'Safer environment interventions': a qualitative synthesis of the experiences and perceptions of people who inject drugs.
'Safer environment interventions': a qualitative synthesis of the experiences and perceptions of people who inject drugs.
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DOI：
10.1016/j.socscimed.2014.01.051
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发表时间：
2014-04
影响因子：
5.4
通讯作者：
Small, Will
中科院分区：
文献类型：
--
作者：
McNeil, Ryan;Small, Will
关键词：
越来越多的人认识到，社会、结构和环境力量使注射毒品者（PWID）容易受到健康危害，而安全环境干预措施（SEI）已被确定为减轻这些背景力量对毒品相关危害的影响的关键。然而，迄今为止，SEI在文献中的理论化程度较低，并且它们如何在干预类型和设置中最大限度地减少药物相关风险尚未得到充分研究。本文介绍了一个系统的审查和定性研究报告PWID的经验与三种类型的SEI（注射器交换计划，监督注射设施和基于同行的危害减少干预）1997年和2012年之间发表的荟萃综合的结果。这种综合集成旨在通过PWID的经验来全面了解SEI。本荟萃综合分析纳入了代表21项独特研究的29篇论文，其中包括800多项PWID。这项Meta研究发现，社会环境影响评价促进了社会和物质环境，减轻了与毒品有关的危害，增加了获得社会和物质资源的机会。具体而言，SEIs：（1）提供了远离街头毒品场景的避难所;（2）通过重塑注射吸毒的社会和环境背景，实现了更安全的注射;（3）以中介方式获得资源和医疗保健服务;（4）受到禁毒和执法活动的制约。这些研究结果表明，这是至关重要的，以ISOSEIs在有关的生活经验的PWID，特别是提供更广泛的环境支持PWID。鉴于现行药物法律限制了干预措施的有效性，需要进行药物政策改革，以使公共卫生，特别是SEIs，在应对注射吸毒方面发挥更突出的作用。
There is growing acknowledgment that social, structural, and environmental forces produce vulnerability to health harms among people who inject drugs (PWID), and safer environment interventions (SEI) have been identified as critical to mitigating the impacts of these contextual forces on drug-related harm. To date, however, SEIs have been under-theorized in the literature, and how they minimize drug-related risks across intervention types and settings has not been adequately examined. This article presents findings from a systematic review and meta-synthesis of qualitative studies reporting PWID’s experiences with three types of SEIs (syringe exchange programmes, supervised injection facilities and peer-based harm reduction interventions) published between 1997 and 2012. This meta-synthesis seeks to develop a comprehensive understanding of SEIs informed by the experiences of PWID. Twenty-nine papers representing twenty-one unique studies that included an aggregate of more than 800 PWID were included in this meta-synthesis. This meta- synthesis found that SEIs fostered social and physical environments that mitigated drug-related harms and increased access to social and material resources. Specifically, SEIs: (1) provided refuge from street-based drug scenes; (2) enabled safer injecting by reshaping the social and environmental contexts of injection drug use; (3) mediated access to resources and health care services; and, (4) were constrained by drug prohibition and law enforcement activities. These findings indicate that it is critical to situate SEIs in relation to the lived experiences of PWID, and in particular provide broader environmental support to PWID. Given that existing drug laws limit the effectiveness of interventions, drug policy reforms are needed to enable public health, and specifically SEIs, to occupy a more prominent role in the response to injection drug use.
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影响因子：
4.4
作者：
Fast, Danya;Small, Will;Kerr, Thomas
通讯作者：
Kerr, Thomas
DOI：
10.1007/s11524-006-9145-3
发表时间：
2007-03-01
影响因子：
6.6
作者：
Kimber, Jo;Dolan, Kate
通讯作者：
Dolan, Kate
影响因子：
2.3
作者：
Bluthenthal, R N;Kral, A H;Watters, J K
通讯作者：
Watters, J K
DOI：
10.1016/s0277-9536(02)00064-3
发表时间：
2003-02-01
期刊：
Social science & medicine (1982)
影响因子：
--
作者：
Campbell, Rona;Pound, Pandora;Donovan, Jenny
通讯作者：
Donovan, Jenny
DOI：
10.1080/09540120802385645
发表时间：
2009-01-01
影响因子：
1.7
作者：
Krusi, Andrea;Small, Will;Kerr, Thomas
通讯作者：
Kerr, Thomas