Abstract
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.
