Evaluation capacity building: Advancing community-centered solutions to substance use health inequities in Chicago.

In the city of Chicago, opioid overdose is one of the top five drivers of the life expectancy gap between Black and non-Black Chicagoans, which reached 11.4 years in 2022. The city has responded by supporting social and behavioral health community-based organizations (i.e., delegate agencies) in implementing place-based and community-centered evidence-informed harm reduction strategies for local populations most impacted by opioid overdoses. This study highlights key findings from qualitative interviews with agency staff related to how agencies are implementing a variety of harm reduction strategies emergent practice-based innovations. Findings demonstrated how agencies creatively contended with systems-level challenges through emergent harm reduction innovations that emphasized community-based education, outreach, and choice; a person-centered approach; and a hyperlocal, place-based coordination of overdose response. Findings from this study contribute to the growing harm reduction evidence base while offering practical recommendations and examples of uptake to address challenges that impact the effectiveness of harm reduction strategies.