At the table with people who use drugs: transforming power inequities

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dc.contributor.author Belle-Isle, Lynne
dc.date.accessioned 2016-04-27T14:29:37Z
dc.date.available 2016-04-27T14:29:37Z
dc.date.copyright 2016 en_US
dc.date.issued 2016-04-27
dc.identifier.uri http://hdl.handle.net/1828/7199
dc.description.abstract Background: People who use illegal drugs are disproportionately affected by HIV and hepatitis C, stigmatization and social exclusion. Health inequities are worsened by drug policy of criminalization, which thwarts health promotion efforts and hinders access to services. To address these inequities, people who use drugs are increasingly included in decisions that affect them by sitting on policy, service delivery and research committees. This study addressed a gap in understanding how power inequities are transformed in committees where people who use drugs are at the table. Methods: In partnership with the Drug Users Advocacy League and the Society of Living Illicit Drugs Users, this participatory critical emancipatory inquiry explored power relations in four committees in Ontario and BC. Data were collected in 2013 through meeting observations, interviews, demographics surveys and document reviews. Data analysis was guided by theoretical frameworks grounded in critical theory and transformative learning theory. Results: Findings confirmed striking socioeconomic inequities between people who use drugs and others at the table. Inconsistent measures were taken by committees to alleviate barriers to inclusion. Despite openness to inclusion, committee members tended to underestimate people who use drugs. The presence of local organizations of people who use drugs ensured a more democratic selection of their representatives to sit on committees. Once at the table, creating a safe space entailed building trust, authentic relationships, relational and reflective dialogue, and skilled facilitation. Democratic practices of negotiated relationships and consensus-based decision-making enhanced meaningful inclusion. A structural environment in which drug policy criminalizes people who use illegal drugs hindered capacity to transform power inequities by feeding stigma, which worsens health and social inequities. Committees were committed to inclusion of people who use drugs though capacity to do so varied due to budgetary and human resources constraints. Study limitations, practice implications and future research directions are offered. en_US
dc.language English eng
dc.language.iso en en_US
dc.rights Available to the World Wide Web en_US
dc.rights.uri http://creativecommons.org/licenses/by-nc-sa/2.5/ca/ *
dc.subject social inclusion en_US
dc.subject social dimensions of health en_US
dc.subject social determinants of health en_US
dc.subject people who use drugs en_US
dc.subject power inequities en_US
dc.subject power relations en_US
dc.subject practice guidelines en_US
dc.subject harm reduction en_US
dc.subject health inequities en_US
dc.subject critical emancipatory inquiry en_US
dc.subject community-based participatory research en_US
dc.subject decision-making structures en_US
dc.subject transformative learning en_US
dc.subject models of inclusion en_US
dc.title At the table with people who use drugs: transforming power inequities en_US
dc.type Thesis en_US
dc.contributor.supervisor Pauly, Bernadette M.
dc.contributor.supervisor Benoit, Cecilia
dc.degree.department Program: Social Dimensions of Health en_US
dc.degree.level Doctor of Philosophy Ph.D. en_US
dc.description.scholarlevel Graduate en_US
dc.description.proquestcode 0700 en_US
dc.description.proquestcode 0680 en_US

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