Informed implementation practice - formative research of a mobile drug consumption room in Brno, Czech Republic.

IF 4 2区 社会学 Q1 SUBSTANCE ABUSE
Viktor Mravčík, Barbara Janíková, Danica Thanki, Daniela Nováková, Petr Matoušek, Simona Psárska, Martin Matušák, Žofie Buchalová, Lenka Dospiviová, Lucie Mašková, Petr Blažek
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引用次数: 0

Abstract

Background: Drug consumption rooms (DCRs) are harm reduction facilities providing safer and hygienic setting for supervised administration of drugs aimed at decreasing negative health and social consequences of drug use. The first DCR in Czechia was opened in September 2023 in city of Brno in a mobile form operating in a socially excluded area (SEA). A research project informed the implementation of the DCR.

Methods: A mixed methods design was applied in the following phases: desk review, research before and after the launch of the mobile DCR, and routine monitoring of programme performance. Two cross-sectional questionnaire surveys among PWUDs (n = 131 and 135), ethnographic observation, focus group (n = 19), interviews with PWUDs (n = 26 and 19), with personnel of addiction services and local officials (n = 16 and 12), and residents (n = 7 and 6) were performed prior to and after the launch of the DCR. Thematic analysis of qualitative data, descriptive and regression analyses of quantitative data were performed.

Results: There was a need and high willingness to use the DCR among potential clients. The significant predictors were opioid use (adjusted odds ratio, AOR = 3.4 in survey 1 and 3.9 in survey 2), drug injection in the last 30 days (AOR 4.3 in survey 1), being in the probationary period during the previous 30 days (AOR 10.0 in survey 1), witnessing an overdose in the past 30 days (AOR 8.5 in survey 2), HCV positivity ever in life (AOR 2.9 in survey 2), living in SEA (AOR 2.7 in survey 2) and Roma ethnicity (AOR 2.8 in survey 2). The beginnings of the DCR were relatively slow with low initial number of clients and drug administrations. However, with time, and programme adjustments following research results, the attendance at the facility has grown.

Conclusions: Research was instrumental in shaping the DCR in Brno before and during its implementation. The DCR showed a potential to attract the most vulnerable PWUDs from SEA. Despite a slow start, the DCR has become an integral part of low-threshold services for PWUDs in Brno and has proven its feasibility in the Czech settings.

捷克布尔诺流动吸毒室知情实施实践形成性研究。
背景:药物消耗室是一种减少危害的设施,为药物监督管理提供更安全和卫生的环境,旨在减少药物使用对健康和社会的负面影响。捷克的第一个DCR于2023年9月在布尔诺市以流动形式开放,在一个社会排斥地区(SEA)开展业务。一项研究项目为执行国别报告提供了信息。方法:采用混合方法设计,在案头审查、移动DCR启动前后的研究和项目绩效的常规监测三个阶段进行研究。在DCR启动前后,对戒毒所进行了两次横断面问卷调查(n = 131和135),人种学观察,焦点小组(n = 19),对戒毒所人员和地方官员(n = 16和12)以及居民(n = 7和6)的访谈。对定性数据进行专题分析,对定量数据进行描述性和回归分析。结果:潜在客户有使用DCR的需求和意愿。重要预测因子是阿片类药物使用(调整后的优势比,优势在调查1 = 3.4和3.9调查2),药物注射在过去30天(优势比4.3调查1),在试用期期间前30天(优势比10.0调查1),见证过量在过去30天(优势比8.5调查2),丙肝病毒积极性在生活(优势比2.9调查2),生活在海洋调查2(优势比2.7)和罗马民族调查2(优势比2.8)。DCR的开始相对缓慢,最初的客户和药物管理数量较少。然而,随着时间的推移和研究成果后的课程调整,该设施的出勤率有所增加。结论:在布尔诺实施DCR之前和期间,研究有助于形成DCR。DCR显示了从东南亚吸引最脆弱的pwud的潜力。尽管起步缓慢,但DCR已成为布尔诺市pwud低门槛服务的一个组成部分,并已证明其在捷克的可行性。
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来源期刊
Harm Reduction Journal
Harm Reduction Journal Medicine-Public Health, Environmental and Occupational Health
CiteScore
5.90
自引率
9.10%
发文量
126
审稿时长
26 weeks
期刊介绍: Harm Reduction Journal is an Open Access, peer-reviewed, online journal whose focus is on the prevalent patterns of psychoactive drug use, the public policies meant to control them, and the search for effective methods of reducing the adverse medical, public health, and social consequences associated with both drugs and drug policies. We define "harm reduction" as "policies and programs which aim to reduce the health, social, and economic costs of legal and illegal psychoactive drug use without necessarily reducing drug consumption". We are especially interested in studies of the evolving patterns of drug use around the world, their implications for the spread of HIV/AIDS and other blood-borne pathogens.
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