The peer in outreach teams: a specialist among specialists?

The use of peer methodologies within health education services is a relatively disseminated practice, namely in projects that address populations that are ‘hard to reach’ (people who use drugs, sex workers or inmates) or target-groups with specific characteristics, like teenagers. However, despite its widespread use, there is not a single and consensual definition of the peer’s role in technical teams. It is frequently mentioned that his or her role should be established according to the needs of the project and the target-population. This variability - which can be seen as one of the advantages of using this strategy, especially in less structured contexts where the peer is a collaborator or volunteer - seems to contribute simultaneously to the frailty of those who are integrated as professionals in technical teams, namely, at the level of its recognition as a 'specialist' among other specialists.

At a time when more and more people advocate the professionalization of peers, there are still some questions to address, i.e. their integration and relationship with the team; the peers’ and professionals’ expectations; the acknowledgment of specific skills to carry out their activities and consequences to the peers’ professionalization.

In order to shed a light on these questions, an exploratory research of institutional scope was carried out, resorting to a mixed methodology: documental analysis of the material produced and the application of public funding by APDES’ outreach teams (GIRUS, Check!n, PortoG and INCLUS@) and administration of a semi-structured questionnaires to outreach workers, team coordinators and peers/volunteers who are part of APDES’ outreach projects.

The analysis of the collected data showed elements that ought to be further explored, namely the heterogeneity of peer roles and the diverse bonds established between peers and the organisation; the difficulties in acknowledging peers as “specialists” among “specialists” and the tendency to define the peers’ role according to their peers and not according to the team they belong to. The heterogeneity of roles and relationships with the team/organisation tends to be perceived as a good strategy, but also as a challenge to its professionalization. Provisional conclusions point to the fact that the dynamics established in the teams are contributing to keep the peers in a non-specialised position and that this is an obstacle to their professionalization. This is sometimes done unconsciously or unintentionally, even when specific competences of the peers are acknowledged, as well as the importance of their contribution. Hence, it is important to develop guidelines to support teams who resort to peers to carry out their outreach work.