Evaluating public health vending machine rollout and utilization in criminal-legal settings

Abstract

Introduction

Harm reduction resources for people who are involved in the criminal-legal system should be easily accessible. The Rhode Island Department of Corrections (DOC) used funding from a state opioid stewardship fund created through the Rhode Island Opioid Stewardship Act (legislation passed in 2019) to implement five custom-designed vending machines for community corrections offices and state awaiting trial carceral facilities. The vending machines provide resources for overdose prevention, infection prevention, basic needs, and nicotine replacement therapy (NRT). We aim to describe the development and rollout of the vending machines and present data about items taken most frequently by setting.

Methods

Research and design experts, with DOC and community stakeholders, developed and tailored the public-facing design of the vending machines. Before implementation, the researchers from the development team conducted meetings with staff at each location to discuss harm reduction and their role in addressing the opioid crisis in this high-risk population. The machines were manufactured in 2022 and installed in early 2023 (dates varied by location). The community support and advocacy organization tracks and maintains inventory (items taken and replaced) by month. No individual-level client data is collected.

Results

There were 3720 items dispensed from May 2022 to February 2024 across five locations. Overall, hygiene kits were the most frequently accessed item (28.3 %, n = 1051), followed by NRT (19.0 %, n = 706) and ponchos (16.6 %, n = 616). The fentanyl tests (n = 230), wound care kits (n = 248), resource guide (n = 253), naloxone (n = 221), and safer sex kits (n = 218) each made up between 5.9 % and 6.8 % of items accessed. The pregnancy test was the least accessed at 4.8 % (n = 177). There were statistically significant differences in the monthly number of items distributed by location for the basic needs items, excluding NRT, with 39 items per month at the three Probation/Parole locations compared to 21 per month for the two DOC facilities.

Conclusions

The utilization patterns demonstrate the demand for basic supplies and support related to harm reduction. Monitoring and summarizing utilization ensures that the vending machines remain useful to the community and facilitates transparency and communication with stakeholders.