Optimal characteristics of peer navigators: adapting peer-based intervention with street-involved youth in Canada and Kenya with the aim of increasing HIV prevention, testing and treatment
Abstract Background We sought to adapt a peer navigator (PN) model to increase uptake of human immunodeficiency virus (HIV) prevention, testing and treatment of street-involved youth (SIY) in Canada and Kenya. This article presents key findings on the optimal characteristics of the PN model for SIY...
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BMC
2025-04-01
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| Series: | Health Research Policy and Systems |
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| Online Access: | https://doi.org/10.1186/s12961-025-01309-9 |
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| author | Edward Ou Jin Lee Thai-Son Tang Javi Fuentes-Bernal Katie MacEntee Juddy Wachira Edith Apondi Alex Abramovich Abe Oudshoorn David Ayuku Reuben Kiptui Amy Van Berkum Sue-Ann MacDonald Olli Saarela Paula Braitstein |
| author_facet | Edward Ou Jin Lee Thai-Son Tang Javi Fuentes-Bernal Katie MacEntee Juddy Wachira Edith Apondi Alex Abramovich Abe Oudshoorn David Ayuku Reuben Kiptui Amy Van Berkum Sue-Ann MacDonald Olli Saarela Paula Braitstein |
| author_sort | Edward Ou Jin Lee |
| collection | DOAJ |
| description | Abstract Background We sought to adapt a peer navigator (PN) model to increase uptake of human immunodeficiency virus (HIV) prevention, testing and treatment of street-involved youth (SIY) in Canada and Kenya. This article presents key findings on the optimal characteristics of the PN model for SIY across and between sites, prior to intervention implementation. Methods Using an integrated mixed methods approach, eligible participants included SIY aged 16–29 years, healthcare providers and community stakeholders. Data collection tools drew from the CATIE (Canada) PN practice guidelines related to: PN role and responsibilities, training, supervision and integration into sites, among others. During interviews (n = 53) or focus groups (n = 11) with participants, a 39-item PN components checklist was administered (quantitative data), followed immediately by a semi-structured interview protocol with questions that allowed for deeper exploration into the acceptability and appropriateness of the PN intervention (qualitative data). The checklist enabled participants to identify PN characteristics and/or activities as core (essential) or peripheral (adaptable and less important). Spearman’s rank correlations (ρ) were used to quantify agreement across sites and participant groups. Qualitative data were inductively coded and analysed using a single codebook. Results Quantitative data analysis revealed that out of 39 checklist items, 31 (79%) were considered core. These primarily pertained to host organization, PN characteristics and PN activities. For example, it was agreed that core PN activities included outreach to out-of-care SIY and providing health and social service referrals. There were mixed opinions about asking the PN to declare previous experience with drug use and HIV status, but there was agreement that the PN should have previous experience of street-involvement. Qualitative data analysis suggested that although all participant groups across sites agreed that the PN intervention was acceptable and appropriate, the participants from each site also identified specific adaptations related to their host organization and target SIY. Conclusions Our findings indicate high agreement among participant groups across all sites on some optimal PN intervention characteristics, particularly host organization characteristics, the PN themselves and their activities. However, context-specific adaptations are necessary to successfully scale-up the PN intervention. This model is applicable in diverse regions and organizational contexts. |
| format | Article |
| id | doaj-art-6ffd4f3fcfc34f0ca3b11d3fbfc0c63f |
| institution | OA Journals |
| issn | 1478-4505 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
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| series | Health Research Policy and Systems |
| spelling | doaj-art-6ffd4f3fcfc34f0ca3b11d3fbfc0c63f2025-08-20T02:11:49ZengBMCHealth Research Policy and Systems1478-45052025-04-0123111410.1186/s12961-025-01309-9Optimal characteristics of peer navigators: adapting peer-based intervention with street-involved youth in Canada and Kenya with the aim of increasing HIV prevention, testing and treatmentEdward Ou Jin Lee0Thai-Son Tang1Javi Fuentes-Bernal2Katie MacEntee3Juddy Wachira4Edith Apondi5Alex Abramovich6Abe Oudshoorn7David Ayuku8Reuben Kiptui9Amy Van Berkum10Sue-Ann MacDonald11Olli Saarela12Paula Braitstein13School of Social Work, Université de MontréalDalla Lana School of Public Health, University of TorontoSchool of Social Work, Université de MontréalDalla Lana School of Public Health, University of TorontoSchool of Medicine, Moi UniversityMoi Teaching and Referral HospitalCentre for Addiction and Mental Health, Institute for Mental Health Policy ResearchArthur Labatt Family