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Salvi A, Gillenwater LA, Cockrum BP, Wiehe SE, Christian K, Cayton J, Bailey T, Schwartz K, Dir AL, Ray B, Aalsma MC, Reda K. Development of a Real-Time Dashboard for Overdose Touchpoints: User-Centered Design Approach. JMIR Hum Factors 2024; 11:e57239. [PMID: 38861717 PMCID: PMC11200046 DOI: 10.2196/57239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/24/2024] [Accepted: 05/13/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND Overdose Fatality Review (OFR) is an important public health tool for shaping overdose prevention strategies in communities. However, OFR teams review only a few cases at a time, which typically represent a small fraction of the total fatalities in their jurisdiction. Such limited review could result in a partial understanding of local overdose patterns, leading to policy recommendations that do not fully address the broader community needs. OBJECTIVE This study explored the potential to enhance conventional OFRs with a data dashboard, incorporating visualizations of touchpoints-events that precede overdoses-to highlight prevention opportunities. METHODS We conducted 2 focus groups and a survey of OFR experts to characterize their information needs and design a real-time dashboard that tracks and measures decedents' past interactions with services in Indiana. Experts (N=27) were engaged, yielding insights on essential data features to incorporate and providing feedback to guide the development of visualizations. RESULTS The findings highlighted the importance of showing decedents' interactions with health services (emergency medical services) and the justice system (incarcerations). Emphasis was also placed on maintaining decedent anonymity, particularly in small communities, and the need for training OFR members in data interpretation. The developed dashboard summarizes key touchpoint metrics, including prevalence, interaction frequency, and time intervals between touchpoints and overdoses, with data viewable at the county and state levels. In an initial evaluation, the dashboard was well received for its comprehensive data coverage and its potential for enhancing OFR recommendations and case selection. CONCLUSIONS The Indiana touchpoints dashboard is the first to display real-time visualizations that link administrative and overdose mortality data across the state. This resource equips local health officials and OFRs with timely, quantitative, and spatiotemporal insights into overdose risk factors in their communities, facilitating data-driven interventions and policy changes. However, fully integrating the dashboard into OFR practices will likely require training teams in data interpretation and decision-making.
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Affiliation(s)
- Amey Salvi
- School of Informatics, Computing, and Engineering, Indiana University Indianapolis, Indianapolis, IN, United States
| | - Logan A Gillenwater
- Children's Health Services Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Brandon P Cockrum
- Indiana Clinical and Translational Science Institute, Indianapolis, IN, United States
| | - Sarah E Wiehe
- Children's Health Services Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States
- Indiana Clinical and Translational Science Institute, Indianapolis, IN, United States
| | | | - John Cayton
- Indiana Management Performance Hub, Indianapolis, IN, United States
| | - Timothy Bailey
- Indiana Management Performance Hub, Indianapolis, IN, United States
| | - Katherine Schwartz
- Children's Health Services Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Allyson L Dir
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Bradley Ray
- RTI International, Research Triangle Park, NC, United States
| | - Matthew C Aalsma
- Children's Health Services Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Khairi Reda
- School of Informatics, Computing, and Engineering, Indiana University Indianapolis, Indianapolis, IN, United States
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Yedinak J, Krieger MS, Joseph R, Levin S, Edwards S, Bailer DA, Goyer J, Daley Ndoye C, Schultz C, Koziol J, Elmaleh R, Hallowell BD, Hampson T, Duong E, Shihipar A, Goedel WC, Marshall BD. Public Health Dashboards in Overdose Prevention: The Rhode Island Approach to Public Health Data Literacy, Partnerships, and Action. J Med Internet Res 2024; 26:e51671. [PMID: 38345849 PMCID: PMC10897802 DOI: 10.2196/51671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 12/12/2023] [Accepted: 01/09/2024] [Indexed: 02/15/2024] Open
Abstract
As the field of public health rises to the demands of real-time surveillance and rapid data-sharing needs in a postpandemic world, it is time to examine our approaches to the dissemination and accessibility of such data. Distinct challenges exist when working to develop a shared public health language and narratives based on data. It requires that we assess our understanding of public health data literacy, revisit our approach to communication and engagement, and continuously evaluate our impact and relevance. Key stakeholders and cocreators are critical to this process and include people with lived experience, community organizations, governmental partners, and research institutions. In this viewpoint paper, we offer an instructive approach to the tools we used, assessed, and adapted across 3 unique overdose data dashboard projects in Rhode Island, United States. We are calling this model the "Rhode Island Approach to Public Health Data Literacy, Partnerships, and Action." This approach reflects the iterative lessons learned about the improvement of data dashboards through collaboration and strong partnerships across community members, state agencies, and an academic research team. We will highlight key tools and approaches that are accessible and engaging and allow developers and stakeholders to self-assess their goals for their data dashboards and evaluate engagement with these tools by their desired audiences and users.
