“The system always undermined what I was trying to do as an individual”: identifying opportunities to improve the delivery of opioid use services for youth from the perspective of service providers in four communities across British Columbia, Canada

Addiction Science & Clinical Practice

Research

Jill Fairbank¹  Christina Katan¹  Corinne Tallon²  Kirsten Marchand³  Skye Barbic⁴  Roxanne Turuba⁵  Oonagh Fogarty⁶  Steve Mathias⁷ 

[1] Canadian Centre on Substance Use and Addiction, 500-75 Albert St, K1P 5E7, Ottawa, ON, Canada;Foundry, 915-1045 Howe St, V6Z 2A9, Vancouver, BC, Canada;Foundry, 915-1045 Howe St, V6Z 2A9, Vancouver, BC, Canada;Centre for Health Evaluation Outcome Sciences, 588-1081 Burrard St, V6Z 1Y6, Vancouver, BC, Canada;Foundry, 915-1045 Howe St, V6Z 2A9, Vancouver, BC, Canada;Centre for Health Evaluation Outcome Sciences, 588-1081 Burrard St, V6Z 1Y6, Vancouver, BC, Canada;St. Paul’s Hospital, Providence Health Care, 1081 Burrard St, V6Z 1Y6, Vancouver, BC, Canada;Providence Research, 1190 Hornby St, V6Z 1Y6, Vancouver, BC, Canada;Foundry, 915-1045 Howe St, V6Z 2A9, Vancouver, BC, Canada;Department of Occupational Science and Occupational Therapy, University of British Columbia, 317-2194 Health Sciences Mall, V6T 1Z3, Vancouver, BC, Canada;Foundry, 915-1045 Howe St, V6Z 2A9, Vancouver, BC, Canada;Faculty of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, V6T 1Z3, Vancouver, BC, Canada;Foundry, 915-1045 Howe St, V6Z 2A9, Vancouver, BC, Canada;Faculty of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, V6T 1Z3, Vancouver, BC, Canada;Centre for Health Evaluation Outcome Sciences, 588-1081 Burrard St, V6Z 1Y6, Vancouver, BC, Canada;St. Paul’s Hospital, Providence Health Care, 1081 Burrard St, V6Z 1Y6, Vancouver, BC, Canada;Providence Research, 1190 Hornby St, V6Z 1Y6, Vancouver, BC, Canada;

关键词: Youth;    Opioid use disorder;    Opioid use;    Service providers;    Human-centered co-design;    Community-based participatory research;   

DOI  :  10.1186/s13722-022-00359-6

 received in 2022-07-18, accepted in 2022-12-21,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundSubstance use among youth is a longstanding global health concern that has dramatically risen in the era of highly toxic and unregulated drugs, including opioids. It is crucial to ensure that youth using unregulated opioids have access to evidence-based interventions, and yet, youth encounter critical gaps in the quality of such interventions. This study aims to address these gaps by identifying opportunities to improve the quality of opioid use services from the perspective of service providers, a perspective that has received scant attention.MethodsThis community-based participatory study was conducted in four communities in British Columbia (Canada), a province that declared a public health overdose emergency in 2016. Human-centered co-design workshops were held to understand service providers’ (n = 41) experiences, needs, and ideas for improving the quality of youth opioid use services/treatments in their community. Multi-site qualitative analysis was used to develop overarching experiences and needs themes that were further contextualized in each local community. A blended deductive and inductive thematic analysis was used to analyze the ideas data.ResultsThree overarching themes were identified, reflecting service providers’ goals to respond to youth in a timely and developmentally appropriate manner. However, this was significantly limited by organizational and systems-level barriers, revealing service providers’ priorities for intra- and inter-organizational support and collaboration and systems-level innovation. Across communities, service providers identified 209 individual ideas to address these prioritized needs and improve the quality of youth opioid use services/treatments.ConclusionThese themes demonstrate a multi-level tension between macro-level systems and the meso-level organization of youth opioid use services, which undermine the quality of individual-level care service providers can deliver. These findings underscore the need for a coordinated multi-level response, such as developing youth-specific standards (macro-level), increasing inter-organizational activities and collaboration (meso-level), and creating programs that are specific to youths’ needs (micro-level).

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

Fig. 54