JMIR Publications

ABSTRACT

Background:

Drug-related overdoses impact communities all over the United States (US). In the past two decades, over 28,000 people have died from a drug overdose in North Carolina (NC). Research has shown that there has been an increase in overdose deaths throughout NC, particularly in rural areas. To reduce overdose rates, healthcare interventions should be expanded. Naloxone distribution is one intervention to combat overdose rates. Naloxone is a medication designed to reverse an opioid overdose rapidly. Public health vending machines (PHVMs) are a strategy recently implemented in some US communities to expand access to harm reduction supplies. Examples of locations where PHVMs have been installed include public health departments, libraries, county detention centers, and law enforcement offices.

Objective:

This protocol aims to develop a community-engaged approach to implementing PHVMs as a healthcare delivery option for harm reduction supplies in five rural counties in NC.

Methods:

This study utilized a community-based participatory approach in which we partnered with the North Carolina Harm Reduction Coalition and Community Impact North Carolina to engage with substance use prevention providers and community members in five rural counties in NC to improve naloxone access. We will collect qualitative interview data from people with lived experience of substance use to identify the optimal placement of PHVMs and items to be stocked in PHVMs. To do this, we are hiring one local community member with lived experience with substance use from each county to be an interviewer, who will recruit, conduct interviews, and collect data from other community members with lived experience of substance use. Interviewers will be trained to recruit participants, conduct interviews, and collect and analyze data. Developing a protocol for training interviewers includes an interview training presentation with an adapted collaborative institutional training initiative (CITI) portion.

Results:

Data will be collected 2024-2025. The findings will inform the implementation of PHVMs to improve harm reduction access and assist in decreasing overdose deaths.

Conclusions:

This study is designed to engage a community-based participatory approach to improve naloxone access in rural communities. Community partners will assist the academic team in developing a sustainability plan for each county and an implementation toolkit for other communities to use. Clinical Trial: NA