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Affiliation(s)
- Jesse Yedinak
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States
| | - Maxwell S Krieger
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States
| | | | - Stacey Levin
- Parent Support Network, Warwick, RI, United States
| | - Sarah Edwards
- Rhode Island Department of Health, Providence, RI, United States
| | | | | | | | - Cathy Schultz
- State of Rhode Island Executive Office of Health and Human Services, Cranston, RI, United States
| | - Jennifer Koziol
- Rhode Island Department of Health, Providence, RI, United States
| | - Rachael Elmaleh
- Rhode Island Department of Health, Providence, RI, United States
| | | | - Todd Hampson
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States
| | - Ellen Duong
- Center for Computation and Visualization, Brown University, Providence, RI, United States
| | - Abdullah Shihipar
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States
| | - William C Goedel
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States
| | - Brandon Dl Marshall
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States
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Burgan K, McCollum CG, Guzman A, Penney B, Hill SV, Kudroff K, Thorn S, Burton T, Turner K, Mugavero MJ, Rana A, Elopre L. A mixed methods evaluation assessing the feasibility of implementing a PrEP data dashboard in the Southeastern United States. BMC Health Serv Res 2024; 24:101. [PMID: 38238697 PMCID: PMC10797978 DOI: 10.1186/s12913-023-10451-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 12/07/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Alabama is one of seven priority states for the National Ending the HIV Epidemic Initiative due to a disproportionate burden of rural infections. To reverse growing infection rates, the state must increase its focus on prevention efforts, including novel strategies. One such approach is to utilize dashboards that visualize real-time data on the pre-exposure prophylaxis (PrEP) care continuum to assist in prioritizing evidence-based preventative care for those most vulnerable for HIV infection. METHODS We conducted a mixed methods evaluation to ascertain stakeholders' perceptions on the acceptability, feasibility, appropriateness, and usability of a PrEP care continuum dashboard, as well as gain insight on ways to improve the activities necessary to sustain it. Clinicians, administrators, and data personnel from participating sites in Alabama completed surveys (n = 9) and participated in key informant interviews (n = 10) to better understand their experiences with the prototype data dashboard and to share feedback on how it can be modified to best fit their needs. RESULTS Surveys and interviews revealed that all participants find the pilot data dashboard to be an acceptable, feasible, and appropriate intervention for clinic use. Overall, stakeholders find the pilot dashboard to be usable and helpful in administrative efforts, such as report and grant writing; however, additional refining is needed in order to reduce burden and optimize usefulness. Participants voiced concerns about their site's abilities to sustain the dashboard, including the lack of systematized PrEP protocols and limited funds and staff time dedicated to PrEP data collection, cleaning, and upload. CONCLUSION Study participants from clinics providing HIV prevention services, including PrEP, in Alabama voiced interest in sustaining and refining a data dashboard that tracks clients across the PrEP care continuum. Despite viewing the platform itself as an acceptable, feasible, and appropriate intervention, participants agreed that efforts need to be focused on standardizing PrEP data collection protocols in order to ensure consistent, accurate data capture and that limited funds and staff time are barriers to the sustained implementation of the dashboard in practice.
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Affiliation(s)
- Kaylee Burgan
- Division of Infectious Diseases, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, USA
| | - C Greer McCollum
- Division of Infectious Diseases, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, USA
| | - Alfredo Guzman
- Division of Infectious Diseases, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, USA
| | - Brooke Penney
- Division of Infectious Diseases, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, USA
| | - Samantha V Hill
- Department of Pediatrics, Division of Adolescent Medicine, University of Alabama at Birmingham, Birmingham, USA
| | - Kachina Kudroff
- Division of Infectious Diseases, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, USA
| | - Shey Thorn
- Five Horizons Health Services, Montgomery, AL, 36111, USA
| | - Toya Burton
- Whatley Health Services, Tuscaloosa, AL, 35401, USA
| | - Kelly Turner
- Health Services Center, Hobson City, AL, 36201, USA
| | - Michael J Mugavero
- Division of Infectious Diseases, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, USA
| | - Aadia Rana
- Division of Infectious Diseases, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, USA
| | - Latesha Elopre
- Division of Infectious Diseases, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, USA.
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Seitz HH, Robertson MN, Steen J, Dulaney SG, Buys DR. Development and Pretesting of Prescription Opioid Misuse Prevention Messages: Results and Implications for Practice. HEALTH COMMUNICATION 2023; 38:2865-2883. [PMID: 36127799 DOI: 10.1080/10410236.2022.2124059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Well-designed health communication campaigns can contribute to the uptake of preventive behaviors, but there has been a lack of attention on using communication research to develop opioid misuse prevention messages. We report the results of two studies designed to inform the development of prescription opioid misuse prevention messages for adults ages 30-59. In Study 1, 16 adults across 4 counties participated in semi-structured interviews to provide input on message concepts addressing six key prescription opioid misuse prevention behaviors. In Study 2, 1,335 adults completed an online, survey-based between-subjects experiment in which participants were randomized to a no message control condition or a message condition that aligned with a prevention behavior. The survey examined Reasoned Action Approach (RAA) predictors of intention in no message control participants and examined differences in intention to perform prevention behaviors among experimental conditions. The qualitative interviews yielded insights about message preferences and perceived facilitators and barriers related to the prevention behaviors. The online survey demonstrated that attitude and descriptive norms are important determinants of preventive behaviors and potential targets for communication interventions. Message testing results demonstrated that the draft messages were effective in changing intentions to safely store, securely dispose of, and monitor the use of prescription opioids, but they were not effective in increasing intentions to talk to healthcare providers, older adults, or children about proper opioid use. A communication campaign addressing attitudes and perceived descriptive norms may be successful in increasing intentions to engage in opioid misuse prevention behaviors.
