Sex, Drugs and Politics – Understanding community and peer-led health promotion as a complex system

The W3 Project is presenting in London on January 21

We will be providing an overview of our journey in the development and trialling of the W3 framework with our community partners, and discussing what we have learned. If you are in London come and join us. Thank you to our friends at Sigma Research.

Date: Thursday 21 January 2016
Time: 1:00 pm – 2:00 pm

Hosted by Sigma Research
Venue: Jerry Morris B, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK

Full details about the seminar are at the following link


A video walk-through of the W3 Framework for Learning & Evaluation

The framework shows the four key functions that need to be happening for any peer based program to be effective and sustainable in a continually changing community and political environment.

W3 at the Australasian HIV/AIDS Conference 2015


Dr Graham Brown and Natalie Hendry are representing the W3 project at the Australasian HIV/AIDS Conference 2015 in Brisbane.  We have three posters — one for each of our partner case studies — which you can view here online.

Reflections from a workshop on using a systems approach

Workshop in partnership with CEIPS on Thurs 12 March at VicHealth.

In evaluation research, a systems approach provides a conceptual vocabulary and toolkit for improving our understanding of the relationships among the social processes that make programs and interventions ‘work’ as a whole.

In the W3 project we used a systems approach to develop a mid-level program theory for peer and community based health promotion. Here is our theory:

peer-and-community-based health promotion programs mediate between two complex adaptive systems, their target communities and policy environment, and the programs need to fulfil four key functions – engagement, adaptation, influence and alignment – in order to remain effective and sustainable in a constantly changing environment.

In early March we held a workshop with our colleagues at the Centre of Excellence in Implementation and Prevention Science (CEIPS) on using a systems approach in evaluation research with community-based health promotion programs.

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Forthcoming workshop (Thurs 12 March)

Using a systems approach in research with peer and community based health promotion: insights, challenges and lessons learned from the W3 project

Thursday 12th March, 2015 at 9.30am-12.30pm
VicHealth Seminar Room, Ground Floor, 15-31 Pelham Street Carlton Victoria

workshop photo bwThe What Works and Why (W3) project at ARCSHS and the Centre of Excellence in Implementation and Prevention Science (CEIPS) are holding an interactive workshop on Thursday 12 March 2015. The W3 project seeks to help researchers and policy-makers understand the ‘system logic’ of peer and community-based approaches to HIV and hepatitis C. In particular, we are interested in the way flows of knowledge within health promotion programs enable them to adapt to the diversity and dynamism of their target communities, understood as complex adaptive systems. We facilitated workshops with program staff and managers using systems thinking tools and concepts, and through an iterative process, developed program theories for peer based approaches working at different levels – from direct service provision up to policy advocacy.

At this workshop, W3 and CEIPS will share and invite discussion of the insights, challenges and lessons learned along the way – both about implementing the systems approach and engaging with communities as systems in health promotion.

Places are limited, so please RSVP to Courtney Yam ( by Tues 10th March COB.

End of year one wrap post

The first year of the W3 project has been incredibly busy, challenging and yet also fulfilling.

Here are some of the things we got done in 2014:

  • Workshops with practitioners in four different programs — two state and two federal; one service delivery, one health promotion, and two leadership and advocacy; with people who use drugs, sex workers, gay men and people living with HIV; to articulate ‘theories in use’ by practitioners about how their programs actually work.
  • Cross-sectional workshops with practitioners from a range of sectors — two national and one international — to help us identify common challenges faced by programs and organisations no matter what sector or level they work at.
  • Program theories expressed in diagram and textual formats that describe how peer based programs engage with and influence the complex social and policy/funding systems in which they are located.
  • Lists of what items or relationships in those diagrams practitioners thought it would be most important to monitor, both to check our understanding of the maps is correct and to assess how the program could be improved.
  • A draft framework of indicators and domains that our partner organisations could use to generate, organise and package up shareable knowledge about their effectiveness against those priorities and common challenges we identified (to be distributed to partners for feedback and refinement in January).

Here’s what to expect in 2015:

  • An online survey of partner organisations to get a sense of what formal and informal monitoring, evaluation and learning practices are used to generate knowledge about programs and the community and policy systems they engage with.
  • A conversation with W3 partner organisations about the draft indicator framework to refine and get a sense of what looks most useful and worth testing in 2015.
  • We’ll be reporting back to our funders, the Commonwealth Department of Health, at the end of January about our progress so far.  We’re hoping to include preliminary survey results and some or all of the draft indicators to provide examples of insights from the project.
  • We’ll be asking our partners to try a couple of draft indicators from each of 3-4 domains — covering those high-level common challenges discussed in the workshops like engagement, influence, learning and adaptation, and integration — and to give us feedback on whether the exercise as a whole helped or hindered them in meeting those challenges.

