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Cooptation of Peer Support Staff: Quantitative Evidence

机译：同行支持人员的增选：定量证据

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Objective: In 2007, the Centers for Medicare and Medicaid Services (CMS) sent a letter to state Medicaid directors outlining requirements for implementing peer-based recovery support services (P-BRSS) as a Medicaid-funded service. Since then, 30 states have implemented these services. Although the literature describing implementation of P-BRSS has identified the cooptation of peer support staff (PSS) as a barrier to the effective provision of P-BRSS, the evidence for it remains anecdotal. This study attempts to determine if the context of employment in either a treatment organization or peer organization affected cooptation.Methods: We conducted a survey of PSS in the fall of 2013. In all, 92 of the 181 respondents were working as PSS at the time, 53 in treatment organizations. Chi-square analysis was used to determine if the context of employment had an effect on the cooptation of peer staff.Results: Peer staff working in treatment organizations reported that they were supervised by treatment staff and participated in employment-related training to improve their skills at providing treatment services more frequently than their counterparts in peer organizations. Peer staff working in treatment organizations also participated in training and education to prepare for employment as treatment professionals more frequently than peer staff working in peer organizations.Conclusions and implications for practice: Peer staff members working in treatment organizations are subject to processes of acculturation into professional cultures that peer staff working in peer organizations are not. Effective implementation of P-BRSS should include specific efforts to minimize the cooptation of peer staff.
机译：目标：2007年，医疗保险和医疗补助服务中心（CMS）致函州医疗补助主任，概述了将基于对等的恢复支持服务（P-BRSS）实施为医疗补助资助的服务的要求。自那时以来，已有30个州实施了这些服务。尽管描述P-BRSS实施的文献已将同伴支持人员（PSS）的选择列为有效提供P-BRSS的障碍，但有关它的证据仍是传闻。这项研究试图确定治疗组织或同行组织的就业环境是否影响了选择。方法：我们于2013年秋季进行了PSS调查。当时，在181名受访者中，有92名从事PSS工作，治疗组织中的53个。卡方分析被用来确定就业环境是否对同伴的选择产生影响。结果：在治疗组织工作的同伴报告说，他们受到治疗人员的监督，并参加了与就业有关的培训，以提高他们的技能比同等组织的同伴更频繁地提供治疗服务。在治疗组织中工作的同龄人也比在同行组织中工作的同龄人更频繁地参加培训和教育，以准备作为治疗专业人士就业。结论和对实践的启示：在治疗组织中工作的同龄人必须接受专业化培训在同级组织中工作的同级员工所没有的文化。有效实施P-BRSS应该包括为减少对等人员的选拔而做出的具体努力。

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