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Affiliation(s)
- Holli H Seitz
- Department of Communication, Mississippi State University
- Social Science Research Center, Mississippi State University
| | - Mary Nelson Robertson
- Department of Food Science, Nutrition and Health Promotion, Mississippi State University
| | - Je'Kylynn Steen
- Department of Food Science, Nutrition and Health Promotion, Mississippi State University
| | - Sarah G Dulaney
- Social Science Research Center, Mississippi State University
| | - David R Buys
- Department of Food Science, Nutrition and Health Promotion, Mississippi State University
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Borge TC, Muller AE. Overdosevarslingssystemer – en kartleggingsoversikt med maskinlæring. NORDIC STUDIES ON ALCOHOL AND DRUGS 2023; 40:443-462. [PMID: 37969899 PMCID: PMC10634385 DOI: 10.1177/14550725221143180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 11/18/2022] [Indexed: 11/17/2023] Open
Abstract
Bakgrunn: Helsedirektoratet ønsker å vurdere muligheten for å etablere et nasjonalt overdosevarslingssystem (OVS) for å kunne varsle brukere om økt overdosefare. OVS som system forstås her som et sett med sammenhengende elementer som fungerer som en helhet, der hensikten er tidlig oppdagelse av økt overdoserisiko kombinert med rask varsling til de som står i fare for overdoser. Metode: Vi utførte en kartleggingsoversikt over forskning om varslingssystemer for økt overdosefare. Mål 1 var å kartlegge eksisterende forskning om effekten av et OVS (antall brukere nådd, antall overdoser, varslingshurtighet). Mål 2 var å kartlegge eksisterende forskning som kunne belyse brukeres erfaringer med slike systemer. Resultater: Vi brukte flere maskinlæringsfunksjoner for å identifisere og vurdere totalt 4102 referanser fra litteratursøk gjennomført i mars/april 2022, hvorav 11 studier oppfylte inklusjonskriteriene. Effekt av OVS på antall overdoser var ikke mulig å skille fra eksisterende overdoseforebyggende tiltak. OVS’er varslet skadereduksjonsgrupper eller erfaringskonsulenter så tidlig som fire timer etter innmeldt/oppdaget fare. Antall brukere varslet ble i stor grad ikke rapportert, antageligvis fordi data om dette ikke ble innsamlet. Fra syv kvalitative studier ble mønstre i hovedfunn sett på tvers, som omhandlet preferanser for språkbruk og innhold, hvor varslinger burde komme fra, og prinsippene bak dem. Konklusjon: Vi identifiserte lite empirisk forskning om eksisterende OVS’er, særlig relatert til effekt av slike systemer. Uten tilstrekkelig forskningsgrunnlag om effekt må vi være forsiktige med å trekke konklusjoner om hvilke typer OVS’er som bør og ikke bør innføres i Norge. Opprettelse av et OVS trenger ikke nødvendigvis innebære etablering av en ny infrastruktur, men heller være snakk om at to godt utviklede, eksisterende systemer – systemer for overvåking og skadereduksjonstiltak – kan kobles sammen.
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Ali F, Kaura A, Russell C, Bonn M, Bruneau J, Dasgupta N, Imtiaz S, Martel-Laferrière V, Rehm J, Shahin R, Elton-Marshall T. Identifying barriers and facilitators to COVID-19 vaccination uptake among People Who Use Drugs in Canada: a National Qualitative Study. Harm Reduct J 2023; 20:99. [PMID: 37516836 PMCID: PMC10387201 DOI: 10.1186/s12954-023-00826-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 07/16/2023] [Indexed: 07/31/2023] Open
Abstract
BACKGROUND People Who Use Drugs (PWUD) have lower vaccination uptake than the general population, and disproportionately experience the burden of harms from vaccine-preventable diseases. We conducted a national qualitative study to: (1) identify the barriers and facilitators to receiving COVID-19 vaccinations among PWUD; and (2) identify interventions to support PWUD in their decision-making. METHODS Between March and October 2022, semi-structured interviews with PWUD across Canada were conducted. Fully vaccinated (2 or more doses) and partially or unvaccinated (1 dose or less) participants were recruited from a convenience sample to participate in telephone interviews to discuss facilitators, barriers, and concerns about receiving COVID-19 vaccines and subsequent boosters, and ways to address concerns. A total of 78 PWUD participated in the study, with 50 participants being fully vaccinated and 28 participants partially or unvaccinated. Using thematic analysis, interviews were coded based on the capability, opportunity, and motivation-behavior (COM-B) framework. RESULTS Many partially or unvaccinated participants reported lacking knowledge about the COVID-19 vaccine, particularly in terms of its usefulness and benefits. Some participants reported lacking knowledge around potential long-term side effects of the vaccine, and the differences of the various vaccine brands. Distrust toward government and healthcare agencies, the unprecedented rapidity of vaccine development and skepticism of vaccine effectiveness were also noted as barriers. Facilitators for vaccination included a desire to protect oneself or others and compliance with government mandates which required individuals to get vaccinated in order to access services, attend work or travel. To improve vaccination uptake, the most trusted and appropriate avenues for vaccination information sharing were identified by participants to be people with lived and living experience with drug use (PWLLE), harm reduction workers, or healthcare providers working within settings commonly visited by PWUD. CONCLUSION PWLLE should be supported to design tailored information to reduce barriers and address mistrust. Resources addressing knowledge gaps should be disseminated in areas and through organizations where PWUD frequently access, such as harm reduction services and social media platforms.
