The Cost of Caring: Compassion Fatigue among Peer Overdose Response Workers in British Columbia.

Background: The drug toxicity crisis has had dramatic impacts on people who use drugs. Peer overdose response workers (peer responders), i.e., individuals with lived/living experience of drug use who work in overdose response settings, are particularly susceptible to negative physical and mental health impacts of the crisis. Despite that, the mental health impacts on peer responders have yet to be studied and measured. Methods: The Professional Quality of Life survey (Version 5) was completed by 47 peer responders at two organizations in British Columbia between September 2020 and March 2021 to assess compassion satisfaction and compassion fatigue. The Likert scale responses were converted into numerical values and scores were calculated for each sub-scale. The mean score was calculated for each sub-scale and categorized as low, medium, or high, based on the instructions for Version 5 of the instrument. Results: Our study uncovered a high mean score for compassion satisfaction, low mean score for burnout, and medium mean score for secondary traumatic stress among peer responders. These results may be due to the participants' strong feelings of pride and recognition from their work, as well as the low number of participants that felt they had too much to do at work. Conclusion: Although peer responders derive pleasure and fulfillment from their jobs, i.e., compassion satisfaction, they also sometimes face burnout and stress due to continuous exposure to the trauma of the people they support. These results shed light on the areas that need to be targeted when creating supports for peer responders.

Core competencies of peer workers who use pulse oximeters to supplement their overdose response in British Columbia.

INTRODUCTION: Peer workers (those with lived/living experience of substance use) are at the forefront of overdose response initiatives in British Columbia, Canada. The onset of the coronavirus disease pandemic has significantly compounded the impact of the overdose crisis. Peer workers are integral in supporting people who use substances. However, despite the important work they do, peer workers often lack formalized credibility and do not have the same resources available to them as service providers without lived experience. The peer-led project titled the Peer2Peer Project implemented several support programs for peer workers, including providing pulse oximeters to peer workers to supplement their overdose response procedures. MATERIALS AND METHODS: This study was a component of a larger evaluation of the pulse oximeter program at two organizations in BC. The study aims to highlight the competencies of peer workers who use pulse oximeters. Telephone interviews were conducted with seven peer workers who were given pulse oximeters. The transcripts were thematically coded using Covert et al.'s framework of core competencies of community health workers to compare our sample with other widely recognized professions. FINDINGS: We found that peer workers who used pulse oximeters described several core competencies in their work and these were aligned with Covert et al.'s core competencies for community health workers, including assessment, community health practice, communication, diversity and inclusion, professional practice, and disease prevention and management. CONCLUSION: By aligning peer workers' skills to those of community health workers, we create awareness on the competencies of peer workers in using oximeters to supplement overdose response and advocate for them to receive more recognition and respect within the workplace. Further, our findings act as groundwork for future research in identifying the professional proficiencies of peer workers.

Using intervention mapping to develop 'ROSE': an intervention to support peer workers in overdose response settings.

BACKGROUND: Peer workers (those with lived/living experience of substance use working in overdose response settings) are at the forefront of overdose response initiatives in British Columbia (BC). Working in these settings can be stressful, with lasting social, mental and emotional impacts. Peer workers have also been disproportionately burdened by the current dual public health crises characterized by the onset of the COVID-19 pandemic and rise in illicit drug overdose deaths. It is therefore critical to develop supports tailored specifically to their realities. METHODS: We used the six steps outlined in the Intervention Mapping (IM) framework to identify needs of peer workers and design an intervention model to support peer workers in overdose response settings. RESULTS: Eight peer-led focus groups were conducted in community settings to identify peer workers' needs and transcripts were analyzed using interpretive description. The strategies within the intervention model were informed by organizational development theory as well as by lived/living experience of peer workers. The support needs identified by peer workers were categorized into three key themes and these formed the basis of an intervention model titled 'ROSE'; R stands for Recognition of peer work, O for Organizational support, S for Skill development and E for Everyone. The ROSE model aims to facilitate cultural changes within organizations, leading towards more equitable and just workplaces for peer workers. This, in turn, has the potential for positive socio-ecological impact. CONCLUSIONS: Centering lived/living experience in the intervention mapping process led us to develop a framework for supporting peer workers in BC. The ROSE model can be used as a baseline for other organizations employing peer workers.

Integrating career development into an undergraduate IT curriculum at an Australian University.

Career development is a multifaceted, life-stage-dependant and discipline-specific process that is difference for every decision maker. During their time at university, students are building upon their career choice through discipline-specific activities yet many still find the transition into the workforce problematic, particularly for those in the discipline of IT. With the varied nature of the labour market in Australia, it is more important than ever before for universities to assist students in their career development through various opportunities for career education. With this in mind, this research asked: What career development model, and curriculum recommendations, can support IT students to be better prepared for life after university to achieve their graduate outcomes? To answer this, this research will present how career education has been implemented in undergraduate IT education at Deakin University in Australia. In addition, this paper demonstrates how a career development model together with appropriate curriculum resources can assist in addressing students' career needs, specifically for the IT context. The model will help educators' better support students to build their career interest and navigate the changing labour market.

