Accelerating Best Practices in Peer Support Around the World

Program Development Guide

Engaging Your Program Participants

Chapter Navigation

1. Engaging Your Program Participants

2. Reaching the Hardly Reached


Engaging Your Program Participants

Keeping your program participants engaged in the peer support activities is critical to program success. Active engagement requires ongoing effort throughout the process. A few important aspects are highlighted below:


Program design

It is important to understand and address the needs of target populations and explore how features of their culture and communities may influence these needs.


Selection and recruitment of program participants

Engaging the Whole Patient Population
Peers for Progress project at Alivio Medical Center utilized tiered, flexible program approaches to serve their whole 4,000 patients with diabetes. Please check out their program description and intervention flow chart for more information.

Often, a peer support program will target a certain population based on criteria such as clinical conditions, socioeconomic characteristics, and/or ethnicity. How to recruit program participants, therefore, depends on whether or not there is an existing database or a list of eligible participants. For example, clinic-based programs usually can identify and invite patients who may be eligible and interested in peer support through providers’ recommendation or electronic medical records (EMR). In terms of recruitment strategies, print materials (e.g., letters, flyers) and active recruitment (e.g., word-of-mouth and outreach activities) are proven to be effective. It is critical to utilize peer supporters in the process of framing strategies because they often share similar experience and/or background with potential program participants.


Introducing peer supporters to program participants

Developing trust and building rapport are the first and most crucial tasks for peer supporters. In many cases, peer support programs can take advantage of naturalistic settings. For example, programs often match peer supporters with their participants based on where they live to allow frequent and flexible interactions. However, when a naturalistic setting is not available, it is important to create opportunities for a warm introduction. This can be done through a face-to-face meeting, a series of group classes, or a warm hand-off by providers, community coordinators, or supervisors of the peer supporters. In addition, establishing a feedback loop between program participants and the supervisor of peer supporters can help detect problems early.


Dealing with unengaged participants

It is common that some participants will not be enthusiastic about receiving peer support from the supporters. There will also be occasions when peer supporters have a hard time reaching participants even with multiple attempts. In these situations, having clear written protocols in place and training peer supporters to follow them during the initial contacts can be effective in addressing these issues. When dealing with unengaged participants, it is important not to pressure them and to instead offer them options for continuous contact. The Asthma project led by Fisher and colleagues, which successfully engaged 89.7% of low-income, single mothers of children hospitalized for asthma, is one example of this tactic. Specifically, when a patient was reluctant to engage, the peer supporter would tell him or her that there is no urgency and that they will contact the patient again in several weeks to see if there are ways they can be helpful.


Guide for Asthma Coaches on Behaviors for Stage of Readiness and Recommended Intervention by Washington University Internal Medicine This document outlines common behaviors based on the six stages of change, and the corresponding intervention ideas that can be incorporated into an asthma action plan.
Diabetes Management through Peer Support and Community Outreach from the Patient-Centered Medical Home This poster of the Peers for Progress project at the Alivio Medical Center in Chicago provides information on its flexible, non-directive strategies to engage patients in peer support.
Warm Hand-Off and Rapport-Building Opportunities Lead to Program Success: A Vietnamese Peer Support Intervention for Diabetes The success of a peer support program in Vietnam shows us how important it is to provide warm hand-offs and foster rapport between peer supporters and participants.
Alivio Project Toolkit Peers for Progress project at the Alivio Medical Center in Chicago shares our monitoring tools. It is specifically designed with the intention to be integrated into the electronic medical record.


© 2015 | Peers for Progress

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