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Affiliation(s)
- Farihah Ali
- Centre for Addiction and Mental Health (CAMH), Institute for Mental Health Policy Research, Toronto, Canada.
- Ontario CRISM Node Team (OCRINT), IMHPR, Centre for Addiction and Mental Health (CAMH), Room 2035, 33 Russell Street, Toronto, Canada.
| | - Ashima Kaura
- Centre for Addiction and Mental Health (CAMH), Institute for Mental Health Policy Research, Toronto, Canada
| | - Cayley Russell
- Centre for Addiction and Mental Health (CAMH), Institute for Mental Health Policy Research, Toronto, Canada
- Ontario CRISM Node Team (OCRINT), IMHPR, Centre for Addiction and Mental Health (CAMH), Room 2035, 33 Russell Street, Toronto, Canada
| | - Matthew Bonn
- Canadian Association of People Who Use Drugs, Dartmouth, NS, Canada
| | - Julie Bruneau
- Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), 900 Saint-Denis Street, Montreal, QC, H2X 0A9, Canada
- Department of Family and Emergency Medicine, Faculty of Medicine, Université de Montréal, 2900 Boul, Edouard-Montpetit, Montreal, QC, H3T 1J4, Canada
| | - Nabarun Dasgupta
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Sameer Imtiaz
- Centre for Addiction and Mental Health (CAMH), Institute for Mental Health Policy Research, Toronto, Canada
| | - Valérie Martel-Laferrière
- Centre de Recherche du Centre hospitalier de l'Université de Montréal, Montreal, Canada
- Department of Microbiology, Infectious Diseases and Immunology, Université de Montréal, Montreal, Canada
| | - Jürgen Rehm
- Centre for Addiction and Mental Health (CAMH), Institute for Mental Health Policy Research, Toronto, Canada
- Ontario CRISM Node Team (OCRINT), IMHPR, Centre for Addiction and Mental Health (CAMH), Room 2035, 33 Russell Street, Toronto, Canada
- Department of Psychiatry, Dalla Lana School of Public Health, & Institute of Medical Science (IMS), Toronto, Canada
- 1 King's College Circle, University of Toronto, Toronto, ON, M5S 1A8, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), 1001 Queen St. West, Toronto, ON, M6J 1H4, Canada
- Institut Für Klinische Psychologie Und Psychotherapie, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
- Department of Psychiatry and Psychotherapy, Center for Interdisciplinary Addiction Research (ZIS), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
| | | | - Tara Elton-Marshall
- Ontario CRISM Node Team (OCRINT), IMHPR, Centre for Addiction and Mental Health (CAMH), Room 2035, 33 Russell Street, Toronto, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
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7
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Brien R, Volpe I, Grigg J, Lyons T, Hughes C, McKinnon G, Tzanetis S, Crawford S, Eade A, Lee N, Barratt MJ. Co-designing drug alerts for health and community workers for an emerging early warning system in Victoria, Australia. Harm Reduct J 2023; 20:30. [PMID: 36894933 PMCID: PMC9995746 DOI: 10.1186/s12954-023-00761-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 02/24/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Alerts about changes in unregulated drug markets may be useful for supporting health and community workers to anticipate, prevent, and respond to unexpected adverse drug events. This study aimed to establish factors influencing the successful design and implementation of drug alerts for use in clinical and community service settings in Victoria, Australia. METHODS An iterative mixed methods design was used to co-produce drug alert prototypes with practitioners and managers working across various alcohol and other drug services and emergency medicine settings. A quantitative needs-analysis survey (n = 184) informed five qualitative co-design workshops (n = 31). Alert prototypes were drafted based on findings and tested for utility and acceptability. Applicable constructs from the Consolidated Framework for Implementation Research helped to conceptualise factors that impact successful alert system design. RESULTS Timely and reliable alerts about unexpected drug market changes were important to nearly all workers (98%) yet many reported insufficient access to this kind of information (64%). Workers considered themselves 'conduits' for information-sharing and valued alerts for increasing exposure to drug market intelligence; facilitating communication about potential threats and trends; and improving capacity for effective responding to drug-related harm. Alerts should be 'shareable' across a range of clinical and community settings and audiences. To maximise engagement and impact, alerts must command attention, be easily recognisable, be available on multiple platforms (electronic and printable formats) in varying levels of detail, and be disseminated via appropriate notification mechanisms to meet the needs of diverse stakeholder groups. Three drug alert prototypes (SMS prompt, summary flyer, and a detailed poster) were endorsed by workers as useful for supporting their work responding to unexpected drug-related harms. DISCUSSION Alerts informed by coordinated early warning networks that offer close to real-time detection of unexpected substances can provide rapid, evidence-based drug market intelligence to inform preventive and responsive action to drug-related harm. The success of alert systems requires adequate planning and resourcing to support design, implementation, and evaluation, which includes consultation with all relevant audiences to understand how to maximise engagement with information, recommendations, and advice. Our findings about factors impacting successful alert design have utility to inform the development of local early warning systems.
