York research examines role of ‘peer leader’ in community health context

The involvement of peer workers in community-centered health programs is a key strategy to address health inequities, according to existing literature to reach under-serviced communities.

To better understand the meaning of “being a peer leader”, York University Faculty of Health Professor Farah Ahmad and Post-doctoral Fellow Manuela Ferrari, both in the School of Health Policy and Management, conducted a qualitative study with peer leaders who worked for the Cancer Awareness: Ready for Education and Screening (CARES) project.

The project promoted awareness, knowledge, and uptake of breast and cervical cancer screening among under-/never-screened women who belonged to ethnic minority, recent immigrant and low income communities in Toronto, Canada.

Peer workers have been found to improve knowledge, attitudes and health behaviors of community members, and to provide health and social service with a better understanding of community needs; yet, the experiences of being peer or lay workers are under-examined.

The research team conducted three focus groups with 14 immigrant peer leaders.

Situational analysis was conducted to determine both dominant and underlying aspects that define the meaning of being a peer leader. The first level of analysis, according to Ahmad, revealed that being a peer leader included not only “helping” others and one’s self, as previously reported, but “re-defining” one’s social and professional position leading to professional development and networking.

Exploration of the “re-defining process” at the second level of analysis, said Ahmad, identified some peer-leaders’ challenges and negotiations in relation to knowledge (science vs. myth), beliefs (fear vs. assurance) and boundaries (private vs. work).

“The findings reveal various ways through which peer workers gain personal empowerment when employed for the community-centered programs – an important insight that has not been given much attention, as the evaluations often focus on the outcomes for the community served by these programs,” said Ahmad.

At the same time, the community-based work of peer workers is complex, as some experience tensions between their ‘expert’ and community roles.

“This theoretical advancement is meaningful to inform training programs for peer workers”, said Ferrari.

The findings highlight the complexity of peer workers’ roles, and offer practical insights for training programs.

The study was funded by the Cancer Care Ontario and the project led by Dr. Sheila Dunn from Women’s College Hospital.