School of Nursing, Western UniversitySchool of Medicine, Moi UniversityAcademic Model Providing Access to Healthcare in Eldoret, KenyaArthur Labatt Family School of Nursing, Western UniversitySchool of Social Work, Université de MontréalDalla Lana School of Public Health, University of TorontoDalla Lana School of Public Health, University of TorontoAbstract Background We sought to adapt a peer navigator (PN) model to increase uptake of human immunodeficiency virus (HIV) prevention, testing and treatment of street-involved youth (SIY) in Canada and Kenya. This article presents key findings on the optimal characteristics of the PN model for SIY across and between sites, prior to intervention implementation. Methods Using an integrated mixed methods approach, eligible participants included SIY aged 16–29 years, healthcare providers and community stakeholders. Data collection tools drew from the CATIE (Canada) PN practice guidelines related to: PN role and responsibilities, training, supervision and integration into sites, among others. During interviews (n = 53) or focus groups (n = 11) with participants, a 39-item PN components checklist was administered (quantitative data), followed immediately by a semi-structured interview protocol with questions that allowed for deeper exploration into the acceptability and appropriateness of the PN intervention (qualitative data). The checklist enabled participants to identify PN characteristics and/or activities as core (essential) or peripheral (adaptable and less important). Spearman’s rank correlations (ρ) were used to quantify agreement across sites and participant groups. Qualitative data were inductively coded and analysed using a single codebook. Results Quantitative data analysis revealed that out of 39 checklist items, 31 (79%) were considered core. These primarily pertained to host organization, PN characteristics and PN activities. For example, it was agreed that core PN activities included outreach to out-of-care SIY and providing health and social service referrals. There were mixed opinions about asking the PN to declare previous experience with drug use and HIV status, but there was agreement that the PN should have previous experience of street-involvement. Qualitative data analysis suggested that although all participant groups across sites agreed that the PN intervention was acceptable and appropriate, the participants from each site also identified specific adaptations related to their host organization and target SIY. Conclusions Our findings indicate high agreement among participant groups across all sites on some optimal PN intervention characteristics, particularly host organization characteristics, the PN themselves and their activities. However, context-specific adaptations are necessary to successfully scale-up the PN intervention. This model is applicable in diverse regions and organizational contexts.https://doi.org/10.1186/s12961-025-01309-9Peer navigatorStreet-involved youthHIV preventionTesting and treatmentImplementation sciencePeer navigator intervention |
| spellingShingle | Edward Ou Jin Lee Thai-Son Tang Javi Fuentes-Bernal Katie MacEntee Juddy Wachira Edith Apondi Alex Abramovich Abe Oudshoorn David Ayuku Reuben Kiptui Amy Van Berkum Sue-Ann MacDonald Olli Saarela Paula Braitstein Optimal characteristics of peer navigators: adapting peer-based intervention with street-involved youth in Canada and Kenya with the aim of increasing HIV prevention, testing and treatment Health Research Policy and Systems Peer navigator Street-involved youth HIV prevention Testing and treatment Implementation science Peer navigator intervention |
| title | Optimal characteristics of peer navigators: adapting peer-based intervention with street-involved youth in Canada and Kenya with the aim of increasing HIV prevention, testing and treatment |
| title_full | Optimal characteristics of peer navigators: adapting peer-based intervention with street-involved youth in Canada and Kenya with the aim of increasing HIV prevention, testing and treatment |
| title_fullStr | Optimal characteristics of peer navigators: adapting peer-based intervention with street-involved youth in Canada and Kenya with the aim of increasing HIV prevention, testing and treatment |
| title_full_unstemmed | Optimal characteristics of peer navigators: adapting peer-based intervention with street-involved youth in Canada and Kenya with the aim of increasing HIV prevention, testing and treatment |
| title_short | Optimal characteristics of peer navigators: adapting peer-based intervention with street-involved youth in Canada and Kenya with the aim of increasing HIV prevention, testing and treatment |
| title_sort | optimal characteristics of peer navigators adapting peer based intervention with street involved youth in canada and kenya with the aim of increasing hiv prevention testing and treatment |
| topic | Peer navigator Street-involved youth HIV prevention Testing and treatment Implementation science Peer navigator intervention |
| url | https://doi.org/10.1186/s12961-025-01309-9 |
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