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Affiliation(s)
- Rita Brien
- Turning Point, Eastern Health Statewide Services, Richmond, Australia.,Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Isabelle Volpe
- Social and Global Studies Centre, RMIT University, Melbourne, Australia.,Drug Policy Modelling Program, Social Policy Research Centre, UNSW Sydney, Sydney, Australia
| | - Jasmin Grigg
- Turning Point, Eastern Health Statewide Services, Richmond, Australia.,Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Tom Lyons
- Department of Health, State Government of Victoria, Melbourne, Australia
| | - Caitlin Hughes
- Law and Commerce, Flinders University, Adelaide, Australia.,National Drug and Alcohol Research Centre, UNSW, Sydney, Australia
| | - Ginny McKinnon
- Department of Health, State Government of Victoria, Melbourne, Australia
| | - Stephanie Tzanetis
- Harm Reduction Victoria (DanceWize), Melbourne, Australia.,CanTEST - Directions Health Services, Canberra, Australia
| | - Sione Crawford
- Harm Reduction Victoria (DanceWize), Melbourne, Australia
| | - Alan Eade
- Safer Care Victoria, Melbourne, Australia.,Department of Paramedicine, Monash University, Melbourne, Australia
| | - Nicole Lee
- 360Edge, Melbourne, Australia.,National Drug Research Institute, Curtin University, Perth, Australia
| | - Monica J Barratt
- Social and Global Studies Centre, RMIT University, Melbourne, Australia. .,National Drug and Alcohol Research Centre, UNSW, Sydney, Australia. .,Digital Ethnography Research Centre, RMIT University, Melbourne, Australia.
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Volpe I, Brien R, Grigg J, Tzanetis S, Crawford S, Lyons T, Lee N, McKinnon G, Hughes C, Eade A, Barratt MJ. 'We don't live in a harm reduction world, we live in a prohibition world': tensions arising in the design of drug alerts. Harm Reduct J 2023; 20:3. [PMID: 36624508 PMCID: PMC9829230 DOI: 10.1186/s12954-022-00716-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 10/22/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Drug alerts designed for health and community workforces have potential to avert acute harms associated with unpredictable illicit drug markets, by preparing workers to respond to unusual drug-related events, and distribute information to service users. However, the design of such alerts is complicated by diverse needs of individuals, and broader socio-political contexts. Here, we discuss the tensions that arose in the process of co-designing drug alert templates with health and community workers. METHODS We conducted five in-depth digital co-design workshops with 31 workers employed in alcohol and other drug and urgent care settings. Our approach to analysis was informed by Iterative Categorisation and reflexive thematic analysis methods. RESULTS We identified five key tensions. First, there is a need to provide comprehensive information to meet the information needs of a diverse group of workers with varying knowledge levels, while also designing alerts to be clear, concise, and relevant to the work of individuals. Second, it is important that alerts do not create 'information overload'; however, it is also important that information should be available to those who want it. Third, alert design and dissemination must be perceived to be credible, to avoid 'alert scepticism'; however, credibility is challenging to develop in a broader context of criminalisation, stigmatisation, and sensationalism. Fourth, alerts must be carefully designed to achieve 'intended effects' and avoid unintended effects, while acknowledging that it is impossible to control all potential effects. Finally, while alerts may be intended for an audience of health and community workers, people who use drugs are the end-users and must be kept front of mind in the design process. CONCLUSIONS The co-design process revealed complexities in designing drug alerts, particularly in the context of stigmatised illicit drug use, workforce diversity, and dissemination strategies. This study has highlighted the value of developing these important risk communication tools with their target audiences to ensure that they are relevant, useful, and impactful. The findings have informed the development of our drug alert prototypes and provide local context to complement existing best-practice risk-communications literature.
