Transcript: The Power of Peers to Change Lives
Alameda County Medical Center, Oakland, CA
(Photo of Kathleen Clanon, MD at Highland Hospital, Alameda County Medical Center)
Kathleen Clanon:
I was not always a believer in peer support programs. Our clinic turned to the practice, frankly, because our backs were up against the wall. This was in 1996 when the first antiretroviral medications came out. We believe very strongly in antiretroviral therapy, but a whole bunch of our patients were very worried about it.
(Photo of Kathleen with Aries Brown, WORLD Peer Advocate)
And the thought was, if they wouldn’t believe me when I said that therapy was safe, maybe they would feel more comfortable asking a peer, “What’s the real deal about this?” and would trust the answers in a different way. I was skeptical. I was concerned that peers might say to patients things like, “I’m on X medicine, you should get on that too.” Plus, the peers we worked with would not be employees of our clinic.
(Photo of WORLD logo- Women Organized to Respond to Life-Threatening Diseases)
They’d be trained and supervised by WORLD, which is an organization based here in Oakland that provides peers to support HIV positive women in care organizations around the area. But this meant that I would have less control over the peers, and that was a little worrisome to me.
Kansas City Free Health Clinic, Kansas City, MO
(Photo of Sally Neville, RN & Director of HIV Primary Care at Kansas City Free Health Clinic)
Sally Neville:
In 2003 I was faced with the prospect of taking over the peer program at the Kansas City Free Health clinic where I’m director of HIV primary care. I really didn’t want to do it.
I’ve been a nurse for a long time. I’ve always acted on the belief that patients were partners in their own care, but they were partners with me, or another health care provider. They weren’t partners with each other. I didn’t trust that a patient acting as a peer educator could offer something to another patient and view themselves as a partner with the care team.
(Photo of Sally with Jerry, peer educator; Leo, client)
And if I’m really honest, I didn’t trust them not to undermine my relationship with the patient.
Alameda County Medical Center, Oakland, CA
(Photo of Kathleen and Aries)
Kathleen Clanon:
But ten years into it, I’m a total believer. The support of peers has helped so many of my clients learn to take charge of their treatment and take charge of their lives.
(Photo of WORLD Peer Advocates: Aries, Sharon, Agripina, Liz, and Sylvia)
We’ve developed trust with a small cadre of peers we work with on an ongoing basis– the current peer that I work with the most is Aries. And seeing what those peers are able to do one on one with clients has convinced me that peers are a critical part of the care team.
(Photo of Kathleen and Aries with Monica Chadwick, Medical Assistant; Cynthia Rowden, RN; and Caitlin McCarthy, RN & Nurse Manager)
I think there are really two things that peers can do that we just can’t do for our patients. You can talk ‘til you’re blue in the face saying that these medications and treatment will allow them to live a normal life and you will not get through in the same way as them just being able to see someone who is having that experience.
(Photos of Kathleen and Aries)
And then secondly, there’s a different kind of communication, because patients will tell things to other patients and will listen to things from other patients that they will not tell us; things that are very important, about what they are struggling with in terms of adherence, in terms of safer sex, in terms of lots of other issues in their lives.
I am a complete convert at this point. I would never go back to practicing without peers in my practice. I think they’re really an incredibly important part of the team. Peers show people what adhering to treatment can mean for them. They give people hope for the future.
Kansas City Free Health Clinic, Kansas City, MO
(Photos of Sally, Jerry, and Leo)
Sally Neville:
Within three months we saw a decrease in the number of missed appointments, patients started taking a more active role in their own care, and providers started to trust, and therefore use the peers.
Six years into the program, the peers have become an essential part of our programs and services. Providers rely on them. Peers actually help establish providers’ credibility with patients. My fears were wrong when I took over the program in 2003. I’ve watched patients who felt hopeless recover their sense of self through their relationship with a peer. I’ve seen patients who once said, “I’ll never take meds, they’re poison,” successfully manage their antiretroviral therapy and achieve non-detectable viral loads.
(Photo of Sally with Justin Suelter, who began work at the clinic as a peer educator and is now a medical assistant.)
And, I didn’t anticipate the effect on the peers themselves. It’s so powerful to watch their self-confidence, sense of purpose, and pride in the work they do grow as they do this work.
This experience has converted, baptized, and confirmed me in the belief of the power of peers to change lives.
Story by Kathleen Clanon, MD and Sally Neville, RN, MSN
Many thanks to the following people for their help in creating this story.
Highland Hospital, Alameda County Medical Center
Kathleen Clanon
Andrea Breaux
Monica Chadwick
Yvonne Escarcega
Caitlin McCarthy
Cynthia Rowden
WORLD
Aries Brown
Liz Bates
Sharon Gambles
Agripina
Sylvia Young
Shalini Eddens
Kansas City Free Health Clinic
Sally Neville
Jerry
Leo
Justin Suelter
LaTrischa C. Miles
Alicia Downes
Joy Biddison
Vanessa Engelbert
Lara Salveter
Additional thanks to Creative Commons musicians:
blues_agent
Klaus_Neumaier
Mario Mattioli
Story created by the PEER Center with help from Storybuilders
This publication was supported by cooperative agreement #U20H8557-01-00 from the Health Resources and Services Administration (HRSA). This cooperative agreement is funded through the HIV/AIDS Bureau’s Division of Training and Technical Assistance with Minority AIDS Initiative funding. The contents of this publication are solely the responsibility of the PEER Center and do not necessarily represent the views of the funding agencies or the U.S. government.
