Towards a Scope of Practice for Peer Support Workers in Addictions: A Community-Based Study Using Qualitative Description

Abstract

The aim of this study was to identify how Peer Support Workers (PSWs) understand their scope of practice, to provide greater clarity for PSWs working in addiction care with interprofessional teams. We conducted semi-structured interviews with PSWs and analysed the results using qualitative description. We interviewed 17 PSWs from a variety of backgrounds. We identified five descriptive themes that illustrate how PSWs delineated their scope of practice: building relationships with clients, therapeutic engagement with clients, system navigation, providing supplies to clients, and professional development. PSWs had a clear sense of their scope of practice and how they could be most effective, despite a lack of recognition of this scope in their workplaces. By creating a preliminary description for a PSW scope of practice, we hope that PSWs and nurses can work together to support the PSW professional role, enhancing patient outcomes.

Peer Support Workers (PSWs) are an important part of addiction and mental healthcare teams. The duties of PSWs vary by setting; however, in addictions healthcare, their role is characterized as someone who has lived experience of substance use, who works as a mentor to support clients as they access services (Cabral et al., 2014; Tate et al., 2022). Clients reported that working with PSWs improves their mental health (Cabral et al., 2014; Rebeiro Gruhl et al., 2016). For example, PSWs may meet with clients to discuss practical strategies to manage their care or share empathy about addiction treatment. PSWs reported that their shared experiences with clients were the foundation for their therapeutic relationships, supporting positive client outcomes (Cabral et al., 2014).

Peer support services have a long history of utilization for the treatment of mental health conditions, dating to the 1700s (Gremmen & Hopkins, 2022). Peer support work has shaped the way patients accessed care for mental health conditions, from advocacy groups against involuntary confinement in the 1800s, the Survivor Ex-Patient Movement in the 1970’s, and the Recovery Movement present today (Davidson, 2016; Gremmen & Hopkins, 2022; Solomon, 2004). Across the history of treatment for mental illnesses, the role of peer support has been advocacy, connection, and the mutual understanding of shared lived experience (Gremmen & Hopkins, 2022; Solomon, 2004). In addiction care, PSWs connect with clients by utilizing their own lived experience and supporting clients to access services (Parkes et al., 2022).

Until the 2000s, peer support in substance use treatment existed informally in recovery groups like Alcoholics Anonymous (Gremmen & Hopkins, 2022; Scannell, 2021). Today, PSWs can be hired members of addiction healthcare teams, creating positive impacts for clients by building trust, enhancing client treatment retention, and reducing overdose risk among clients (Mercer et al., 2021).

However, the role of PSWs in interprofessional addictions treatment teams is nebulous (Cleary et al., 2018; Rebeiro Gruhl et al., 2016). Researchers found that PSWs have vaguely defined roles, without a clear scope of practice (Cabral et al., 2014; Felton et al., 2023; Lennox et al., 2021; Simpson et al., 2018; Vandewalle et al., 2016). In this study, scope of practice refers to the activities in the remit of PSWs in their professional roles. The Substance Abuse and Mental Health Services Administration (2015) have created competencies for peer workers following extensive consultation, which include foundational knowledge, skills, attitudes, and behaviours that PSWs demonstrate in practice. However, PSWs and their employers may benefit from additional guidelines to identify the workplace duties that are included in PSWs’ practice.

As a result of having ill-defined scopes of practice, PSWs have reported feeling they are utilized to fill gaps, rather than having a clear therapeutic role (Felton et al., 2023). As a result, PSWs experienced frustration in their work and felt unable to reach their professional potential (Rebeiro Gruhl et al., 2016; Vandewalle et al., 2016; Walker & Bryant, 2013). PSWs also reported that they were not seen as equals by other colleagues (Walker & Bryant, 2013). Nurse may also underestimate the potential contributions of PSWs to addiction healthcare, as nurses have reported that they perceive PSWs as having only their personal stories to offer clients (Cleary et al., 2018).

