Integrating Reflexivity in Public Health Practice: A Proposed Framework for Autoethnographic Exploration to Strengthen Meaningful Engagement of People Who Use (d) Drugs

People who use drugs (PWUD) face significant stigma and are often excluded from or afforded little decision-making power in the development of services and policies that affect their health. This lack of agency has been recognized in recent years and engagement of PWUD is increasingly becoming best practice approach in Canada (Greer, Amlani, Pauly, Burmeister, & Buxton, 2018). However, special consideration needs to be paid to the process of engaging peers which can be addressed by integrating reflexivity at both interpersonal and institutional levels of public health practice. I will use this capstone paper to explore how public health practitioners who are cultural outsiders can operationalize reflexivity in their practice to ensure meaningful engagement of PWUD. I argue that when applied in an appropriate framework, autoethnography is a valuable methodological approach to practice reflexivity. I propose a framework for autoethnographic exploration to guide myself and potentially interested others to examine how the positionality of cultural outsiders working with PWUD can impact power relations, methods of engagement, representation of voice and production of knowledge within public health institutions. I draw from literature on reflexive practices, autoethnography, and peer engagement as well as my own work experiences to inform the framework. I hope this framework can serve as a tool for those interested in reflexive practice and shed light on ways each one of us can reshape our practices of working in health and social institutions as we aim to create more equitable spaces for meaningful engagement of PWUD in public health.