Ingenuity and resiliency of syringe service programs on the front lines of the opioid overdose and COVID-19 crises.
Ingenuity and resiliency of syringe service programs on the front lines of the opioid overdose and COVID-19 crises.
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DOI：
10.1016/j.trsl.2021.03.011
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发表时间：
2021-08
期刊：
影响因子：
--
通讯作者：
Lambdin BH
中科院分区：
文献类型：
--
作者：
Wenger LD;Kral AH;Bluthenthal RN;Morris T;Ongais L;Lambdin BH
随着 COVID-19 在 2020 年加速蔓延，注射器服务计划 (SSP) 面临着挑战，需要进行计划调整以防止过量死亡，同时确保工作人员和参与者免受 COVID-19 的侵害。我们使用定性方法来了解 SSP 在 COVID-19 大流行期间运作的社会背景。我们对来自 18 个项目的项目代表进行了 36 次深度访谈，并使用探索、准备、实施、维持 (EPIS) 实施框架来指导数据分析。我们重点关注 4 个 EPIS 结构中的 3 个：外部背景、内部背景和创新因素。我们的数据表明，应对这一流行病导致了服务提供方面的创新，例如二级和基于邮件的分发、采用远程医疗来招募阿片类药物使用障碍（MOUD）药物的参与者以及使用虚拟培训平台来预防过量用药。我们发现员工和志愿者的高度投入，这是这些创新成功的基石。我们观察到，许多 SSP 由于对安全的承诺而人手短缺，一些 SSP 失去了当前的资金以及未来的资金机会。尽管人员配备很少且资金减少，SSP 的创新速度仍然加快。为了确保这些新方法的可持续性，需要一个支持性的外部环境（联邦、州和地方政策和资金）来支持 SSP 的内部环境（组织特征、个人特征）的发展以及纳洛酮和 MOUD 交付方面所取得的创新的维持。
As COVID-19 accelerated throughout 2020, syringe service programs (SSPs) faced challenges necessitating programmatic adaptations to prevent overdose deaths while simultaneously keeping workers and participants safe from COVID-19. We used qualitative methods to gain an understanding of the social context within which SSPs are operating during the COVID-19 pandemic. We conducted 36 in-depth interviews with program representatives from 18 programs and used the Exploration, Preparation, Implementation, Sustainment (EPIS) implementation framework to guide data analysis. We focused on 3 of the 4 EPIS constructs: Outer context, inner context, and innovation factors. Our data indicate that responding to the pandemic led to innovations in service delivery such as secondary and mail-based distribution, adoption of telemedicine for enrolling participants in medications for opioid use disorder (MOUD) and use of virtual training platforms for overdose prevention. We found high levels of staff and volunteer commitment, which was a cornerstone to the success of these innovations. We observed that many SSPs were short-staffed because of their commitment to safety, and some lost current funding as well as opportunities for future funding. Despite minimal staffing and diminished funding, SSPs innovated at an accelerated pace. To ensure the sustainability of these new approaches, a supportive external context (federal, state, and local policies and funding) is needed to support the development of SSPs’ inner contexts (organizational characteristics, characteristics of individuals) and sustainment of the innovations achieved regarding delivery of naloxone and MOUD.
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DOI：
10.1097/qai.0b013e3181f9c0b6
发表时间：
2010-12
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
Friedland G
通讯作者：
Friedland G
旧金山阿片类药物用户的预防过量预防和纳洛酮处方。
DOI：
10.1007/s11524-010-9495-8
发表时间：
2010-12
影响因子：
6.6
作者：
Enteen, Lauren;Bauer, Joanna;McLean, Rachel;Wheeler, Eliza;Huriaux, Emalie;Kral, Alex H.;Bamberger, Joshua D.
通讯作者：
Bamberger, Joshua D.
对患者和提供者对阿片类药物使用障碍的治疗药物的观点的系统评价。
影响因子：
3.9
作者：
Cioe K;Biondi BE;Easly R;Simard A;Zheng X;Springer SA
通讯作者：
Springer SA
结构水平的针/注射器计划的有效性减少注射药物的人的HCV和HIV感染：系统评价。
影响因子：
4.4
作者：
Abdul-Quader AS;Feelemyer J;Modi S;Stein ES;Briceno A;Semaan S;Horvath T;Kennedy GE;Des Jarlais DC
通讯作者：
Des Jarlais DC
影响因子：
12.7
作者：
Bluthenthal, Ricky N.;Heinzerling, Keith G.;Kral, Alex H.
通讯作者：
Kral, Alex H.