There could be negative outcomes for PSWs because of their ill-defined role. PSWs in American healthcare settings found it challenging to identify how organizational supports could assist PSWs’ own recovery, as they provided support to clients (Felton et al., 2023; Tate et al., 2022). PSWs also benefit from professional mentorship in their workplaces (Felton et al., 2023; Lennox et al., 2021; Nossek et al., 2021; Vandewalle et al., 2016). For example, PSWs may have sought mentorship around maintaining boundaries with clients in their therapeutic engagements (Felton et al., 2023). However, effective mentorship for PSWs could be challenging because of a lack of understanding of the boundaries between PSWs and clients (Felton et al., 2023; Foglesong et al., 2022; Forbes et al., 2022). There could be longer-term implications for job satisfaction and staff turnover if PSWs experienced frustration in their roles. By exploring how PSWs understand their scope of practice, we hope to enable PSWs to maximize their contributions to client care and interprofessional teams.

Aim

Our aim was to describe how peer support workers understand their scope of practice within interprofessional addictions care teams. Specifically, we explored how PSWs describe their role in practice, rather than how organizations might prescribe that role.

Methods

We located our community-based research in the philosophical/theoretical framework of classical pragmatism (Dewey, 1998), which meant choosing a method that worked and gaining knowledge through engagement with people. Classical pragmatism provided opportunity for consideration of both social and scientific knowledge development in understanding how PSWs identify their scope of practice (Ginn et al., 2019).

We completed a community-based qualitative explorative study, using qualitative description (Sandelowski, 2010). Sandelowski (2010) explained qualitative description as a method where the researchers create findings close to these data, rather than highly abstracted findings. We analyzed our data for relevant patterns, staying close to the words of participants (Sandelowski, 2010) to illustrate how PSWs understand their scope of practice. While some authors have viewed qualitative description as in introductory qualitative method (Hall & Liebenberg, 2024), we found it valuable as a complement to classical pragmatism, and an opportunity to prioritise fidelity to participants’ voices over higher levels of abstraction (Turale, 2020).

Inclusion of PSW

We designed our community-based study in partnership with PSWs, with a PSW (SP) embedded in the research team throughout the project. In pragmatic research, Dewey (1998) emphasized shared humanness between researchers and participants. We counted PSWs’ expertise as crucial to conducting this study (Dewey, 1998; Ginn et al., 2019). Our research team has ongoing relationships with organizations that employ PSWs in our community. While collaborating on a previous project, PSWs indicated they needed more professional support in their roles and wanted us to work with them on a study about scope of practice. We held regular meetings with local organizations, and during these meetings, several PSWs expressed interest in the study. We created the aim of the study through engagement with PSWs around our broader program of research on supporting the addictions workforce. Our partnership with PSWs to address their professional concerns was consistent with our pragmatic approach to the study (Ginn et al., 2019), where we sought to co-create practical outcomes to solve a community problem.

OUr peer researcher SP was named as a co-applicant in the funding application for this work. They were also involved in the literature review, developing the study methods and protocol, and the interview guide. SP completed several of the interviews and was the leader of the data analysis process. They were also closely involved with writing the manuscript and revisions.

In addition to our peer researcher, we also engaged PSW participants. We completed interviews with PSWs and sent our provisional findings to participants for input. We sent each participant a lay summary of the research findings and offered to meet with each of them to discuss the outcomes of the study. We also presented the research invitation at several local organizations and PSW groups. We aimed to involve PSWs throughout the research process as much as possible, while maintaining participant confidentiality. These steps were our effort to overcome limitations of previous work, where there was minimal engagement with PSWs.

Setting

We worked with PSWs in addiction treatment settings, both in public healthcare services and in grassroots organizations in the community. We recruited participants in a single Canadian province with a single health authority that provides all hospital services across the province, for a current population of about 5 million people. We connected with both the health authority and various community agencies to recruit participants for interviews. The local health authority was the provincial, publicly funded healthcare system, available to everyone with no cost at the point of care. The community organizations were groups that worked in shelters, street outreach, and other services specifically for people with addictions. The political climate in this province was generally regarded as hostile towards people who use drugs, with emphasis on abstinence-based addiction treatment (Wilson et al., 2024).