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Affiliation(s)
- Isabelle Volpe
- grid.1017.70000 0001 2163 3550Social and Global Studies Centre, RMIT University, Melbourne, Australia ,grid.1005.40000 0004 4902 0432Drug Policy Modelling Program, Social Policy Research Centre, UNSW Sydney, Sydney, Australia
| | - Rita Brien
- grid.414366.20000 0004 0379 3501Turning Point, Eastern Health Statewide Services, Richmond, Australia ,grid.1002.30000 0004 1936 7857Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Jasmin Grigg
- grid.414366.20000 0004 0379 3501Turning Point, Eastern Health Statewide Services, Richmond, Australia ,grid.1002.30000 0004 1936 7857Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
| | | | - Sione Crawford
- Harm Reduction Victoria (DanceWize), North Melbourne, Australia
| | - Tom Lyons
- Department of Health, Victoria State Government, Melbourne, Australia
| | - Nicole Lee
- 360Edge, Melbourne, Australia ,grid.1032.00000 0004 0375 4078National Drug Research Institute, Curtin University, Perth, Australia
| | - Ginny McKinnon
- Department of Health, Victoria State Government, Melbourne, Australia
| | - Caitlin Hughes
- grid.1014.40000 0004 0367 2697Law and Commerce, Flinders University, Adelaide, Australia ,grid.1005.40000 0004 4902 0432National Drug and Alcohol Research Centre, UNSW, Sydney, Australia
| | - Alan Eade
- Safer Care Victoria, Melbourne, Australia ,grid.1002.30000 0004 1936 7857Department of Paramedicine, Monash University, Melbourne, Australia
| | - Monica J. Barratt
- grid.1017.70000 0001 2163 3550Social and Global Studies Centre, RMIT University, Melbourne, Australia ,grid.1005.40000 0004 4902 0432National Drug and Alcohol Research Centre, UNSW, Sydney, Australia ,grid.1017.70000 0001 2163 3550Digital Ethnography Research Centre, RMIT University, Melbourne, Australia
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Fernandez P, Azucar D, Zambole K. A Dose of Truth: A Qualitative Assessment of Reactions to Messages about Fentanyl for People Who Use Drugs. Subst Use Misuse 2023; 58:520-527. [PMID: 36762461 DOI: 10.1080/10826084.2023.2177112] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Background: Fentanyl-related overdoses are occurring at alarming rates and developing campaigns to increase awareness about fentanyl and harm-reduction strategies is critical. A Dose of Truth is an educational campaign aiming to increase knowledge about the threat of fentanyl and risk of exposure among people who use drugs (PWUD). The current study tests preliminary concepts and messages for the campaign. Methods: Twenty-one one-on-one interviews were conducted with young adults ages 18-35 who use drugs. Participants discussed knowledge of fentanyl and perceived risk of exposure, and provided feedback on four concepts. Thematic analysis of transcripts generated insights about promising approaches and topics. Results: Findings demonstrated that fentanyl awareness is growing among PWUD, but they perceive low risk of exposure because they trust a source. Messaging that challenged that trust, by highlighting that contaminated drug supplies are increasingly widespread, made personal risk salient. Additionally, messaging conveyed through a personal narrative that encouraged carrying naloxone to protect friends was perceived as personally relevant. Conclusions: While opioid- and fentanyl-related campaigns exist, few have used an evidence-based process to guide campaign development. Addressing gaps in knowledge and developing messages that are personally relevant are foundational steps in creating effective campaigns on fentanyl and other substances.
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Affiliation(s)
| | | | - Kim Zambole
- Prevention First, Springfield, Illinois, USA
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10
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Schulze A, Brand F, Geppert J, Böl GF. Digital dashboards visualizing public health data: a systematic review. Front Public Health 2023; 11:999958. [PMID: 37213621 PMCID: PMC10192578 DOI: 10.3389/fpubh.2023.999958] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 04/05/2023] [Indexed: 05/23/2023] Open
Abstract
Introduction Public health is not only threatened by diseases, pandemics, or epidemics. It is also challenged by deficits in the communication of health information. The current COVID-19 pandemic demonstrates that impressively. One way to deliver scientific data such as epidemiological findings and forecasts on disease spread are dashboards. Considering the current relevance of dashboards for public risk and crisis communication, this systematic review examines the state of research on dashboards in the context of public health risks and diseases. Method Nine electronic databases where searched for peer-reviewed journal articles and conference proceedings. Included articles (n = 65) were screened and assessed by three independent reviewers. Through a methodological informed differentiation between descriptive studies and user studies, the review also assessed the quality of included user studies (n = 18) by use of the Mixed Methods Appraisal Tool (MMAT). Results 65 articles were assessed in regards to the public health issues addressed by the respective dashboards, as well as the data sources, functions and information visualizations employed by the different dashboards. Furthermore, the literature review sheds light on public health challenges and objectives and analyzes the extent to which user needs play a role in the development and evaluation of a dashboard. Overall, the literature review shows that studies that do not only describe the construction of a specific dashboard, but also evaluate its content in terms of different risk communication models or constructs (e.g., risk perception or health literacy) are comparatively rare. Furthermore, while some of the studies evaluate usability and corresponding metrics from the perspective of potential users, many of the studies are limited to a purely functionalistic evaluation of the dashboard by the respective development teams. Conclusion The results suggest that applied research on public health intervention tools like dashboards would gain in complexity through a theory-based integration of user-specific risk information needs. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=200178, identifier: CRD42020200178.
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Lasher L, Hallowell BD, Chambers LC, Koziol J, McDonald J, Elmaleh R, Karim S, Viner-Brown S. Using Timely Overdose Data to Address a Spike in Nonfatal Overdoses and Inform a Coordinated Community-Level Response in Rhode Island, 2019. Public Health Rep 2021; 136:24S-30S. [PMID: 34726976 DOI: 10.1177/00333549211012407] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The Rhode Island Department of Health (RIDOH) uses emergency department data to monitor nonfatal opioid overdoses in Rhode Island. In April 2019, RIDOH detected an increase in nonfatal opioid overdoses in Woonsocket, Rhode Island, and sent an alert to state and local partners (eg, fire departments, emergency departments, faith leaders) with guidance on how to respond. To guide community-level, strategic response efforts, RIDOH analyzed surveillance data to identify overdose patterns, populations, and geographic areas most affected. During April-June 2019, nonfatal opioid overdoses in Woonsocket increased 463% (from 13 to 73) when compared with the previous 3 months. Because of the sustained increase in nonfatal opioid overdoses, RIDOH brought together community partners at a meeting in June 2019 to discuss RIDOH opioid overdose data and coordinate next steps. Data analyses were essential to framing the discussion and allowed community partners at the event to identify an unexpected increase in cocaine-involved nonfatal opioid overdoses in Woonsocket. Many patients with cocaine-involved nonfatal overdoses also had fentanyl in their system, and input from community partners suggested that many patients were unaware of using fentanyl. Community response actions included targeting harm reduction services (eg, distribution of naloxone, mobile needle exchange); deploying peer recovery support specialists to overdose hotspots to connect people to treatment and recovery resources; placing harm reduction messaging in high-traffic areas; and targeted social media messaging. After the meeting, nonfatal opioid overdoses returned to pre-outbreak levels. This case study provides an example of how timely opioid overdose data can be effectively used to detect a spike in nonfatal opioid overdoses and inform a strategic, community-level response.
