Accepted for/Published in: JMIR Research Protocols
Date Submitted: Jul 30, 2024
Date Accepted: Jun 9, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Empowering Health: A Community-Based Participatory Approach for Introducing Public Health Vending Machines in Rural North Carolina
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. The purpose of this study is a community-engaged approach to implement PHVMs as a healthcare delivery option for harm reduction supplies in five rural counties in NC.
Objective:
The study's purpose is to employ a community-based participatory approach to improving naloxone access in rural communities 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 a surveyor, who will recruit, conduct interviews, and collect data from other community members with lived experience of substance use. Surveyors will be trained to recruit participants, conduct interviews, and collect and analyze data. Developing a protocol for training surveyors includes an interview training presentation with an adapted collaborative institutional training initiative (CITI) portion.
Results:
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 the development of a sustainability plan for each county. Clinical Trial: NA
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