Evidence map›Paper›PMID 39794533›Full record

ArticleCommunications medicine2025

Applying Normalisation Process Theory to a peer-delivered complex health intervention for people experiencing homelessness and problem substance use.

Rebecca Foster, Hannah Carver, Catriona Matheson, Bernie Pauly, Jason Wallace, Graeme MacLennan, John Budd, Tessa Parkes

Abstract read
In one paragraph

Article in Communications medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. "We Don't Normally Go Down This Avenue; This Is Normally Taboo": Using Co-Design to Develop a Training Intervention for Spiritual Health in Primary Care.Health expectations : an international journal of public participation in health care and health policy · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Rebecca Foster *School of Applied Sciences, Sighthill Campus, Edinburgh Napier University, Edinburgh, Scotland, UK.ORCID http://orcid.org/0000-0002-8321-1801
Hannah Carver *Salvation Army Centre for Addiction Services and Research, Faculty of Social Sciences, Colin Bell Building, University of Stirling, Stirling, Scotland, UK. hannah.carver@stir.ac.uk.ORCID http://orcid.org/0000-0002-6846-2661
Catriona MathesonNursing, Midwifery and Allied Health Professions Research Unit, Centre for Healthcare and Community Research, University of Stirling, Stirling, Scotland, UK.
Bernie PaulyCanadian Institute for Substance Use Research, University of Victoria, Victoria, Canada.
Jason WallaceScottish Drugs Forum, 91 Mitchell Street, Glasgow, Scotland, UK.
Graeme MacLennanCentre for Healthcare Randomised Trials, Health Sciences Building University of Aberdeen, Foresterhill, Aberdeen, Scotland, UK.
John BuddUniversity of Edinburgh Medical School, Chancellor's Building, 49 Little France Crescent, University of Edinburgh, Edinburgh, Scotland, UK.
Tessa ParkesSalvation Army Centre for Addiction Services and Research, Faculty of Social Sciences, Colin Bell Building, University of Stirling, Stirling, Scotland, UK.

Funding

DH | National Institute for Health Research (NIHR) 16/153/14
6 · The paper itself

Abstract

backgroundThe Supporting Harm Reduction through Peer Support (SHARPS) study involved designing and implementing a peer-delivered, harm reduction intervention for people experiencing homelessness and problem substance use. Normalisation Process Theory (NPT) provided a framework for the study.

methodsFour Peer Navigators (individuals with personal experience of problem substance use and/or homelessness) were recruited and hosted in six third sector (not-for-profit) homelessness services in Scotland and England (United Kingdom). Each worked with participants to provide practical and emotional support, with the aim of reducing harms, and improving well-being, social functioning and quality of life. NPT guided the development of the intervention and, the process evaluation, which assessed the acceptability and feasibility of the intervention for this cohort who experience distinct, and often unmet, health challenges. While mixed-methods data collection was undertaken, this paper draws only on the qualitative data.

resultsThe study found that, overall, the intervention is feasible, and acceptable to, the intervention participants, the Peer Navigators and staff in host settings. Some challenges were encountered but these were outweighed by benefits. NPT is particularly useful in encouraging our team to focus on the relationship between different aspects of the intervention and context(s) and identify ways of maximising 'fit'.

conclusionsTo our knowledge, this is the first application of NPT to this cohort, and specifically by non-clinicians (peers) in non-healthcare settings (homelessness services). Our application of NPT helped us to identify ways in which the intervention could be enhanced, with the key aim of improving the health/well-being of this underserved group.

Identifiers

PMID39794533
PMCPMC11724100

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.