Development, acceptability and feasibility of a personalised, behavioural intervention to prevent bacterial skin and soft tissue infections among people who inject drugs: a mixed-methods Person-Based Approach study

Harm Reduction Journal

Research

Leonie Roberts¹  Maggie Telfer²  Deborah Hussey²  Catherine Lord²  James Bayliss³  Jenny Scott⁴  Andrew Preston⁵  Magdalena Harris⁶  Georgie MacArthur⁷  Matthew Hickman⁸  Harriet Fisher⁸  Joanna Kesten⁹  Helen Erswell^1,10  Dominic Mellon^1,10 

[1]Bristol City Council, Bristol, UK

[2]Bristol Drugs Project, Bristol, UK

[3]Bristol, North Somerset, South Gloucestershire Integrated Care System, Bristol, UK

[4]Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, UK

[5]Exchange Supplies, Dorchester, UK

[6]London School of Hygiene and Tropical Medicine, London, UK

[7]Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK

[8]Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK

[9]The National Institute for Health and Care Research (NIHR) Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, University of Bristol, Bristol, UK

[10]Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK

[11]The National Institute for Health and Care Research (NIHR) Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, University of Bristol, Bristol, UK

[12]The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK

[13]UK Health Security Agency (UKHSA), South West Region, Bristol, UK

关键词: People who inject drugs;    Skin and soft tissue infections;    Co-production;    Person-Based Approach;    Intervention development;    Acceptability;    Feasibility;    Harm reduction;    Behaviour change;   

DOI  :  10.1186/s12954-023-00823-9

 received in 2022-12-02, accepted in 2023-07-10,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundSkin and soft tissue infections (SSTI) among people who inject drugs (PWID) are a public health concern. This study aimed to co-produce and assess the acceptability and feasibility of a behavioural intervention to prevent SSTI.MethodsThe Person-Based Approach (PBA) was followed which involves: (i) collating and analysing evidence; (ii) developing guiding principles; (iii) a behavioural analysis; (iv) logic model development; and (v) designing and refining intervention materials. Co-production activities with target group representatives and key collaborators obtained feedback on the intervention which was used to refine its design and content. The intervention, harm reduction advice cards to support conversation between service provider and PWID and resources to support safer injecting practice, was piloted with 13 PWID by four service providers in Bristol and evaluated using a mixed-methods approach. Semi-structured interviews were conducted with 11 PWID and four service providers. Questionnaires completed by all PWID recorded demographic characteristics, SSTI, drug use and treatment history. Interviews were analysed thematically and questionnaires were analysed descriptively.ResultsPublished literature highlighted structural barriers to safer injecting practices, such as access to hygienic injecting environments and injecting practices associated with SSTI included: limited handwashing/injection-site swabbing and use of too much acidifier to dissolve drugs. Co-production activities and the literature indicated vein care and minimisation of pain as PWID priorities. The importance of service provider–client relationships and non-stigmatising delivery was highlighted through the co-production work. Providing practical resources was identified as important to address environmental constraints to safer injecting practices. Most participants receiving the intervention were White British, male, had a history of SSTI and on average were 43.6 years old and had injected for 22.7 years. The intervention was well-received by PWID and service providers. Intervention content and materials given out to support harm reduction were viewed positively. The intervention appeared to support reflections on and intentions to change injecting behaviours, though barriers to safer injecting practice remained prominent.ConclusionsThe PBA ensured the intervention aligned to the priorities of PWID. It was viewed as acceptable and mostly feasible to PWID and service providers and has transferability promise. Further implementation alongside broader harm reduction interventions is needed.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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