Starting a Peer Support Program

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1. Starting a Peer Support Program

2. Developing Peer Support Protocols

3. Collaborating with Existing Peer Support Programs in the Community

Starting a Peer Support Program

Starting a peer support program involves thinking about the kinds of support that people need, and how your programs can address those needs. Doing so requires attention to the needs and strengths of your organization, the target population you aim to serve, the peer supporters and what they need to provide support, and ideas about what peer support would look like in your setting. The following two sections provide an overview of the essential phases in developing and managing a peer support program, as well as information about adapting a peer support program from a previously successful one.

Program Development and Management

As illustrated in Figure 2 below, starting or strengthening a peer support program often goes through four phases, including:

1. Community and Organizational Readiness – such as assessing needs, obtaining stakeholders’ buy-in, and securing resources.
2. Program Development – planning peer support interventions, developing protocols, and recruiting and training peer supporters.
3. Program Implementation – reaching and engaging program participants, and monitoring and supporting peer supporters.
4. Evaluation – documenting the process, and identifying indicators and tools to evaluate outcomes/impact.

All phases are critical to Program Sustainability. However, attention should also be paid to behavioral, programmatic and policy-related aspects order to better sustain a program. This guide is organized in the way that walks you through these phases and provides examples and resources to help you start or enhance a peer support program.

Figure 2. Four phases of program development and management

For specific guidance for developing a peer support program addressing a particular disease or condition, please refer to the example manuals in Resource section.

Adapting Peer Support

It is common for program managers to initiate a peer support program by adapting an existing program that has demonstrated success. Adaptation is the modification of an evidence-based intervention without competing with, contradicting, or removing its core elements or internal logic (Winwood et al., 2008). An adapted peer support program will have a higher likelihood of success when it maintains fidelity to established peer support frameworks (i.e. four key functions) while modifying program components to fit the target population, increase cultural competency, address the needs of the community, and allow integration with the local health system.

In general, various adaptation guidelines share the following steps (see Figure 3):

1. Assess the needs of target population and settings
2. Determine core areas that need adaptation and ways to address them
3. Pretest your strategies, products and/or interventions
4. Modify or revise your strategies, products and/or interventions based on the feedback from pretesting
5. Proceed with full implementation and then evaluation

When adapting an existing program, the key is to continually modify or revise your approaches based on the needs and characteristics of your program participants and settings. In fact, Continuous Quality Improvement (CQI) is applicable to all peer support programs regardless they are starting from the ground up, or adapting an existing model.

Figure 3. Framework for Adaptation

What are Key Points to Developing a Successful Peer Support Program?

There’s no single ingredient that is required or guarantees success, but these components often comprise successful peer support programs.

• Maintain frequent contact (long-term and ongoing support).
• Develop and maintain linkages with health systems and primary care providers.
• Encourage regular care, healthy eating, physical activity and medicine adherence; share experiences and advice for those activities; and assist in completing those activities.
• Provide support in coping with day-to-day stressors.
• Assist in developing problem-solving, decision-making, and coping skills.
• Take into account the individual, social and cultural characteristics of the patient.
• Consider individual rights, privacy, and the limits on the role of the peer supporter.
• Encourage peer supporters to contact health care providers if they are unable to answer specific questions or provide assistance to patients. Peer supporters must acknowledge the boundaries of the care that they can provide and should refrain from giving medical advice or diagnoses.

Through research and global networking, Peers for Progress has identified a few success factors for designing and managing a peer support program:

• Keep it simple – Remember that peer support is meant to be from “people like me”
• Avoid too many details of training – Remember, key is knowing, listening, and being available
• Ongoing support and information for peer supporters are key