ASAP: Access to Syringes at Pharmacies for the Prevention of Bloodborne Infections among People who Inject Drugs

尽快：在药房使用注射器以预防注射毒品者的血源性感染

• 批准号: 10380878
• 负责人: Beth Meyerson
• 金额: $ 7.68万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-01 至 2023-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10380878
• 关键词: Address; Adopted; Adoption; Area; Arizona; Blood; COVID-19 pandemic; Centers for Disease Control and Prevention (U.S.); Characteristics; Communities; Consolidated Framework for Implementation Research; County; Development; Disease Outbreaks; Dissemination and Implementation; Drug usage; Drug user; Education; Educational Intervention; Elements; Ethnography; Evaluation; Evidence based intervention; Feedback; Future; HIV; Hepatitis C virus; Hybrids; Individual; Infection; Injecting drug user; Injections; Intervention; Interview; Legal; Manuals; Minority Groups; Modeling; Motivation; Needle Sharing; Needle-Exchange Programs; Opioid; Pharmacists; Pharmacy facility; Phase; Preparation; Prevention; Process; Protocols documentation; Reporting; Research; Research Personnel; Sales; Sampling; Site; Source; Sterility; Stigmatization; Surveys; Syringes; Testing; Time; Training; Work; base; cost effective; effectiveness trial; evidence base; experience; improved; injection drug use; innovation; interest; intervention program; motivational intervention; novel; operation; opioid epidemic; pandemic disease; prevent; programs; provider behavior; response; screening; success; testing access

Although interventions such as syringe service programs have attempted to address the need for sterile syringes to prevent blood borne infections (BBI) among people who inject drugs (PWID), the programs are often fragmented and therefore difficult to evaluate in terms of a “product” with potential for widespread dissemination and implementation in a sustainable manner. Further, these types of prevention efforts do not exist universally across the U.S., especially in the Southwestern region among largely minority populations. Access to Syringes at Pharmacies (ASAP) is a refinement of an evidence-based, pharmacy intervention to increase pharmacy-based sales of syringes to PWID in order to reduce BBI among them. The refinement integrates a motivational enhancement to reduce staff ambivalence about syringe sales to PWID, sampling improvements to assure that project pharmacies are likely serving PWID, and refinements to the intervention training content and delivery in three selected Arizona project counties of Mohave, Maricopa and Pima. Our development and refinement of ASAP relies on: 1) interviews with pharmacy staff of 6 pharmacies (2 for each county) that will assess feasibility, acceptance and likely adoption of the initial draft of the ASAP intervention, and 2) interviews and surveys among pharmacy staff of 3 pharmacies (1 from each county). ASAP’s adaptations and refinements will be guided by a highly iterative process between investigators and a community advisory board (CAB). Further, the Consolidated Framework for Implementation Research (CFIR) will guide feasibility assessment with a focus on selected CFIR elements across the domains of intervention characteristics, outer and inner setting, characteristics of individuals and process. The project will occur in two phases. The Year 1 formative phase will involve: 1) in-depth interviews with staff of 6 pharmacies to clarify intervention components, training and feasibility. Findings will inform the Year 2 iterative ASAP development and refinement phase between investigators and the CAB; including extensive feedback from pharmacy staff of 3 pharmacies following an ASAP beta test. Specific Aims are: Aim 1: To conduct the formative research among pharmacy staff required to develop and beta test the ASAP intervention materials (e.g., training manual, manual of operations, evaluation protocols). Aim 2: To determine the feasibility of the ASAP intervention relative to impact on pharmacy syringe- related sales and pharmacy interactions with PWID at time of syringe buy request.

尽管诸如注射器服务计划之类的干预措施已试图满足无菌的需求 预防注射毒品的人（PWID）的注射器以防止血液传播感染（BBI），这些程序是 经常分散，因此很难根据“产品”来评估，并具有宽度的潜力 以可持续的方式传播和实施。此外，这些类型的预防工作没有 在美国，尤其是在大部分少数群体中，尤其是在西南地区的普遍存在。 在药房获取注射器（ASAP）是基于证据的药学干预的改进 增加基于药房的注射器销售对PWID的销售，以减少其中的BBI。精致 集成了激励性的增强，以减少员工对注射器销售对PWID的矛盾性，取样 改进以确保项目药房可能正在提供PWID，并进行干预的改进 在三个选定的亚利桑那州项目县的莫哈夫，马里科帕和皮马县培训内容和交付。我们的 ASAP的开发和完善依赖于：1）与6家药房的药房工作人员的访谈（每家2个 县）将评估ASAP干预措施的最初草案的可行性，接受和可能采用 2）在药房的3家药房（每项计数中有1个）对药房的访谈和调查。尽快 适应和改进将由研究人员与A之间的高度迭代过程指导 社区顾问委员会（CAB）。此外，实施研究的合并框架（CFIR） 将指导可行性评估，重点关注整个干预领域的选定CFIR元素 特征，外部和内部环境，个体的特征和过程。该项目将分为两个 阶段。第一年的形成阶段将涉及：1）与6家药房的工作人员进行深入的访谈以澄清 干预组件，培训和可行性。调查结果将告知第二年的ASAP开发 研究人员和驾驶室之间的改进阶段；包括药房工作人员的大量反馈 ASAP Beta测试后的3家药房。具体目的是： 目的1：在开发和beta测试所需的药房工作人员之间进行形成性研究 ASAP干预材料（例如，培训手册，操作手册，评估协议）。 目标2：确定ASAP干预相对于对药学注射器的影响的可行性 - 注射器购买请求时，相关的销售和药房与PWID的互动。