A McMaster-led project that integrates people with lived experience of drug use into care teams for a vulnerable population has been recognized with the President’s Award for Community-Engaged Research (PACER).

Robin Lennox, an assistant professor of family medicine at McMaster, heads the Second Heart Project, a peer-focused, multi-disciplinary harm reduction strategy that helps people with infective endocarditis who inject drugs.

Infective endocarditis is a severe infection caused by bacteria entering the bloodstream and settling in the heart lining.

“In this case, the risk factor for many people to develop this infection is injection drug use, and more specifically, usually drug use in unsafe conditions or with unsafe supply,” says Lennox, who is the co-head of service for the Inpatient Addiction Medicine Service at Hamilton Health Sciences and St. Joseph’s Healthcare Hamilton.

The President’s Award for Community-Engaged Research recognizes teams of campus and community representatives who have demonstrated a commitment to initiating and supporting excellence in community-campus research initiatives.

The $10,000 grant for furthering community-engaged research that comes with the award will help with what Lennox refers to as the core of the program — those peer support workers with lived experience of drug use who Lennox says are integral in connecting with a ‘hard to reach’ population that is often socially disadvantaged and facing unstable housing.

“It’s because of that value of the shared experience they’re able to relate to our participants, to really engage them in care in a way that overcomes some of the negative previous interactions that they may have had with health care.”

The peer support worker role is an addition to a multidisciplinary endocarditis care team within the project that includes an addiction medicine physician, a family doctor, a systems navigator, an infectious disease doctor and a cardiovascular surgeon.

“What our program does is basically create an endocarditis team that’s a little bit more tailored towards the unique needs of this patient group,” says Lennox.

A bridge between the hospital and the community

The program’s three peer support workers — one is from the Hamilton Social Medicine Response Team and two are from the Canadian Mental Health Association — have taken on many roles and duties that include connecting participants to housing and community supports, accompanying participants to appointments and forging emotional connections with them, Lennox says.

“[The peer support workers] give a little bit more trust and a little bit more credibility to all the other team members, which is very helpful,” says Lennox. “They’re really able to be a bit of a bridge between the participants and their traditional health-care team, and also be a bridge between the hospital and the community.”

The PACER grant will go towards salary support for the peer support workers, increasing the amount of time each worker can spend with participants.

“I’d say for the participants in our program they’ve often said that the peer support worker is the one person on that team who makes the biggest impact,” says Lennox.

The Second Heart Project team was thrilled to win the award and hopes the pilot project will become a permanent fixture — especially given the great need in this community, according to Lennox.

“Hamilton has disproportionately high rates of drug-related harms compared to the rest of the province.”

People who inject drugs and get infective endocarditis have extremely poor long-term health outcomes, she notes.

“After one year, generally, about a quarter of these patients have died […] and most of our patients are under the age of 40. And so those sorts of high mortality rates are tragic,” says Lennox.

“And so part of what we’re trying to do is figure out ways to provide more support so that people not only hopefully will have better access to care and treatment for both their infection and their substance use, but also hopefully try to mitigate some of those long-term negative outcomes.”