Chunqing Lin , Li Li , Anh Tuan Le , Hoang My Lien Tran , Thanh Duyen Pham , Anh Tuan Nguyen
{"title":"An intervention pilot to facilitate harm reduction service decentralization in Vietnam","authors":"Chunqing Lin , Li Li , Anh Tuan Le , Hoang My Lien Tran , Thanh Duyen Pham , Anh Tuan Nguyen","doi":"10.1016/j.jsat.2022.108927","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p><span>Harm reduction services, including methadone maintenance therapy (MMT), have been decentralized to Vietnam's community </span>health care settings. This study aims to pilot test an intervention to facilitate decentralized harm reduction service delivery in Vietnam.</p></div><div><h3>Methods</h3><p><span>The research team conducted an intervention pilot between August 2020 and May 2021 with six community MMT distribution sites in Thai Nguyen Province of Vietnam. We recruited five commune health workers (CHW) from each center (</span><em>N</em><span> = 30). In-person intervention training included content to correct misconceptions about harm reduction and reduce stigmatizing attitudes toward patients who use drugs and teach CHWs to self-examine and improve their service provision process. The study team developed a web-based platform to streamline CHW's patient monitoring and referral efforts. The team assessed intervention outcomes at baseline, 3-, and 6-months. CHWs in the intervention group provided acceptability ratings and feedback on the intervention at 6-months.</span></p></div><div><h3>Results</h3><p>CHWs in both intervention and control groups had similar background characteristics and outcome measures at baseline. CHWs in the intervention group, compared to those in the control group, showed a significantly higher level of improvement in adherence to service delivery protocol at 3-months. CHW in the intervention group had a significantly lower level of management-related stress compared to the control group at 6-months, although the intervention effect measured by the difference in change from baseline was not statistically significant. CHWs who participated in the final focus group reported high acceptability of the intervention.</p></div><div><h3>Conclusion</h3><p>This intervention pilot demonstrated acceptability and promising outcomes on community-based harm reduction service delivery. Similar intervention strategies can be applied to enhance the decentralization of other chronic disease treatment services.</p></div>","PeriodicalId":17148,"journal":{"name":"Journal of Substance Abuse Treatment","volume":null,"pages":null},"PeriodicalIF":3.7000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9759177/pdf/nihms-1851647.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Substance Abuse Treatment","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0740547222002094","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHOLOGY, CLINICAL","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction
Harm reduction services, including methadone maintenance therapy (MMT), have been decentralized to Vietnam's community health care settings. This study aims to pilot test an intervention to facilitate decentralized harm reduction service delivery in Vietnam.
Methods
The research team conducted an intervention pilot between August 2020 and May 2021 with six community MMT distribution sites in Thai Nguyen Province of Vietnam. We recruited five commune health workers (CHW) from each center (N = 30). In-person intervention training included content to correct misconceptions about harm reduction and reduce stigmatizing attitudes toward patients who use drugs and teach CHWs to self-examine and improve their service provision process. The study team developed a web-based platform to streamline CHW's patient monitoring and referral efforts. The team assessed intervention outcomes at baseline, 3-, and 6-months. CHWs in the intervention group provided acceptability ratings and feedback on the intervention at 6-months.
Results
CHWs in both intervention and control groups had similar background characteristics and outcome measures at baseline. CHWs in the intervention group, compared to those in the control group, showed a significantly higher level of improvement in adherence to service delivery protocol at 3-months. CHW in the intervention group had a significantly lower level of management-related stress compared to the control group at 6-months, although the intervention effect measured by the difference in change from baseline was not statistically significant. CHWs who participated in the final focus group reported high acceptability of the intervention.
Conclusion
This intervention pilot demonstrated acceptability and promising outcomes on community-based harm reduction service delivery. Similar intervention strategies can be applied to enhance the decentralization of other chronic disease treatment services.
期刊介绍:
The Journal of Substance Abuse Treatment (JSAT) features original reviews, training and educational articles, special commentary, and especially research articles that are meaningful to the treatment of alcohol, heroin, marijuana, and other drugs of dependence. JSAT is directed toward treatment practitioners from all disciplines (medicine, nursing, social work, psychology, and counseling) in both private and public sectors, including those involved in schools, health centers, community agencies, correctional facilities, and individual practices. The editors emphasize that JSAT articles should address techniques and treatment approaches that can be used directly by contemporary practitioners.