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

尽管诸如注射器服务计划的干预措施试图解决对无菌注射器的需求， 注射器，以防止血液传播感染（BBI）的人谁注射毒品（PWID），该计划是 往往是零散的，因此难以从“产品”的角度进行评估， 以可持续的方式传播和实施。此外，这些类型的预防工作并不 在美国普遍存在，尤其是在西南地区的少数民族中。 在药房获得注射器（ASAP）是一项基于证据的药房干预措施， 增加药店对PWID的注射器销售，以减少其中的BBI。细化 整合了激励增强措施，以减少员工对向PWID销售注射器的矛盾心理， 改进以确保项目药房可能为PWID提供服务，并改进干预措施 在亚利桑那州选定的三个项目县（莫哈维、马里亚和皮马）开展培训内容和交付。我们 ASAP的开发和完善依赖于：1）与6家药房的药房工作人员进行访谈（每家2人 县），将评估可行性，接受和可能通过的初步草案的ASAP干预， （2）对3家药店（每个县1家）的药房工作人员进行访谈和调查。尽快 调整和改进将由研究人员和 社区咨询委员会（CAB）。实施研究综合框架（CFIR） 将指导可行性评估，重点关注干预领域中选定的CFIR要素 特征、外部环境和内部环境、个体特征和过程。该项目将在两个 阶段。第一年的形成阶段将包括：1）与6家药店的员工进行深入访谈，以澄清 干预内容、培训和可行性。调查结果将为第2年迭代ASAP开发提供信息 研究者和CAB之间的改进阶段;包括药房工作人员的广泛反馈 三家药店的测试结果具体目标是： 目的1：在需要开发和测试的药房工作人员中进行形成性研究 ASAP干预材料（例如，培训手册、操作手册、评价议定书）。 目的2：确定ASAP干预对药房注射器影响的可行性- 在注射器购买请求时与PWID进行相关销售和药房互动。

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.