysis.

Additionally, we used what we learned during this project to develop the W3 Framework Guide.

The guide provides:

  • Background information about peer work and the W3 Framework
  • A step-by-step process to applying the W3 Framework to peer work
  • A toolkit of templates and examples to help peer responses work through the process

Partners

Funding

Stage 2 of the W3 Project received funding from the Australian Government Department of Health.


More from Stage 2 of the W3 Project


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