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Affiliation(s)
- Leanne Lasher
- 6749 Rhode Island Department of Health, Providence, RI, USA
| | | | | | | | - James McDonald
- 6749 Rhode Island Department of Health, Providence, RI, USA
| | | | - Sarah Karim
- 6749 Rhode Island Department of Health, Providence, RI, USA
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12
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Hallowell BD, Chambers LC, Rhodes J, Basta M, Viner-Brown S, Lasher L. Using Emergency Medical Services Data to Monitor Nonfatal Opioid Overdoses in Real Time : Development, Validation, and Use of a Case Definition, Rhode Island, 2018. Public Health Rep 2021; 136:40S-46S. [PMID: 34726979 PMCID: PMC8573786 DOI: 10.1177/00333549211018989] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2021] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE No case definition exists that allows public health authorities to accurately identify opioid overdoses using emergency medical services (EMS) data. We developed and evaluated a case definition for suspected nonfatal opioid overdoses in EMS data. METHODS To identify suspected opioid overdose-related EMS runs, in 2019 the Rhode Island Department of Health (RIDOH) developed a case definition using the primary impression, secondary impression, selection of naloxone in the dropdown field for medication given, indication of medication response in a dropdown field, and keyword search of the report narrative. We developed the case definition with input from EMS personnel and validated it using an iterative process of random medical record review. We used naloxone administration in consideration with other factors to avoid misclassification of opioid overdoses. RESULTS In 2018, naloxone was administered during 2513 EMS runs in Rhode Island, of which 1501 met our case definition of a nonfatal opioid overdose. Based on a review of 400 randomly selected EMS runs in which naloxone was administered, the RIDOH case definition accurately identified 90.0% of opioid overdoses and accurately excluded 83.3% of non-opioid overdose-related EMS runs. Use of the case definition enabled analyses that identified key patterns in overdose locations, people who experienced repeat overdoses, and the creation of hotspot maps to inform outbreak detection and response. PRACTICE IMPLICATIONS EMS data can be an effective tool for monitoring overdoses in real time and informing public health practice. To accurately identify opioid overdose-related EMS runs, the use of a comprehensive case definition is essential.
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Affiliation(s)
| | | | - Jason Rhodes
- Rhode Island Department of Health, Providence, RI, USA
| | - Melissa Basta
- Rhode Island Department of Health, Providence, RI, USA
| | | | - Leanne Lasher
- Rhode Island Department of Health, Providence, RI, USA
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13
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Yedinak JL, Li Y, Krieger MS, Howe K, Ndoye CD, Lee H, Civitarese AM, Marak T, Nelson E, Samuels EA, Chan PA, Bertrand T, Marshall BDL. Machine learning takes a village: Assessing neighbourhood-level vulnerability for an overdose and infectious disease outbreak. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 96:103395. [PMID: 34344539 PMCID: PMC8568646 DOI: 10.1016/j.drugpo.2021.103395] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 07/08/2021] [Accepted: 07/16/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Multiple areas in the United States of America (USA) are experiencing high rates of overdose and outbreaks of bloodborne infections, including HIV and hepatitis C virus (HCV), due to non-sterile injection drug use. We aimed to identify neighbourhoods at increased vulnerability for overdose and infectious disease outbreaks in Rhode Island, USA. The primary aim was to pilot machine learning methods to identify which neighbourhood-level factors were important for creating "vulnerability assessment scores" across the state. The secondary aim was to engage stakeholders to pilot an interactive mapping tool and visualize the results. METHODS From September 2018 to November 2019, we conducted a neighbourhood-level vulnerability assessment and stakeholder engagement process named The VILLAGE Project (Vulnerability Investigation of underlying Local risk And Geographic Events). We developed a predictive analytics model using machine learning methods (LASSO, Elastic Net, and RIDGE) to identify areas with increased vulnerability to an outbreak of overdose, HIV and HCV, using census tract-level counts of overdose deaths as a proxy for injection drug use patterns and related health outcomes. Stakeholders reviewed mapping tools for face validity and community distribution. RESULTS Machine learning prediction models were suitable for estimating relative neighbourhood-level vulnerability to an outbreak. Variables of importance in the model included housing cost burden, prior overdose deaths, housing density, and education level. Eighty-nine census tracts (37%) with no prior overdose fatalities were identified as being vulnerable to such an outbreak, and nine of those were identified as having a vulnerability assessment score in the top 25%. Results were disseminated as a vulnerability stratification map and an online interactive mapping tool. CONCLUSION Machine learning methods are well suited to predict neighborhoods at higher vulnerability to an outbreak. These methods show promise as a tool to assess structural vulnerabilities and work to prevent outbreaks at the local level.
