Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/33996
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dc.contributor.authorParkes, Tessaen_UK
dc.contributor.authorMatheson, Catrionaen_UK
dc.contributor.authorCarver, Hannahen_UK
dc.contributor.authorFoster, Rebeccaen_UK
dc.contributor.authorBudd, Johnen_UK
dc.contributor.authorLiddell, Daveen_UK
dc.contributor.authorWallace, Jasonen_UK
dc.contributor.authorPauly, Bernieen_UK
dc.contributor.authorFotopoulou, Mariaen_UK
dc.contributor.authorBurley, Adamen_UK
dc.contributor.authorAnderson, Isobelen_UK
dc.contributor.authorMacLennan, Graemeen_UK
dc.date.accessioned2022-03-04T01:04:40Z-
dc.date.available2022-03-04T01:04:40Z-
dc.date.issued2022-02en_UK
dc.identifier.urihttp://hdl.handle.net/1893/33996-
dc.description.abstractBackground: For people experiencing homelessness and problem substance use, access to appropriate services can be challenging. There is evidence that development of trusting relationships with nonjudgemental staff can facilitate service engagement. Peer-delivered approaches show particular promise, but the evidence base is still developing. This study tested the feasibility and acceptability of a peerdelivered intervention, through ‘Peer Navigators’, to support people who are homeless with problem substance use to address a range of health and social issues. Objectives: The study objectives were to design and implement a peer-delivered, relational intervention to reduce harms and improve health/well-being, quality of life and social functioning for people experiencing homelessness and problem substance use, and to conduct a concurrent process evaluation to inform a future randomised controlled trial. Design: A mixed-methods feasibility study with concurrent process evaluation was conducted, involving qualitative interviews [staff interviews (one time point), n = 12; Peer Navigator interviews (three or four time points), n = 15; intervention participant interviews: first time point, n = 24, and second time point, n = 10], observations and quantitative outcome measures. Setting: The intervention was delivered in three outreach services for people who are homeless in Scotland, and three Salvation Army hostels in England; there were two standard care settings: an outreach service in Scotland and a hostel in England. Participants: Participants were people experiencing homelessness and problem substance use (n = 68) (intervention). Intervention: This was a peer-delivered, relational intervention drawing on principles of psychologically informed environments, with Peer Navigators providing practical and emotional support. Main outcome measures: Outcomes relating to participants’ substance use, participants’ physical and mental health needs, and the quality of Peer Navigator relationships were measured via a ‘holistic health check’, with six questionnaires completed at two time points: a specially created sociodemographic, health and housing status questionnaire; the Patient Health Questionnaire-9 items plus the Generalised Anxiety Disorder-7; the Maudsley Addiction Profile; the Substance Use Recovery Evaluator; the RAND Corporation Short Form survey-36 items; and the Consultation and Relational Empathy Measure. Results: The Supporting Harm Reduction through Peer Support (SHARPS) study was found to be acceptable to, and feasible for, intervention participants, staff and Peer Navigators. Among participants, there was reduced drug use and an increase in the number of prescriptions for opioid substitution therapy. There were reductions in risky injecting practice and risky sexual behaviour. Participants reported improvements to service engagement and felt more equipped to access services on their own. The lived experience of the Peer Navigators was highlighted as particularly helpful, enabling the development of trusting, authentic and meaningful relationships. The relationship with the Peer Navigator was measured as excellent at baseline and follow-up. Some challenges were experienced in relation to the ‘fit’ of the intervention within some settings and will inform future studies. Limitations: Some participants did not complete the outcome measures, or did not complete both sets, meaning that we do not have baseline and/or follow-up data for all. The standard care data sample sizes make comparison between settings limited. Conclusions: A randomised controlled trial is recommended to assess the effectiveness of the Peer Navigator intervention. Future work: A definitive cluster randomised controlled trial should particularly consider setting selection, outcomes and quantitative data collection instruments. Trial registration: This trial is registered as ISRCTN15900054.en_UK
