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

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dc.contributor.authorBelle-Isle, Lynne
dc.contributor.supervisorPauly, Bernadette M.
dc.contributor.supervisorBenoit, Cecilia
dc.date.accessioned2016-04-27T14:29:37Z
dc.date.available2016-04-27T14:29:37Z
dc.date.copyright2016en_US
dc.date.issued2016-04-27
dc.degree.departmentProgram: Social Dimensions of Healthen_US
dc.degree.levelDoctor of Philosophy Ph.D.en_US
dc.description.abstractBackground: 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.description.proquestcode0700en_US
dc.description.proquestcode0680en_US
dc.description.proquestemaillynnebel@uvic.caen_US
dc.description.scholarlevelGraduateen_US
dc.identifier.urihttp://hdl.handle.net/1828/7199
dc.languageEnglisheng
dc.language.isoenen_US
dc.rightsAvailable to the World Wide Weben_US
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/2.5/ca/*
dc.subjectsocial inclusionen_US
dc.subjectsocial dimensions of healthen_US
dc.subjectsocial determinants of healthen_US
dc.subjectpeople who use drugsen_US
dc.subjectpower inequitiesen_US
dc.subjectpower relationsen_US
dc.subjectpractice guidelinesen_US
dc.subjectharm reductionen_US
dc.subjecthealth inequitiesen_US
dc.subjectcritical emancipatory inquiryen_US
dc.subjectcommunity-based participatory researchen_US
dc.subjectdecision-making structuresen_US
dc.subjecttransformative learningen_US
dc.subjectmodels of inclusionen_US
dc.titleAt the table with people who use drugs: transforming power inequitiesen_US
dc.typeThesisen_US

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