Drug service user groups: Only a partial solution to the problem of developing user involvement

Establishing the impact of consumer participation in alcohol and other drug treatment settings in Australia

It is generally recognised that engaging consumers to participate in policy making, programming, and practice is fundamental to effective alcohol and other drug (AOD) treatment, however, literature continues to document challenges and barriers to its implementation in AOD settings. This study reports on an evaluation of the Consumer Participation Project implemented in key non-government AOD services in Australia. Data collection consisted of an online survey of 86 staff members at the five participating AOD services and 27 consumer interviews. The survey examined staff attitudes towards and beliefs about consumer participation, perceived current levels of consumer participation and service changes as a result of the consumer participation project. The qualitative arm explored consumer's prior knowledge and current experiences of consumer participation. Staff who took part in the consumer participation training offered as part of the project were more likely to believe that service changes could encourage greater consumer participation rather than any barriers associated with consumer circumstances. Additionally, while services offered low-level involvement consumer activities, there were fewer examples of mid- and high-level activities being conducted at the different services. Consumers discussed the significance of being actively involved in their AOD treatment service while stressing the importance of proper training and support for those engaging in consumer participation. This research highlights the benefits of consumer participation in AOD treatment and suggests that most consumer participation activities undertaken at present are "low" level involvement concerned with providing and receiving information from consumers. Importantly, however, our study did demonstrate some support for "high" level involvement activities and service providers being open to doing more to encourage consumer participation.

How People with Lived Experiences of Substance Use Understand and Experience User Involvement in Substance Use Care: A Synthesis of Qualitative Studies

There is a need for more knowledge on how people with substance use problems (SUPs) understand and experience user involvement when receiving care. In this systematic review, we identify and reanalyse the existing qualitative research that explores how people with lived experiences of substance use understand user involvement, and their experiences of key practices for achieving user involvement. We systematically searched seven electronic databases. We applied Noblit and Hare’s meta-ethnography, revised by Malterud, to identify, translate, and summarise the studies. The electronic search resulted in 2065 articles. We conducted a full-text evaluation of 63 articles, of which 12 articles met the inclusion criteria. The primary studies’ synthesis reveals three different understandings of user involvement: user involvement as joint meaning production, points of view represented, and user representation in welfare services. Key practices for achieving user involvement involved seeing and respecting the service user as a unique person, the quality of the interactional process, and the scope of action for people with SUPs, as well as professionals, including issues of stigma, power, and fatalism. The metasynthesis recognises the ambiguity of the concept of user involvement concept and the importance of including the service user’s perspective when defining user involvement. The analysis of key practices emphasises the importance of relational processes and contextual aspects when developing user involvement concepts.

Health worker attitudes toward peer workers in hepatitis C prevention

Attitudes toward people who inject drugs (PWID) and attitudes toward peer workers among a cross-section of 101 Australian hepatitis C health workers were assessed. A survey consisting of Likert-type questions and one open-ended question regarding training was used. Bivariate and regression analyses demonstrated that health workers' attitudes toward peer workers were associated with their attitudes toward PWID, independent of type of organization or time in the hepatitis C sector. Qualitative analysis revealed four training areas suggested by health workers for peer workers. Implications of these findings for staff and peer training are discussed and future research directions suggested.

Evaluation of consumer participation demonstration projects in five Australian drug user treatment facilities: the impact of individual versus organizational stability in determining project progress

This project evaluated consumer participation projects in five drug user treatment services in metropolitan and regional areas in three Australian states. Qualitative interviews were conducted with staff and consumers at two time points between 2008 from 2010 (n = 108). At baseline staff and some consumers focused on the stability of consumers to undertake representative roles. At postimplementation, the focus was on the stability of the organization, as frequent staffing changes and lack of adequate handover affected the progress of the projects. These issues combined with the perceived "noncore" status of consumer participation resulted in none of the projects achieving all of their agreed goals.