Recruitment

We used purposive sampling in this study, aligned with qualitative description (Turale, 2020). We recruited PSWs by emailing program managers in both the health authority and community agencies our recruitment information and asking them to forward the study materials to their staff. We included PSWs who work directly with clients in any phase of addiction treatment, from outreach work to long term recovery support. Participants had to be able to complete a Zoom interview in English and be currently working as a PSW. We interviewed all PSWs who expressed interest and provided informed consent. Participants had to have lived experience of addiction, but we did not ask PSWs to disclose the nature of the experience-only to confirm they had lived experience.

We sent potential participants the consent form to review before the interviews. Participants signed (digitally or signed and scanned) and returned consent forms before beginning interviews. We also asked participants verbally if they had any questions about the study before we proceeded with the interviews. We had four potential participants who returned consent forms but did not conduct an interview, either due to not attending a planned interview or an inability to find a mutually convenient time. No participants withdrew from the study after completing an interview.

Data Collection

We completed semi-structured, individual interviews with participants (Sandelowski, 2010). This modality was identified by PSWs as their preferred way to speak about their experiences, aligning with our pragmatic approach (Ginn et al., 2019). We used an interview guide as part of semi-structured interviews, which was co-developed with SP, our peer researcher (Appendix A). We asked participants how they understood their scope of practice, their roles at work, the boundaries of their responsibilities, and how they envisioned working to their full scope of practice.

We conducted interviews via Zoom, for about 60 minutes, with audio recording. JJ and SP both conducted interviews, based on mutual convenience with participants. We were careful not to assume understanding from our personal experiences and used probes with participants to explore how participants understood a topic. We also invited participants to share other relevant topics we may not have covered.

Data Analysis

We reviewed transcripts to construct descriptive themes based on patterns in participants’ experiences (Sandelowski, 2010). Our interviews were professionally transcribed, and we used NVivo v.14 software for data management during analysis. SP completed the initial coding of interviews, which was consistent with co-creating knowledge with PSWs, our population of interest (Ginn et al., 2019). They began by reviewing the interview transcripts to be more familiar with the participants’ perspectives. They identified single words or ideas (i.e., “motivational interviews”) that were present in more than one interview and coded these as initial codes (Sandelowski, 2010).

The next stage in our analysis was to meet with the principal investigator JJ to discuss these codes and start creating broader descriptive themes. We organized similar ideas to build descriptive themes of what PSWs understood as their scope of practice. We repeated this process of grouping related ideas and discussing them as a team (JJ, JC, CG, SP) until our themes were representative of our participants’ experiences. Our themes reflected the patterns evident in these data, recognizing that we were not aiming to identify all possible experiences of the phenomenon (Braun & Clarke, 2021). We were also mindful to include different dimensions of a descriptive theme to round out our examples of both what was and was not the scope of practice.

We also used member checking as a technique to enhance rigour in our study (Morse, 2015), which aligns with our pragmatic approach of creating knowledge by engaging participants (Ginn et al., 2019). After we created a preliminary scope of practice description for PSWs, we sent the description to participants via email to invite their feedback. Three participants responded with additional comments. They agreed broadly with our themes and proposed alternative wording for some of the theme’s details, which we used to refine the language in the description.

Reflexivity

Throughout the study, we employed reflexive writing and regular team debriefing discussions to support rigour in the study (Dean, 2017; Morse, 2015). SP was aware of their positioning as a PSW and how their experiences could influence their interactions with participants. SP reflected on positionality throughout the study, making personal notes and discussing their experiences with JJ. In interviews, we were careful to ask for clarification to avoid making assumptions about participants’ experiences. The feedback from our member checking suggested that our description of PSW scope of practice was authentic to participants.

Ethical Considerations

We obtained ethical approval from the Conjoint Health Research Ethics Board at the University of Calgary (REB23-0695). All participants signed written consent forms prior to participating in our study. Study participants received a gift card for $30 as a thank you for their participation in the study, roughly equivalent to an hourly wage for a PSW. We offered all participants mental health follow up support from a free, third-party organization on the consent forms and verbally at the end of the interviews.

