Risk Environment Effects on Ontological Security Among People Who Use Drugs: An Ethnographic Study

风险环境对吸毒者本体安全的影响：一项人种学研究

• 批准号: 10313524
• 负责人: Jesse Lloyd Goldshear
• 金额: $ 4.6万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-01 至 2023-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10313524
• 关键词: Risk; Environment; Effects; Ontological; Security

PROJECT SUMMARY/ABSTRACT Amidst the ongoing COVID-19 pandemic Los Angeles county has seen a surge in the unhoused population. Among this group are people who use drugs (PWUD) – a community at dramatically increased risk for bloodborne infection such as HIV and Hepatitis C, skin and soft tissue infections, and other health vulnerabilities related to the daily violence of life on the street. Los Angeles County data from 2020 estimate that people with substance use disorders account for 32% of the total unhoused population. Unhoused PWUD are subject to frequent displacement and victimization at the hands of public safety and sanitation along with hostile housed residents. On the other hand, a wide array of public health services including syringe exchange programs, drug treatment centers, street medicine, housing outreach programs, and housing have been implemented in recent years, with dramatic expansion occurring due to the COVID-19 pandemic. These risk environment features, coupled with the uncertain and unpredictable nature of street life, may lead to decreased feelings of overall well- being and ontological security among this population. The overall goal of this effort is to document how these features (i.e. public safety/sanitation efforts, public health and housing efforts, and local interest groups) impact unhoused PWUD in Los Angeles, CA. The first aim of this study is to explore how interactions with public safety agencies and hostile neighborhood residents shape feelings of ontological security among this community, while the second aim will examine how interactions with public health agencies (i.e. homeless services, housing, syringe exchanges) and activists impacts these same outcomes. In order to elucidate these associations, this study will use complementary methodologies. First, in his role as an independent provider of harm reduction supplies and as a member of a local mutual aid organization, the PI will engage in ethnography using direct participant observation consistent with the Extended Case Method approach. Simultaneously, 30 unhoused PWUD will be recruited using snowball sampling to partake in hour- long semi-structured interviews. The utilization of both approaches is key – ongoing ethnography will highlight the present situation of unhoused PWUD and their relationship to public safety and public health organizations, while interviews will illuminate how these interactions impact feelings of security and well-being, to better understand social determinants of health. Analysis of both ethnographic data from fieldnotes and formal interview data will be conducted with guidance from a Community Advisory Board whose members will be drawn from the community and local stakeholder organizations. The inclusion of a CAB is consistent with the PI’s commitment to community-engaged participatory methods. Analysis of the data will be done using the ATLAS.ti 8 software package and will feature both inductive and deductive qualitative techniques. Final results will form the core of the PI’s doctoral dissertation and will be presented to the CAB as well as community members and other stakeholders in order to inform their future work with this population.

项目概要/摘要 在持续的 COVID-19 大流行期间，洛杉矶县无家可归的人口激增。 该群体中包括吸毒者 (PWUD)——该群体吸毒的风险急剧增加 血源性感染，例如艾滋病毒和丙型肝炎、皮肤和软组织感染以及其他健康脆弱性 与街头生活中的日常暴力有关。洛杉矶县 2020 年的数据估计，患有以下疾病的人 药物滥用障碍占无家可归人口总数的 32%。无住房的 PWUD 须遵守 公共安全和卫生设施以及敌对住所造成频繁的流离失所和受害 居民。另一方面，一系列广泛的公共卫生服务，包括注射器交换计划、药物 近年来实施了治疗中心、街头医疗、住房外展计划和住房 多年来，由于 COVID-19 大流行而急剧扩张。这些风险环境特征， 再加上街头生活的不确定性和不可预测性，可能会导致整体幸福感下降 这个群体中的存在和本体论安全。这项工作的总体目标是记录这些 特征（即公共安全/卫生工作、公共卫生和住房工作以及当地利益团体）影响 加利福尼亚州洛杉矶无家可归的 PWUD。本研究的首要目的是探讨如何与公众互动 安全机构和敌对的邻里居民在其中塑造了本体安全感 社区，而第二个目标将研究如何与公共卫生机构（即无家可归者）互动 服务、住房、注射器交换）和活动家也会影响这些相同的结果。 为了阐明这些关联，本研究将使用补充方法。首先，他作为 减少危害用品的独立供应商，也是当地互助组织 PI 的成员 将使用符合扩展案例方法的直接参与者观察进行民族志研究 方法。同时，将通过滚雪球抽样的方式招募 30 名无家可归的残疾人士，以在 1 小时内参与活动。 长时间的半结构化访谈。两种方法的利用是关键——正在进行的民族志将突出 无家可归的残疾人士的现状及其与公共安全和公共卫生组织的关系， 而访谈将阐明这些互动如何影响安全感和幸福感，以便更好地 了解健康的社会决定因素。对田野笔记和正式访谈中的人种学数据进行分析 数据将在社区咨询委员会的指导下进行，该委员会的成员将来自 社区和当地利益相关者组织。纳入 CAB 符合 PI 的承诺 社区参与的参与方法。数据分析将使用 ATLAS.ti 8 软件完成 包并将采用归纳和演绎定性技术。最终结果将构成核心 PI 的博士论文，并将提交给 CAB 以及社区成员和其他 利益相关者，以便为他们未来与这一人群的工作提供信息。