Starting and Growing a Rural-based Peer Coach Program

Abstract

People living with HIV in rural areas often have lower rates of retention in care and viral suppression. This workshop will discuss an innovative University of Virginia Peer Coach Program, which uses peers to help at-risk clients overcome stigma and engage in self-management of HIV. We will share lessons learned in moving the program from a pilot phase toward growth/sustainability.

Proposal Summary

This interactive and collaborative workshop’s learning outcomes include that the participant will be able to (1) discuss the evidence behind peer coach programs, (2) examine some of the challenges in starting and growing a peer coach program especially highlighting rural issues, (3) outline best practices for peer coach programs from one Southeast clinic’s experience, and (4) describe opportunities for improvement in peer coach programs from a client perspective and a clinic view. The University of Virginia Ryan White Clinic started the Peer Coach Program in 2014 as a small volunteer-based pilot project serving only women and youth. It was initiated to cover a gap in services related to stigma which prior assessment showed to be a barrier to care. A training program was developed to educate volunteer peer coaches in peer counseling, mental health counseling, HIV education, effective communication, motivational interviewing, medication adherence, substance use, and self-care. To provide a truly peer-based service, the program recruits volunteers from rural areas and those with prior criminal history. Although peer coaches were empowered to provide support in a variety of areas related to self-management of HIV as a chronic condition, program tracking shows that support in coping with stigma has emerged as a critical niche filled by the program. Our peer coaches have found that supporting clients in medication and visit adherence often involves addressing stigma, whether it is internal or external stigma. Another important result of coaching services is effective client referral to other needed services. Through workshops and coaching services, conducted in person and by telephone, the program increases social support provided to rural populations. The success of the program also stems from having coaches who reflect the population served. To achieve this, we had to balance the requirements and regulations related to working/volunteering in a health system and the needs of the patients. This involved working with the health system to overcome legal barriers for some ex-offenders. Successful partnership with the health system, the addition of a full-time staff position dedicated to program coordination/promotion, as well as professionalization of the peer role have emerged as keys to program growth/sustainability.

Relevance And Significance

This presentation will demonstrate how starting and growing a peer coach program can improve access, retention, and care in rural communities. It will focus on the challenges that rural clinics may face in trying to start this type of program and how to overcome barriers. We will highlight how the program allows us to reduce stigma and link clients to needed services. Additionally, peer coaches and clients are trained in disease self-management, which can improve their HIV care as well as other chronic medical conditions.

Session Format

Workshop

Keywords

HIV, HIV care, Peer coach, Rural health, Stigma, HIV stigma, Disease self-management, Retention in care, Linkage to care

Location

Room 129

Publication Type and Release Option

Presentation (Open Access)

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Sep 9th, 3:30 PM Sep 9th, 4:20 PM

Starting and Growing a Rural-based Peer Coach Program

Room 129

People living with HIV in rural areas often have lower rates of retention in care and viral suppression. This workshop will discuss an innovative University of Virginia Peer Coach Program, which uses peers to help at-risk clients overcome stigma and engage in self-management of HIV. We will share lessons learned in moving the program from a pilot phase toward growth/sustainability.