Building and boosting capitals for health care access: a qualitative study of homeless health peer advocacy in London, UK

Peer support is widely promoted as enabling health care access with people experiencing homelessness, including through enabling independence, empowering individuals and managing stigma. However, there is little understanding of these processes, including how they relate to the wide range of potential activities involved in peer support. We studied peer support within a peer advocacy service at a charity run by and for people experiencing homelessness in London, UK. We report analysis from a sub-set of qualitative interviews and focus groups gathered for a qualitative study of peer advocacy. We include interviews that offered insight to particular cases of peer advocacy. These interviews came from 23 clients of the service, 6 peer advocates, 1 staff member and 2 stakeholders. We drew on Bourdieu's theory of capitals to develop a typology of different ways peer support works. The findings focus on reporting three types of experiences: where peer support builds cultural health capital amongst service clients, boosts cultural health capital, social and economic capital, and third, where boosting social and economic capital are priorities. The discussion considers how the analysis helps conceptualise processes of peer support with respect to empowerment, independence and stigma management.