dc.language.isoenen_UK
dc.publisherNational Institute for Health Researchen_UK
dc.relationParkes T, Matheson C, Carver H, Foster R, Budd J, Liddell D, Wallace J, Pauly B, Fotopoulou M, Burley A, Anderson I & MacLennan G (2022) A peer-delivered intervention to reduce harm and improve the well-being of homeless people with problem substance use: the SHARPS feasibility mixed-methods study. <i>Health Technology Assessment</i>, 26 (14), pp. 1-128. https://doi.org/10.3310/wvvl4786en_UK
dc.rightsCopyright © 2022 Parkes et al. This work was produced by Parkes et al. under the terms of a commissioning contract issued by the Secretary of State for Health and Social Care. This is an Open Access publication distributed under the terms of the Creative Commons Attribution CC BY 4.0 licence, which permits unrestricted use, distribution, reproduction and adaption in any medium and for any purpose provided that it is properly attributed. See: https://creativecommons.org/licenses/by/4.0/. For attribution the title, original author(s), the publication source – NIHR Journals Library, and the DOI of the publication must be cited.en_UK
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_UK
dc.subjectHealth Policyen_UK
dc.titleA peer-delivered intervention to reduce harm and improve the well-being of homeless people with problem substance use: the SHARPS feasibility mixed-methods studyen_UK
dc.typeJournal Articleen_UK
dc.identifier.doi10.3310/wvvl4786en_UK
dc.identifier.pmid35212621en_UK
dc.citation.jtitleHealth Technology Assessmenten_UK
dc.citation.issn2046-4924en_UK
dc.citation.issn1366-5278en_UK
dc.citation.volume26en_UK
dc.citation.issue14en_UK
dc.citation.spage1en_UK
dc.citation.epage128en_UK
dc.citation.publicationstatusPublisheden_UK
dc.citation.peerreviewedRefereeden_UK
dc.type.statusVoR - Version of Recorden_UK
dc.contributor.funderNIHR National Institute for Health Researchen_UK
dc.citation.date25/02/2022en_UK
dc.contributor.affiliationFaculty of Social Sciencesen_UK
dc.contributor.affiliationFaculty of Social Sciencesen_UK
dc.contributor.affiliationSociology, Social Policy & Criminologyen_UK
dc.contributor.affiliationFaculty of Social Sciencesen_UK
dc.contributor.affiliationUniversity of Edinburghen_UK
dc.contributor.affiliationScottish Drugs Forumen_UK
dc.contributor.affiliationScottish Drugs Forumen_UK
dc.contributor.affiliationUniversity of Victoriaen_UK
dc.contributor.affiliationSociology, Social Policy & Criminologyen_UK
dc.contributor.affiliationFaculty of Social Sciencesen_UK
dc.contributor.affiliationHousing Studiesen_UK
dc.contributor.affiliationUniversity of Aberdeenen_UK
dc.identifier.isiWOS:000762362600001en_UK
dc.identifier.scopusid2-s2.0-85125549881en_UK
dc.identifier.wtid1799733en_UK
dc.contributor.orcid0000-0002-0409-3254en_UK
dc.contributor.orcid0000-0002-6846-2661en_UK
dc.contributor.orcid0000-0002-8321-1801en_UK
dc.contributor.orcid0000-0002-0988-782Xen_UK
dc.contributor.orcid0000-0003-3019-2894en_UK
dc.contributor.orcid0000-0002-4845-1383en_UK
dc.contributor.orcid0000-0001-5420-5632en_UK
dc.contributor.orcid0000-0002-0631-0558en_UK
dc.contributor.orcid0000-0001-8601-8049en_UK
dc.contributor.orcid0000-0002-1039-5646en_UK
dc.date.accepted2020-10-01en_UK
dcterms.dateAccepted2020-10-01en_UK
dc.date.filedepositdate2022-03-03en_UK
dc.relation.funderprojectHarm reduction intervention for severe drug and/or alcohol dependence among people who are homelessen_UK
dc.relation.funderrefHTA 16/153/14en_UK
rioxxterms.apcnot requireden_UK
rioxxterms.typeJournal Article/Reviewen_UK
rioxxterms.versionVoRen_UK
local.rioxx.authorParkes, Tessa|0000-0002-0409-3254en_UK
local.rioxx.authorMatheson, Catriona|en_UK
local.rioxx.authorCarver, Hannah|0000-0002-6846-2661en_UK
local.rioxx.authorFoster, Rebecca|0000-0002-8321-1801en_UK
local.rioxx.authorBudd, John|0000-0002-0988-782Xen_UK
local.rioxx.authorLiddell, Dave|0000-0003-3019-2894en_UK
local.rioxx.authorWallace, Jason|en_UK
local.rioxx.authorPauly, Bernie|0000-0002-4845-1383en_UK
local.rioxx.authorFotopoulou, Maria|0000-0001-5420-5632en_UK
local.rioxx.authorBurley, Adam|0000-0002-0631-0558en_UK
local.rioxx.authorAnderson, Isobel|0000-0001-8601-8049en_UK
local.rioxx.authorMacLennan, Graeme|0000-0002-1039-5646en_UK
local.rioxx.projectHTA 16/153/14|National Institute for Health Research|http://dx.doi.org/10.13039/501100000272en_UK
local.rioxx.freetoreaddate2022-03-03en_UK
local.rioxx.licencehttp://creativecommons.org/licenses/by/4.0/|2022-03-03|en_UK
local.rioxx.filename3039034.pdfen_UK
local.rioxx.filecount1en_UK
local.rioxx.source2046-4924en_UK
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