ASAP: Access to Syringes at Pharmacies for the Prevention of Bloodborne Infections among People who Inject Drugs

尽快：在药房使用注射器以预防注射毒品者的血源性感染

• 批准号: 10380878
• 负责人: Beth Meyerson
• 金额: $ 7.68万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-01 至 2023-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10380878
• 关键词: Address; Adopted; Adoption; Area; Arizona; Blood; COVID-19 pandemic; Centers for Disease Control and Prevention (U.S.); Characteristics; Communities; Consolidated Framework for Implementation Research; County; Development; Disease Outbreaks; Dissemination and Implementation; Drug usage; Drug user; Education; Educational Intervention; Elements; Ethnography; Evaluation; Evidence based intervention; Feedback; Future; HIV; Hepatitis C virus; Hybrids; Individual; Infection; Injecting drug user; Injections; Intervention; Interview; Legal; Manuals; Minority Groups; Modeling; Motivation; Needle Sharing; Needle-Exchange Programs; Opioid; Pharmacists; Pharmacy facility; Phase; Preparation; Prevention; Process; Protocols documentation; Reporting; Research; Research Personnel; Sales; Sampling; Site; Source; Sterility; Stigmatization; Surveys; Syringes; Testing; Time; Training; Work; base; cost effective; effectiveness trial; evidence base; experience; improved; injection drug use; innovation; interest; intervention program; motivational intervention; novel; operation; opioid epidemic; pandemic disease; prevent; programs; provider behavior; response; screening; success; testing access

Although interventions such as syringe service programs have attempted to address the need for sterile syringes to prevent blood borne infections (BBI) among people who inject drugs (PWID), the programs are often fragmented and therefore difficult to evaluate in terms of a “product” with potential for widespread dissemination and implementation in a sustainable manner. Further, these types of prevention efforts do not exist universally across the U.S., especially in the Southwestern region among largely minority populations. Access to Syringes at Pharmacies (ASAP) is a refinement of an evidence-based, pharmacy intervention to increase pharmacy-based sales of syringes to PWID in order to reduce BBI among them. The refinement integrates a motivational enhancement to reduce staff ambivalence about syringe sales to PWID, sampling improvements to assure that project pharmacies are likely serving PWID, and refinements to the intervention training content and delivery in three selected Arizona project counties of Mohave, Maricopa and Pima. Our development and refinement of ASAP relies on: 1) interviews with pharmacy staff of 6 pharmacies (2 for each county) that will assess feasibility, acceptance and likely adoption of the initial draft of the ASAP intervention, and 2) interviews and surveys among pharmacy staff of 3 pharmacies (1 from each county). ASAP’s adaptations and refinements will be guided by a highly iterative process between investigators and a community advisory board (CAB). Further, the Consolidated Framework for Implementation Research (CFIR) will guide feasibility assessment with a focus on selected CFIR elements across the domains of intervention characteristics, outer and inner setting, characteristics of individuals and process. The project will occur in two phases. The Year 1 formative phase will involve: 1) in-depth interviews with staff of 6 pharmacies to clarify intervention components, training and feasibility. Findings will inform the Year 2 iterative ASAP development and refinement phase between investigators and the CAB; including extensive feedback from pharmacy staff of 3 pharmacies following an ASAP beta test. Specific Aims are: Aim 1: To conduct the formative research among pharmacy staff required to develop and beta test the ASAP intervention materials (e.g., training manual, manual of operations, evaluation protocols). Aim 2: To determine the feasibility of the ASAP intervention relative to impact on pharmacy syringe- related sales and pharmacy interactions with PWID at time of syringe buy request.

尽管诸如注射器服务计划等干预措施试图解决对无菌的需求 预防注射吸毒者血液传播感染(BBI)的注射器(PWID)计划是 往往是支离破碎的，因此很难就具有广泛传播潜力的“产品”进行评估 以可持续的方式传播和实施。此外，这些类型的预防努力不会 在美国各地普遍存在，特别是在以少数族裔为主的西南部地区。 在药房获取注射器(ASAP)是以证据为基础的药房干预措施的精炼 增加以药房为基础的注射器对PWID的销售，以减少其中的BBI。精致的 整合了激励增强功能，以减少员工对向PWID销售注射器的矛盾情绪，抽样 改进以确保项目药房可能为PWID提供服务，并对干预措施进行改进 在选定的三个亚利桑那州项目县--莫哈伊、马里科帕和皮马--提供培训内容和授课。我们的 ASAP的发展和完善依赖于：1)与6家药店的药房工作人员进行面谈(每家2家 县)将评估尽快干预措施初始草案的可行性、接受度和可能采用的可能性， 2)对3家药房(每县1名)药房工作人员进行访谈和调查。尽快的 调整和改进将由调查人员和 社区咨询委员会(CAB)此外，执行研究综合框架(CFIR) 将指导可行性评估，重点放在干预领域中选定的CFIR元素上 特征、外部环境和内部环境、个体特征和过程。这个项目将在两年内完成 阶段。第一年的形成阶段将包括：1)深入访谈6家药店的员工，以澄清 干预内容、培训和可行性。调查结果将为第二年迭代尽快开发提供信息 调查人员和CAB之间的改进阶段；包括药房工作人员的广泛反馈 3家药店进行了尽快的Beta测试。具体目标是： 目标1：在需要开发和测试版的药房员工中进行形成性研究 ASAP干预材料(例如，培训手册、操作手册、评估方案)。 目的2：确定及早干预对药房注射器的影响的可行性。 在要求购买注射器时，与PWID进行相关销售和药房互动。