Results

Participants

We interviewed 17 PSWs. These demographic data for our sample are illustrated in Table 1. The majority of our participants identified as women, with most participants self-describing their ethnicity as white. Our participants had a variety of different ages and levels of education, with most having fewer than 4 years of experience as PSWs.

Table 1.

Participant Demographics

Demographic	Demographic subcategories	N	%
Work Setting	Local Health Authority	11	64%
	Community Organization	6	35%
Age	25-34	3	17%
	35-44	4	24%
	45-54	6	35%
	Above 55	4	24%
Gender	Woman	10	59%
	Man	6	35%
	Non-Binary	1	6%
Ethnicity	First Nations	2	12%
	Black	1	6%
	Latino	1	6%
	White	11	64%
	Preferred not to disclose	2	12%
Years in current position	1-4 years	11	64%
	5-9 years	6	35%
	10-14 years	1	6%
Type of education/training	In house/On the job training	5	29%
	Canadian Mental Health Association Course	2	12%
	College Certification	9	53%
	Other	1	5%

Context

Our findings were situated in our local context. In the study setting, PSWs’ scope of practice was enacted within an environment that prioritized client self-determination and autonomy. Participants could only enact their scope of practice with client consent for their interactions. All participants prioritized client autonomy and clients’ self-directed treatment goals. As a consequence, all interactions, activities, referrals, and decision-making were client led. A participant highlighted how client self-determination informs all their work: “I don’t tell people what to do. I hold no agenda as to what someone else’s life should be like.” (P11) This participant highlighted that their work was a consent-based, client-led process. Consent and autonomy reinforced the choice and safety of clients, which enabled PSWs to create therapeutic relationships with clients. We have highlighted consent and autonomy as the context for these findings because these factors are integral to each theme in the following sections.

PSWs’ Understanding of Their Scope of Practice

Our participants explained several distinct roles within their work, which were the basis of the following scope of practice of PSWs. We acknowledge there are inevitable grey areas in any scope of practice. We generated five descriptive themes about PSW practice: Building Relationships with Clients, Therapeutic Engagement with Clients, System Navigation, Providing Supplies to Clients, and Professional Development, explained further below. Figure 1 presents how participants understood their scope of practice and role in interprofessional teams, followed by the descriptive themes supporting each statement.

Figure 1.

Scope of practice for peer support workers

Theme 1- Building Relationships With Clients

Participants identified that building relationships with clients was the foundational element of their work. A participant summarized their understanding of their scope of practice and their role objectives: “My main objective as a peer support worker is to build rapport [with clients], so at the end of the day, typically, all my tasks fall under building rapport” (P4) Participants detailed how rapport development was essential to building a therapeutic relationship between clients and PSWs, to create trust. Once rapport had been established, participants reported that clients were willing to share their experiences and begin to engage in healthcare services.

Participants also identified that their lived experience was a cornerstone to their role. Participants identified how appropriate disclosure of lived experience played a part in building trust and supporting clients’ willingness to engage with healthcare professionals. A participant shared their success in utilizing their lived experience to develop peer-client relationships: “It can almost help create that relationship… I always heard, “You have no idea what I’m going through.” Or “You have zero idea what it's like.” And to have somebody turn around and go, “Actually, ma’am, I do.”” (P17) While participants considered building rapport and sharing their past lived experiences with clients as part of their scope of practice, they explained that these relationships also have limitations. Participants stated that friendship or relationships outside of a working environment crossed a professional line, and thus, fell outside of PSW scope of practice.

