Applying Normalisation Process Theory to a peer-delivered complex health intervention for people experiencing homelessness and problem substance use
Abstract Background The Supporting Harm Reduction through Peer Support (SHARPS) study involved designing and implementing a peer-delivered, harm reduction intervention for people experiencing homelessness and problem substance use. Normalisation Process Theory (NPT) provided a framework for the stud...
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Nature Portfolio
2025-01-01
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| Series: | Communications Medicine |
| Online Access: | https://doi.org/10.1038/s43856-024-00721-6 |
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| author | Rebecca Foster Hannah Carver Catriona Matheson Bernie Pauly Jason Wallace Graeme MacLennan John Budd Tessa Parkes |
| author_facet | Rebecca Foster Hannah Carver Catriona Matheson Bernie Pauly Jason Wallace Graeme MacLennan John Budd Tessa Parkes |
| author_sort | Rebecca Foster |
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| description | Abstract Background The Supporting Harm Reduction through Peer Support (SHARPS) study involved designing and implementing a peer-delivered, harm reduction intervention for people experiencing homelessness and problem substance use. Normalisation Process Theory (NPT) provided a framework for the study. Methods Four Peer Navigators (individuals with personal experience of problem substance use and/or homelessness) were recruited and hosted in six third sector (not-for-profit) homelessness services in Scotland and England (United Kingdom). Each worked with participants to provide practical and emotional support, with the aim of reducing harms, and improving well-being, social functioning and quality of life. NPT guided the development of the intervention and, the process evaluation, which assessed the acceptability and feasibility of the intervention for this cohort who experience distinct, and often unmet, health challenges. While mixed-methods data collection was undertaken, this paper draws only on the qualitative data. Results The study found that, overall, the intervention is feasible, and acceptable to, the intervention participants, the Peer Navigators and staff in host settings. Some challenges were encountered but these were outweighed by benefits. NPT is particularly useful in encouraging our team to focus on the relationship between different aspects of the intervention and context(s) and identify ways of maximising ‘fit’. Conclusions To our knowledge, this is the first application of NPT to this cohort, and specifically by non-clinicians (peers) in non-healthcare settings (homelessness services). Our application of NPT helped us to identify ways in which the intervention could be enhanced, with the key aim of improving the health/well-being of this underserved group. |
| format | Article |
| id | doaj-art-9140720b75b2430d97cafa32f885f9b3 |
| institution | Kabale University |
| issn | 2730-664X |
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| publishDate | 2025-01-01 |
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| spelling | doaj-art-9140720b75b2430d97cafa32f885f9b32025-01-12T12:37:20ZengNature PortfolioCommunications Medicine2730-664X2025-01-01511810.1038/s43856-024-00721-6Applying Normalisation Process Theory to a peer-delivered complex health intervention for people experiencing homelessness and problem substance useRebecca Foster0Hannah Carver1Catriona Matheson2Bernie Pauly3Jason Wallace4Graeme MacLennan5John Budd6Tessa Parkes7School of Applied Sciences, Sighthill Campus, Edinburgh Napier UniversitySalvation Army Centre for Addiction Services and Research, Faculty of Social Sciences, Colin Bell Building, University of StirlingNursing, Midwifery and Allied Health Professions Research Unit, Centre for Healthcare and Community Research, University of StirlingCanadian Institute for Substance Use Research, University of VictoriaScottish Drugs ForumCentre for Healthcare Randomised Trials, Health Sciences Building University of Aberdeen, ForesterhillUniversity of Edinburgh Medical School, Chancellor’s Building, 49 Little France Crescent, University of EdinburghSalvation Army Centre for Addiction Services and Research, Faculty of Social Sciences, Colin Bell Building, University of StirlingAbstract Background The Supporting Harm Reduction through Peer Support (SHARPS) study involved designing and implementing a peer-delivered, harm reduction intervention for people experiencing homelessness and problem substance use. Normalisation Process Theory (NPT) provided a framework for the study. Methods Four Peer Navigators (individuals with personal experience of problem substance use and/or homelessness) were recruited and hosted in six third sector (not-for-profit) homelessness services in Scotland and England (United Kingdom). Each worked with participants to provide practical and emotional support, with the aim of reducing harms, and improving well-being, social functioning and quality of life. NPT guided the development of the intervention and, the process evaluation, which assessed the acceptability and feasibility of the intervention for this cohort who experience distinct, and often unmet, health challenges. While mixed-methods data collection was undertaken, this paper draws only on the qualitative data. Results The study found that, overall, the intervention is feasible, and acceptable to, the intervention participants, the Peer Navigators and staff in host settings. Some challenges were encountered but these were outweighed by benefits. NPT is particularly useful in encouraging our team to focus on the relationship between different aspects of the intervention and context(s) and identify ways of maximising ‘fit’. Conclusions To our knowledge, this is the first application of NPT to this cohort, and specifically by non-clinicians (peers) in non-healthcare settings (homelessness services). Our application of NPT helped us to identify ways in which the intervention could be enhanced, with the key aim of improving the health/well-being of this underserved group.https://doi.org/10.1038/s43856-024-00721-6 |
| spellingShingle | Rebecca Foster Hannah Carver Catriona Matheson Bernie Pauly Jason Wallace Graeme MacLennan John Budd Tessa Parkes Applying Normalisation Process Theory to a peer-delivered complex health intervention for people experiencing homelessness and problem substance use Communications Medicine |
| title | Applying Normalisation Process Theory to a peer-delivered complex health intervention for people experiencing homelessness and problem substance use |
| title_full | Applying Normalisation Process Theory to a peer-delivered complex health intervention for people experiencing homelessness and problem substance use |
| title_fullStr | Applying Normalisation Process Theory to a peer-delivered complex health intervention for people experiencing homelessness and problem substance use |
| title_full_unstemmed | Applying Normalisation Process Theory to a peer-delivered complex health intervention for people experiencing homelessness and problem substance use |
| title_short | Applying Normalisation Process Theory to a peer-delivered complex health intervention for people experiencing homelessness and problem substance use |
| title_sort | applying normalisation process theory to a peer delivered complex health intervention for people experiencing homelessness and problem substance use |
| url | https://doi.org/10.1038/s43856-024-00721-6 |
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