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Affiliation(s)
- Jesse L Yedinak
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Yu Li
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Maxwell S Krieger
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Katharine Howe
- Center for HIV, Hepatitis, STD, and TB Epidemiology, Rhode Island Department of Health, Providence, RI, USA
| | - Colleen Daley Ndoye
- Project Weber/Renew: Harm Reduction & Recovery Services Provider, Providence, RI, USA
| | - Hyunjoon Lee
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Anna M Civitarese
- Center for HIV, Hepatitis, STD, and TB Epidemiology, Rhode Island Department of Health, Providence, RI, USA
| | - Theodore Marak
- Center for HIV, Hepatitis, STD, and TB Epidemiology, Rhode Island Department of Health, Providence, RI, USA
| | - Elana Nelson
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Elizabeth A Samuels
- Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI, USA; Overdose Prevention Program, Rhode Island Department of Health, Providence, RI, USA
| | - Philip A Chan
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA; Department of Medicine, Alpert Medical School of Brown University, Providence, RI, USA; Center for HIV, Hepatitis, STD, and TB Epidemiology, Rhode Island Department of Health, Providence, RI, USA
| | - Thomas Bertrand
- Center for HIV, Hepatitis, STD, and TB Epidemiology, Rhode Island Department of Health, Providence, RI, USA
| | - Brandon D L Marshall
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.
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Joshi M, Gupta L. Preparing Infographics for Post-publication Promotion of Research on Social Media. J Korean Med Sci 2021; 36:e41. [PMID: 33527783 PMCID: PMC7850859 DOI: 10.3346/jkms.2021.36.e41] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 01/08/2021] [Indexed: 12/13/2022] Open
Abstract
Infographics are pictorial representations of information intended to disseminate information quickly and clearly. Their use has increased in the past decade due to wider and easy access to technology. Infographics are being increasingly used for public advisories, disseminating protocols for healthcare professionals, and post-publication promotion of research. Due to their potential to rapidly reach a vast audience, these have gained larger importance during the coronavirus disease 2019 pandemic. Two key aspects determine the quality of infographics, content and visual appeal. In this brief, the authors attempt to delineate the key aspects of designing an infographic, and the freeware that they may have at their disposal for creating informative, appealing, and useful infographics.
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Affiliation(s)
- Mrudula Joshi
- Byramjee Jeejeebhoy Government Medical College and Sassoon General Hospitals, Pune, India
| | - Latika Gupta
- Department Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
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Warfield SC, Pack RP, Degenhardt L, Larney S, Bharat C, Ashrafioun L, Marshall BDL, Bossarte RM. The next wave? Mental health comorbidities and patients with substance use disorders in under-resourced and rural areas. J Subst Abuse Treat 2020; 121:108189. [PMID: 33162261 DOI: 10.1016/j.jsat.2020.108189] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 09/10/2020] [Accepted: 10/22/2020] [Indexed: 01/30/2023]
Abstract
The rapid spread of the coronavirus disease (COVID-19) has impacted the lives of millions around the globe. The COVID-19 pandemic has caused increasing concern among treatment professionals about mental health and risky substance use, especially among those who are struggling with a substance use disorder (SUD). The pandemic's impact on those with an SUD may be heightened in vulnerable communities, such as those living in under-resourced and rural areas. Despite policies loosening restrictions on treatment requirements, unintended mental health consequences may arise among this population. We discuss challenges that under-resourced areas face and propose strategies that may improve outcomes for those seeking treatment for SUDs in these areas.
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Affiliation(s)
- Sara C Warfield
- Injury Control Research Center, West Virginia University, United States of America; Center of Excellence for Suicide Prevention, Department of Veterans Affairs, United States of America; Department of Behavioral Medicine and Psychiatry, West Virginia University, United States of America.
| | - Robert P Pack
- Department of Community & Behavioral Health, College of Public Health, East Tennessee State University, United States of America; Addiction Science Center, East Tennessee State University, United States of America
| | | | - Sarah Larney
- National Drug and Alcohol Research Centre, UNSW Sydney, Australia; Department of Family Medicine and Emergency Medicine, Université de Montréal, Canada; Université de Montréal Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Canada
| | - Chrianna Bharat
- National Drug and Alcohol Research Centre, UNSW Sydney, Australia
| | - Lisham Ashrafioun
- Center of Excellence for Suicide Prevention, Department of Veterans Affairs, United States of America; Department of Psychiatry, University of Rochester, United States of America
| | - Brandon D L Marshall
- Department of Epidemiology, School of Public Health, Brown University, United States of America
| | - Robert M Bossarte
- Injury Control Research Center, West Virginia University, United States of America; Center of Excellence for Suicide Prevention, Department of Veterans Affairs, United States of America; Department of Behavioral Medicine and Psychiatry, West Virginia University, United States of America
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