Theme 2- Therapeutic Engagement With Clients

All participants identified therapeutic engagement with clients as part of their scope of practice. Therapeutic engagement involved employing techniques like motivational interviewing and active listening skills. However, participants stressed the distinction between their engagement and the role of social workers or psychologists, who may use techniques such as Cognitive Behavioral Therapy or other therapy modalities. A participant highlighted the distinction between the role of PSWs and therapists:

I don't have the proper education to spend [time] with them because I don't want to do something or say something that will push them back further or damage themselves or damage somebody that they care about. I don't have the insurance, I don't have the education, so I'd rather the people that have that have gone to school for it and that have the proper education, that they deal with that. (P07)

Participants highlighted how their role was to listen to and support clients, but not provide therapy. This participant highlighted the critical difference between the approaches and boundaries of licensed-professional relationships and theirs:

I'm sure there's many people that are working in regulated professions that also have lived experience because I was one of them for many years. But when you can't use [your experience] in the same way, the connection, it cannot be as deep. It just can't. (P14)

Participants recognized the limits of their engagement with clients and how PSWs could engage in motivational interviewing but not therapy modalities, as formalized therapy and giving advice fell outside of their scope of practice.

Theme 3- System Navigation

Participants assisted clients in navigating complex systems to meet their needs. The theme of systems navigation included responsibilities such as referring clients to external services and activities, helping clients complete applications for income assistance, supporting clients to access personal identification, and accompanying clients to appointments. Participants recognized potential fear or anxiety when completing these activities and supported clients’ continued engagement in treatment. For example:

I've been to groups and taken people to recreational therapy groups and that stuff as well, helping them get a little bit more engaged and just be a little bit more comfortable being there if they at least know one person. (P17)

This participant recognized how intimidating it could be to access activities without knowing anyone. By accompanying clients to activities, PSW supported clients to access services with reduced anxiety.

Participants also included navigating complex healthcare services with clients as part of their scope of practice. Clients could invite participants to attend an appointment if the client was intimidated to go alone. A participant expanded: “I am the bridge between being outside and being in the community and accessing any sort of health care. It’s more than accessing [the health authority], it’s also accessing other social services. It’s about accessing healthy habits.” (P06) Supporting clients to navigate healthcare services meant that PSWs worked to mitigate challenges and stigma that clients could face in these settings. For example, PSWs could advocate for clients during an appointment if a client was being dismissed. Participants used these opportunities to model calm behaviors and effective communication, to build client capacity for future interactions.

Participants reported when filling out housing, medical or income applications with a client, completing these tasks for or on behalf of the client fell outside of their scope of practice: “The most important piece, in my opinion, is we don’t do it for them. Like, that’s not helping them at all.” (P05) When participants filled out an application or attended an appointment with a client, the event was an educational process, intended to impart skills and confidence for the client. These interactions were based on clients’ requests for support, not organizational programing. Participants also shared that pushing a client to attend appointments that a client did not want to attend fell outside their scope of practice: “That person may not want me to do it. They may not want to go to that appointment. They may not prioritize that thing for themselves. [Pushing clients to attend] is in no way peer support at all,” (P14) Placing pressure on clients to attend appointments could damage the rapport, trust, and client autonomy in the peer relationship and was not in the scope of PSWs’ role.

Theme 4-Providing Supplies to Clients

Participants shared that one of their core role responsibilities was to provide clients with items such as food and clothing, or harm reduction supplies such as new injection supplies or naloxone kits. It was further explained that the responsibility did not end there: “I hand out harm reduction, but I also talk to them about safe supply, safer use, not just handing it out and walking away.” (P07) This participant highlighted the importance of utilizing outreach opportunities to engage in further interaction with the client, in which they provided further harm reduction education to clients. They also used this opportunity to provide information about other resources that were available. All participants shared that providing these types of supplies was a step towards engagement with clients, where they could utilize this opportunity to provide support for other client challenges. Clients left these interactions with supplies and knowledge to manage their health and recovery. Participants shared the importance of providing these supplies with a therapeutic purpose. PSWs’ intent and efforts towards further engagement distinguished participants from other people who distributed supplies to clients.

Theme 5-Professional Development

Participants recognized that a key aspect of their role was ongoing learning and development of their therapeutic engagement skills, as well as prioritizing their own recovery and mental health. Participants sought out further education, through either their own workplace or from other sources. This participant emphasized the need for pursuing continuing education: “It’d be like a doctor that just stopped learning after they went – you’ve got to continue learning. Medicine changes every year.” (P13) Participants also emphasized how the importance of maintaining their own mental health fell under their scope of practice. A participant shared: “I realized if I’m not in my best place, then I can’t be anything for anybody. I need to be there for myself before I can be there for anybody else.” (P11) Participants identified scope of practice as role modelling healthy behaviors and recovery to their clients. Therefore, reflecting on their own practice and wellbeing as an important part of PSWs’ scope of practice. Participants reported that a lack of continued education as outside of their scope of practice.

