Peers In Delivery Research Articles

Access to HIV treatment and care for people who inject drugs in Kenya: a short report

ABSTRACTPeople who inject drugs (PWID) experience a range of barriers to HIV treatment and care access. The Kenyan government and community-based organisations have sought to develop HIV care for PWID. A principal approach to delivery in Kenya is to provide care from clinics serving the general population and for this to be linked to support from community-based organisations providing harm reduction outreach. This study explores accounts of PWID accessing care in Kenya to identify care barriers and facilitators. PWID accounts were collected within a qualitative longitudinal study. In-depth interviews with PWID living with HIV (n = 44) are combined with interviews with other PWID, care providers and community observation. Results show that some PWID are able to access care successfully, whilst other PWID report challenges. The results focus on three principal themes to give insights into these experiences: the hardship of addiction and the costs of care, the silencing of HIV in the community and then discrimination and support in the clinic. Some PWID are able to overcome, often with social and outreach support, barriers to clinic access; for others, the challenges of addiction, hardship, stigma and discrimination are too constraining. We discuss how clinics serving the general population could be further adapted to increase access. Clinic-based care, even with community links, may, however, be fundamentally challenging for some PWID to access. Additional strategies to develop stand-alone care for PWID and also decentralise HIV treatment and care to community settings and involve peers in delivery should be considered.

Characterizing situations in ASEAN cities: Using the Human Security Index

The Human Security Index discussed in Hastings (2013a, this issue) can help assess situations and strategize (1) improved and fair competitiveness, (2) benefits from regional cooperation, and (3) improved individual and community well-being. ASEAN countries are compared here with global peers, and with each other – with respect to well-being situations in their cities and other communities. ASEAN leaders tend to lag some of their global peers in delivery of Human Security and well-being – where lower-income ASEAN countries tend to slightly lead their global peers in such outcomes. Further, a prototype HSI for Thailand is presented and discussed for situations in its cities and their surrounding territories. City-provincial situations are seen to be highly diverse, with some relatively poor (in monetary income) provinces leading in home ownership and other factors in Human Security. Formulation of HSIs for additional ASEAN countries, preferably at district-town levels, will likely increase our understandings of the concept and situations of well-being versus vulnerability in cities of such countries. Such exercises could lead to evolving better strategies for national – including urban – development planning and also help monitoring impacts of sustainable development initiatives.

Using peers to facilitate learning by students with moderate disabilities.

Based on the research of the author with her colleagues, this article describes the effective use of peers in systematic procedures to facilitate learning by students with moderate disabilities. Five research investigations are described, and guidelines for using on peers are offered. Specifically, the article addresses the use of peers in the direct delivery of systematic procedures in both special and general education classrooms to facilitate acquisition and generalization. In addition, guidelines for using peers in the delivery of systematic procedures are offered. ********** Systematic instruction (Wolery, Ault, & Doyle, 1992) is an effective means of teaching skills to students with moderate disabilities. Systematic instructional trials consist of the delivery of an attentional cue, a discriminative stimulus (e.g., task direction), a delay interval, a prompt, a response interval, and a consequence. Response prompting strategies are a form of systematic instruction that employ prompts to increase the likelihood of correct responses. Examples include the time delay procedure in which the controlling prompt is faded over time as students begin to respond correctly before the prompt and the system of least prompts in which prompts are systematically faded by offering only the amount of assistance necessary from a set prompt hierarchy. To increase the efficiency of a response, the instructor may choose to add nontargeted information (i.e., additional information in the antecedent, the prompt, or the consequence) that may be acquired through repeated exposure over time. Also, the instructor may choose to use additional strategies that have been shown to facilitate generalization (e.g., multiple exemplars of material, instructors, or settings). One way that instructors can increase the number of instructional trials per day is to involve peers without disabilities. Peers are readily available to participate in instruction within the general education settings, and many special education classrooms for students with disabilities employ peer tutors within that setting. The purpose of this article is to describe a series of research investigations focusing on peer-mediated strategies that were conducted by the author and her colleagues over the course of several years. Specifically, the article will describe six research studies conducted in special and general education settings in which peers served as tutors in the direct delivery of instructors or as assistants to facilitate generalization and the acquisition of nontargeted information. In addition, the author discusses guidelines for using peers in systematic interactions with students with moderate disabilities REVIEW OF SELECTED RESEARCH STUDIES The following studies focused on the use of peers in the delivery of systematic procedures to facilitate learning. The studies all involved students with functional mental disabilities (FMD), which is the label Kentucky uses to secure services for students with moderate to severe disabilities, and their same-age peers without disabilities. In addition, each study employed a single subject research design to investigate a different aspect of peer involvement. An overview of the investigation is shown in Table 1, and a summary of each investigation is described in the following sections. Peers as Reliable and Effective Instructors Several of the investigations focused on the use of peers to deliver direct systematic instruction. In addition to addressing several research questions, each investigation examined whether peers can reliably implement systematic instructional procedures and whether that instruction is effective in teaching target behaviors. Peer- vs. teacher-delivered instruction in the special education classroom. Miracle, Collins, Schuster, and Grisham-Brown (2001) compared peer- to teacher-delivered instruction in teaching functional sight words to 4 students with FMD. …