Assessing The Feasibility, Acceptability and Accessibility of a Peer-Delivered Intervention to Reduce Harm and Improve The Well-Being of People who Experience Homelessness With Problem Substance Use: The Sharps Study

Author: Michael Roy Tessa Parkes Hannah Carver Catriona Matheson Rebecca Foster John Budd Dave Liddell Jason Wallace Bernie Pauly Maria Fotopoulou Adam Burley Isobel Anderson Bernie Tracey Price Joe Schofield Graeme MacLennan

Theme: Models of Care Year: 2022

People experiencing homelessness often have complex needs and face overlapping challenges
including poor mental and physical health, and problem substance use. They frequently encounter
healthcare and support service landscapes which are challenging to navigate and stigmatising. A
growing field of research suggests that trusting relationships, and particularly ones with peers, can
protect against substance harms by facilitating engagement with mainstream services. Our 2 year
mixed methods feasibility and acceptability study, ‘Supporting Harm Reduction through Peer
Support’ (SHARPS), funded by the UK’s National Institute for Health Research, was informed by this
evidence and assessed the benefits of an innovative peer-led model of care.
Description of model of care/intervention:
A peer-delivered, relational, harm reduction intervention was delivered which drew extensively on
the principles of psychologically informed environments. Four ‘Peer Navigators (PNs)’, individuals
with lived experience of problem substance use and/or homelessness, were located across six third
sector homelessness services in Scotland and England. Through the development of trusting and
equitable relationships, each Peer Navigator delivered holistic, person-centred emotional and
practical support to a caseload of approximately 15 participants for up to 12 months.
The SHARPS intervention was shown to be acceptable to, and feasible and accessible for,
participants, staff in hosting services, and the PNs. Participants reported improved engagement with
a range of health and social care services. The lived experience of the PNs enabled the development
of trusting, authentic and meaningful relationships which were measured as excellent at baseline
and follow-up. Some challenges were experienced in relation to the ‘fit’ of the intervention within
some settings.
Conclusion and next steps:
Having demonstrated feasibility, our findings support the need for a randomised controlled trial to
assess outcomes from the intervention, including effectiveness/cost effectiveness. Delegates will
benefit from hearing about this model of care directly from one of the SHARPS PNs and the study
Disclosure of Interest Statement:
The authors declare that they have no competing interests apart from Catriona Matheson who has
received personal fees and non-financial support from Indivior (Richmond, VA, USA) and personal
fees from Camurus AB (Lund, Sweden) outside the submitted work.

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