Discussion

PSWs in the current study had a clear sense of what their scope of practice could be in addiction care settings. In contrast, other authors reported that the PSW scope of practice was ill defined (Cabral et al., 2014; Cooper et al., 2024; Felton et al., 2023; Lennox et al., 2021; Simpson et al., 2018; Vandewalle et al., 2016). Greer et al. (2021) studied organizational support for harm reduction PSWs, identifying PSWs’ autonomy as important, yet difficult, as they often lacked information surrounding their roles and responsibilities. Training developed by and for PSWs was essential, with an emphasis on contextual factors, including PSWs’ past experiences (Coffey et al., 2025; Haun et al., 2024). We hope that by offering a preliminary scope of practice, we could provide PSWs with a starting point for navigating their scope of practice in their workplaces.

Prior researchers reported that client consent and client autonomy were key priorities for PSWs (Substance Abuse and Mental Health Services Administration, 2015). Our study highlights that PSWs have opportunities to provide material assistance to clients as part of their scope of practice, such as providing new needles or food. The Substance Abuse and Mental Health Services Administration (2015) core competency framework for PSWs identifies respect for individuals’ self-determination, choice, and autonomy as central principles of PSW practice. We also found that documents like the Substance Abuse and Mental Health Services Administration (2015) competencies were not referred to by any participants, suggesting they do not currently inform practice in our jurisdiction.

PSWs in our study identified relationship-building with clients as foundational to their work, including building rapport and therapeutic relationships through their lived experiences. However, other researchers have reported that PSWs found it difficult to build relationships with clients when they were worried about meeting their own needs (Chen et al., 2023; Greer et al., 2021; Mamdani et al., 2021). For example, Mamdani et al. (2021) described how stressors such as financial insecurity due to inequitable pay, job instability, housing, and other socioeconomic factors created barriers to relationship-building with clients. Participants in the current study did not address these points directly, which may mean that adequate wages relieved these concerns, enabling PSWs to focus on supporting clients.

Navigating systems was another role of PSWs in our study, which involved decreasing clients’ feelings of intimidation when accessing services. Greer et al. (2021) also highlighted the importance of systems navigation and helping clients work through social assistance and housing. Russell et al. (2021)’s study of service needs of people who use drugs identified the importance of employing PSWs to decrease stigma when clients were accessing health services. Our study reinforces the role of PSWs as system navigators as a central part of the PSW scope of practice. Atanackovic et al. (2025) identified PSWs as an essential part of a Canadian mental health and substance use workforce, with a focus on culturally appropriate and trauma-informed care, which would likely be the case for other jurisdictions as well.

Limitations

Our community-based study may be limited by the context of our participants. As all the participants were in a single jurisdiction (and subsequently, a single political context), it may be that PSWs in other settings have different scopes of practice. There may also be a need to customize the PSW scope of practice further, to meet the needs of clients in different settings.

Recommendations for Practice

With our pragmatic approach to this study, we prioritized identifying concrete actions that PSWs and their employers could take (Ginn et al., 2019). We recommend that PSWs could start discussions in their workplace using our preliminary PSW scope of practice. It may be useful for colleagues and managers to understand the roles of PSWs so that PSWs can work to their full scope of practice, rather than filling in random gaps. The scope of practice can also offer PSWs an opportunity to identify areas for their continuing professional development, with their clinical managers. Our participants knew ways they could be most effective in working with clients, and we encourage managers and clinical practice leaders to support PSWs to work to full scope.

