HaRePo (harm reduction by post): an innovative and effective harm reduction programme for people who use drugs using email, telephone, and post service
HaRePo (harm reduction by post): an innovative and effective harm reduction programme for people who use drugs using email, telephone, and post service
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DOI：
10.1186/s12954-020-00403-1
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发表时间：
2020-08-24
影响因子：
4.4
通讯作者：
Duplessy, Catherine
中科院分区：
文献类型：
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作者：
Torres-Leguizamon, Magally;Reynaud, Emmanuel G.;Duplessy, Catherine
尽管世界各地有多个减少伤害（HR）计划，但仍有大量吸毒者（PWUD）无法获得这些服务。他们难以获得人力资源工具的原因是无法获得这种服务（偏远和/或客户服务时间有限）、费用、数量限制、害怕评判、药房缺乏保密性以及不熟悉人力资源方案。我们测试了一种创新方法，利用远程在线通信和国家邮政分销网络的力量来改善人力资源工具的使用和咨询。基于这些观察，安全协会创建HaRePo在2011年，一个免费和保密的计划，专为那些有困难的人访问人力资源工具和咨询。PWUD可以通过电话和/或电子邮件访问该计划。人力资源专业人员提供人力资源咨询和人力资源工具，并将PWUD与其他人力资源服务，医疗和社会工作者联系起来。人力资源工具是根据个人的需要准备和发送通过法国邮政服务的消费者在法国本土和海外领土。自2011年以来，1 920名残疾人从HaRePo中受益：发送了10 450个包裹，其中包括170多万支注射器和600万件与人权有关的物品。HaRePo收到来自PWUD的积极反馈，PWUD通过远程但可信的通信改进了他们的实践。在加入该方案后，从未重复使用和（或）分享人力资源工具的人的百分比显著增加。平均而言，71.5%的受益人从不重复使用注射器，81%的受益人不重复使用针头。他们是98.5%的消费者，他们不再共用注射器和99%的针头。44%至80%的HaRePo受益者报告说，他们与毒品有关的做法（注射、吸入和鼻吸）现在更安全。最后，39%至53%的HaRePo消费者声称他们的整体身体状况有所改善（例如静脉状况，注射点外观，手臂，腿部和手部肿胀）。结论HaRePo是一个创新的人力资源计划，对难以接触的PWUD有效。它显示了PWUD在改进实践方面的积极反馈循环的证据。最后，HaRePo为法国卫生当局带来了明显的好处，他们决定在2016年扩大该计划。
Background Despite multiple harm reduction (HR) programmes worldwide, there are still an important number of people who use drugs (PWUD) who do not access those services. Their difficulties to obtain HR tools are due to their inability to reach such services (remoteness and/or limited customer service hours), costs, quantitative restrictions, fear of judgement, lack of confidentiality in pharmacy, and unfamiliarity with HR programmes. We tested an innovative approach using the power of remote online communication and the national postal distribution network to improve HR tool access and counselling. Methods Based on these observations, SAFE association created HaRePo in 2011, a free and confidential programme designed for people who have difficulties accessing HR tools and counselling. PWUD can access the programme by phone and/or email. An HR professional delivers HR counselling and HR tools and connects PWUD to other HR services, medical, and social workers. HR tools are prepared and sent according to the person's needs through the French postal service to consumers across Metropolitan France and overseas territories. Results Since 2011, 1920 PWUD have benefited from HaRePo: 10,450 parcels were sent accounting for more than 1.7 million syringes and 6 million HR-related items. HaRePo receives positive feedback from PWUD who have improved their practices through remote but trusted communication. The percentage of people that, after joining the programme, never reuse and/or share HR tools have significantly increased. On average, 71.5% of beneficiaries never reuse syringes and 81% do not reuse needles. And they are 98.5% consumers who never share syringes and 99% needles any longer. Between 44 and 80% HaRePo beneficiaries have reported that their drug-related practices (injection, inhalation, and snorting) are now safer. Finally, between 39 and 53% HaRePo consumers declared that their overall physical state has improved (e.g. venous condition, the appearance of point of injection, swelling of arms, legs, and hands). Conclusion HaRePo is an innovative HR programme efficient for hard-to-reach PWUD. It shows evidence of a positive feedback loop for PWUD in improving their practices. Finally, HaRePo represents a clear benefit for health authorities in France, who decided to expand the programme in 2016.