In late 2014 we reported on our first-year findings at an ARCSHS Seminar and then sought feedback from our colleagues Alan Shiell and Lyndal Bond at CEIPS, who have a heap of experience using a systems approach in different fields.  They suggested it would be really useful to meet and run through our workshop approach with funders and policy-makers — to get a sense of how they understand the systems they’re engaged with, as well as what kind of knowledge our partner organisations could generate that would help them justify the investment in a peer and community-based approach.

To date our approach has been very much ‘from the ground up’, so seeking an additional ‘top down’ perspective could help us develop indicators that ‘meet in the middle’ — helping to translate knowledge from a practitioner and organisational perspective into forms that are shareable and productive in a policy and funding systemic context.

Wishing you a peaceful break and a productive beginning to 2015,
The W3 Project Team (at different times, Graham, Daniel, Natalie, Marina and Kylie)

Not just individuals and information: articulating the role and value of peer-based programs in HIV and hepatitis C prevention

Australian Research Centre in Sex, Health and Society Seminar Series
Wednesday 26 November 2014, 2-3pm, Room 102-103, La Trobe University, 215 Franklin Street, Melbourne, 3000


Dr Graham Brown, Senior Research Fellow, Australian Research Centre in Sex, Health & Society, La Trobe University
Daniel Reeders, Research officer, Australian Research Centre in Sex, Health & Society, La Trobe University


The What Works & Why (W3) project draws on practice based understandings of how peer based programs engage at the network, community, and structural levels – understandings that are often more sophisticated than much of the published evidence, which tends to focus on individuals and information.[i] We developed and tested an approach based on systems thinking[ii] that uses workshops to elicit and diagram program theories[iii] for different peer based approaches with gay men, sex workers, people who use drugs, and people living with HIV. The approach is based on the insight that communities and policy environments can be understood as complex adaptive systems.[iv] Building on realist evaluation[v], we have developed ‘system logic’ diagrams showing how interventions are embedded in and engage with communities-as-systems.

Evaluation results show participants valued the workshops and the systems approach resonated with them. Early findings have identified aspects of peer approaches that are not well described in the literature, such as the mediating role of ‘peer skill’, the collective perspective in ‘peer leadership’, and the structural and strategic value of peer based programs as sources of real-time knowledge. This presentation will discuss the findings to date from the W3 project, our reflections on using a systems approach, and the next stage of the project, developing quality indicators for the broader role of peer based approaches across the national HIV and HCV responses.


Dr Graham Brown is the Project Lead for the W3 project. He is Senior Research Fellow at ARCSHS. His research interests include the role of peer based programs in public health responses and builds on his previous roles with the West Australian Centre for Health Promotion Research and the Australian Federation of AIDS Organisations.

Daniel Reeders (BA, LLB [Melb] Grad Dip Pub Hlth [Flin]) is the W3 project worker at ARCSHS. Previously he has worked as a senior practitioner in social marketing and community-based research at the Cancer Council Victoria, Centre for Culture, Ethnicity and Health, and Living Positive Victoria.

Contact details (RSVP is not required)
Tel: (03) 9479 8700


[i] Brown, Johnston, Ellard & Carman (2013) Evidence Synthesis and Application for Policy and Practice – Full Report. Monograph Series No. 89. Melbourne: Australian Research Centre in Sex, Health and Society.
[ii] See e.g. Meadows (2008) Thinking in Systems. White River Junction: Chelsea Green Publishing.
[iii] Weiss (1997) “Theory-based evaluation: Past, present and future” in New Directions for Evaluation 76 (Winter) p41-55; Chen (2004) Practical Program Evaluation: Assessing and Improving Planning, Implementation, and Effectiveness. London: SAGE Publications.
[iv] Holland (1995) Hidden Order. How Adaptation Builds Complexity. Reading: Addison-Wesley; Ostrom (1999) “Coping with Tragedies of the Commons” in Ann Rev Polit Sci 1999 (2) 493-535.
[v] Pawson & Tilley (1997) Realistic Evaluation. London: SAGE Publications.