Nurses work alongside PSWs in addiction services, but tend to undervalue their contributions to interprofessional teams (Cleary et al., 2018). As a regulated profession, nurses have a relative degree of authority in these clinical spaces. Nurses and PSWs have shared goals of supporting clients (Cleary et al., 2018), and nurses can encourage interprofessional discussions about how to optimize everyone’s scope of practice in their clinical setting. Nurses could work with PSWs to ensure that PSWs are working to their full scope of practice, improving outcomes for clients. Additionally, nurses can advocate for PSWs to ensure an authentic description of PSW scope of practice is used in their clinical setting, to overcome the problems created by a lack of PSW role clarity. These efforts could help nurses strengthen their teams and support clients in addiction services.

Future Research

The PSWs in our community-based study identified varied understanding about their role and scope of practice. We have offered a preliminary scope of practice for PSWs, which we hope researchers will apply and evaluate. Researchers can continue studying systemic barriers and facilitators for PSWs to fulfill their professional roles fully, and how PSWs’ identity characteristics may influence their work. There are also opportunities to study more about the role of PSWs in supporting clients and how to meet the professional development needs of PSWs.

Conclusion

Researchers have identified that PSWs have an essential role in interprofessional teams in addiction services, but the scope of practice for PSWs has been ill defined. Through our study with PSWs, we identified five descriptive themes of PSWs scope of practice: building relationships with clients, therapeutic engagement with clients, system navigation, providing supplies to clients, and professional development. PSWs and their colleagues could consider this scope of practice to support the role of PSWs in addiction services and provide support for PSWs in their roles.

Author Biographies

Samantha Perry is a Peer Support Worker in Alberta Health Services, in Calgary, Alberta, Canada.

Jeremy Chapdelaine is a Registered Nurse in British Columbia, Canada.

Dr. Carla Ginn is an Associate Professor and Registered Nurse in the Faculty of Nursing at the University of Calgary, Calgary, Alberta, Canada.

Dr. Jennifer Jackson is an Associate Professor and Registered Nurse in the Faculty of Nursing and jointly appointed in the department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.

Appendix.

The purpose of these questions is to collect demographic data on the interviewed participants. This information will serve to describe our sample of participants to contextualize our research findings. We will ask participants the following opening questions:

• What is your age?

• What is your gender identity?

• Do you live with any disabilities?

• Where are you currently employed as a peer support worker?

• What level of education or training was required for this job?

From there, we will begin asking questions pertaining to the interview itself.

Interview Guide:

We are planning to interview 20 people across Alberta who are employed as peer support workers (PSWs). In these interviews, we hope to learn more about what the role looks like in the mental health services setting. We hope to gain further insight into how peer support workers conceptualize their practice, and for the results of this study to guide future research in supporting the role of peer support workers in the health care environment.

Interviews will be conversational and open-ended; however, this interview guide will give some structure to the conversation. Researchers will ask follow-up questions, such as, ‘can you tell me more about what you meant when you said…?’ or ‘can you expand on that?’

Introduction/Background

• Please tell me about your role in the organization.

• What got you interested in working in this position?

• How long have you worked there?

• What level of education or training was required for you to be employed as a PSW?

Scope of Practice

• What are you educated or trained to do in this role?

• What are your daily tasks and role responsibilities?

• Where are the boundaries of what you can do safely within your role?

• Who do PSWs refer to for out-of-scope responsibilities?

• Who do PSWs go to for help in the workplace?

Impact

• We know PSWs have a significant impact on clients, can you tell me a bit more about how and why this position is important for clients?

• What are the main challenges for the peer support workers?

• We have talked about a lot of important things today, is there anything I missed or that you would like to share with me? 

Closing

Thank the participant for their time and for sharing their valuable knowledge and experiences.

ORCID iDs

Samantha Perry https://orcid.org/0009-0006-8609-8599

Jennifer Jackson https://orcid.org/0000-0001-9401-761X

Ethical Considerations

Ethical approval was obtained from the Conjoint Health Research Ethics Board at the University of Calgary, REB23-0695. All participants provided informed consent and signed consent documentation prior to participating in the study.

Data Availability Statement

The participants of this study did not give written consent for their data to be shared publicly, so due to the sensitive nature of the research supporting data is not available.*