"Running myself ragged": stressors faced by peer workers in overdose response settings.

BACKGROUND: Peer workers or "peers" (workers with past or present drug use experience) are at the forefront of overdose response initiatives, and their role is essential in creating safe spaces for people who use drugs (PWUD). Working in overdose response settings has benefits for peer workers but is also stressful, with lasting emotional and mental health effects. Yet, little is known about the stressors peer workers face and what interventions can be implemented to support them in their roles. METHODS: This project used a community-based sequential mixed-methods research design. Eight peer researcher-led focus groups (n = 31) were conducted between November 2018 and March 2019 to assess needs of peer workers. The transcripts were thematically coded and analysed using interpretative description. These results informed a survey, which was conducted (n = 50) in September 2019 to acquire quantitative data on peer workers' perception of health, quality of life, working conditions and stressors. Frequency distributions were used to describe characteristics of participants. X2 distribution values with Yates correction were conducted to check for association between variables. RESULTS: Five themes emerged from the focus groups that point to stressors felt by peer workers: (1) financial insecurity; (2) lack of respect and recognition at work; (3) housing challenges; (4) inability to access and/or refer individuals to resources; and (5) constant exposure to death and trauma. Consistent with this, the factors that survey participants picked as one of their "top three stressors" included financial situation, work situation, and housing challenges. CONCLUSION: Peer workers are faced with a diversity of stressors in their lives which often reflect societal stigmatization of drug use. Recognition of these systemic stressors is critical in designing interventions to ease the emotional, physical and financial burden faced by peer workers.

"It's an emotional roller coaster But sometimes it's fucking awesome": Meaning and motivation of work for peers in overdose response environments in British Columbia.

BACKGROUND: The province of British Columbia (BC), Canada is amid dual public health emergencies in which the overdose epidemic declared in 2016 has been exacerbated by restrictions imposed by the Coronavirus Disease of 2019 (COVID-19) pandemic. Experiential workers, commonly known as 'peers' (workers with past or present drug use experience) are at the forefront of overdose response initiatives and are essential in creating safe spaces for people who use drugs (PWUD) in harm reduction. Working in overdose response environments can be stressful, with lasting emotional and mental health effects. There is limited knowledge about the personal meaning that experiential workers derive from their work, which serve as motivators for them to take on these often-stressful roles. METHODS: This project used a community-based qualitative research design. The research was based at two organizations in BC. Eight experiential worker-led focus groups were conducted (n = 31) where participants spoke about their roles, positive aspects of their jobs, challenges they face, and support needs in harm reduction work. Transcripts were coded and analyzed using interpretative description to uncover the meaning derived from experiential work. RESULTS: Three themes emerged from focus group data that describe the meanings which serve as motivators for experiential workers to continue working in overdose response environments: (1) A sense of purpose from helping others; (2) Being an inspiration for others, and; (3) A sense of belonging. CONCLUSION: Despite the frequent hardships and loss that accompany overdose response work, experiential workers identified important aspects that give their work meaning. These aspects of their work may help to protect workers from the emotional harms associated with stressful work as well as the stigma of substance use. Recognizing the importance of experiential work and its role in the lives of PWUD can help inform and strengthen organizational supports.

Design Elements and Feasibility of an Organized Multiplayer Mobile Active Videogame for Primary School-Aged Children.

OBJECTIVE: This article describes the design, development, and implementation feasibility of a purpose-built mobile active videogame (M-AVG) named "Pirate Adventure," which was designed for primary school-aged children to engage in physical activity (PA) and fundamental movement skills (FMS), such as hopping, sidestepping, jumping, or running, in an afterschool setting. The design of "Pirate Adventure" was the result of a collaboration between games designers and health researchers. SUBJECTS AND METHODS: "Pirate Adventure" was designed and developed using Android(®) (Google, Mountain View, CA) phone sensors to respond to player actions within a playground environment. Using an interactive game framework, players solve clues and complete PA and FMS challenges via sensing the physical world through marked-out key game locations. Fourteen primary school-aged children participated in the feasibility evaluation, which took place in four afternoon sessions. The game was evaluated using Android phone telemetry data and a post-gameplay survey for children on their opinions and enjoyment of the game. RESULTS: The "Pirate Adventure" game design facilitated an enjoyable treasure hunt game (average of 11 minutes of activity per game) with narrative elements supporting children's engagement with movement activities. The majority of children (n=9/13) reported that they would like to play the game again. CONCLUSIONS: Combining real world and virtual world content through "Pirate Adventure" was moderately successful, with multiple gameplay sessions occurring. Further implementation feasibility testing, under more controlled conditions, needs to be conducted to assert the benefits of using a M-AVG for children's PA and FMS.