Implementation and sustainability of safe consumption sites: a qualitative systematic review and thematic synthesis
Abstract Background Safe consumption sites (SCSs) serve diverse populations of people who use drugs (PWUD) and public health objectives. SCS implementation began in the 1980s, and today, there are at least 200 known SCSs operating in over twelve countries. While a growing literature supports their e...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-07-01
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| Series: | Harm Reduction Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12954-022-00655-z |
| _version_ | 1811219364544774144 |
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| author | Grace H. Yoon Timothy W. Levengood Melissa J. Davoust Shannon N. Ogden Alex H. Kral Sean R. Cahill Angela R. Bazzi |
| author_facet | Grace H. Yoon Timothy W. Levengood Melissa J. Davoust Shannon N. Ogden Alex H. Kral Sean R. Cahill Angela R. Bazzi |
| author_sort | Grace H. Yoon |
| collection | DOAJ |
| description | Abstract Background Safe consumption sites (SCSs) serve diverse populations of people who use drugs (PWUD) and public health objectives. SCS implementation began in the 1980s, and today, there are at least 200 known SCSs operating in over twelve countries. While a growing literature supports their effectiveness as a harm reduction strategy, there is limited information on contextual factors that may support or hinder SCS implementation and sustainability. We aimed to fill this gap in knowledge by reviewing existing qualitative studies on SCSs. Methods We conducted a systematic review and thematic synthesis of qualitative studies. We identified all peer-reviewed, English-language qualitative studies on SCSs containing original data in PubMed, Web of Science, Google Scholar, and Science Direct as of September 23, 2019. Two authors independently screened, abstracted, and coded content relating to SCS implementation and sustainment aligned with the Exploration, Preparation, Implementation, Sustainment (EPIS) implementation science framework. Results After removing duplicates, we identified 765 unique records, of which ten qualitative studies met inclusion criteria for our synthesis. Across these ten studies, 236 total interviews were conducted. Overall, studies described how SCSs can (1) keep drug use out of public view while fostering a sense of inclusion for participants, (2) support sustainment by enhancing external communities’ acceptability of SCSs, and (3) encourage PWUD utilization. Most studies also described how involving PWUD and peer workers (i.e., those with lived experience) in SCS operation supported implementation and sustainability. Discussion Our thematic synthesis of qualitative literature identified engagement of PWUD and additional factors that appear to support SCS planning and operations and are critical to implementation success. However, the existing qualitative literature largely lacked perspectives of SCS staff and other community members who might be able to provide additional insight into factors influencing the implementation and sustainability of this promising public health intervention. |
| first_indexed | 2024-04-12T07:24:55Z |
| format | Article |
| id | doaj.art-5f47bfdadd5a42c7a91077cde02d221c |
| institution | Directory Open Access Journal |
| issn | 1477-7517 |
| language | English |
| last_indexed | 2024-04-12T07:24:55Z |
| publishDate | 2022-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Harm Reduction Journal |
| spelling | doaj.art-5f47bfdadd5a42c7a91077cde02d221c2022-12-22T03:42:13ZengBMCHarm Reduction Journal1477-75172022-07-0119111110.1186/s12954-022-00655-zImplementation and sustainability of safe consumption sites: a qualitative systematic review and thematic synthesisGrace H. Yoon0Timothy W. Levengood1Melissa J. Davoust2Shannon N. Ogden3Alex H. Kral4Sean R. Cahill5Angela R. Bazzi6Department of Health, Law, Policy and Management, Boston University School of Public HealthDepartment of Health, Law, Policy and Management, Boston University School of Public HealthDepartment of Health, Law, Policy and Management, Boston University School of Public HealthDepartment of Health, Law, Policy and Management, Boston University School of Public HealthRTI InternationalFenway Institute and Department of Health, Law, Policy and Management, Boston University School of Public HealthHerbert Wertheim School of Public Health and Human Longevity Science, University of CaliforniaAbstract Background Safe consumption sites (SCSs) serve diverse populations of people who use drugs (PWUD) and public health objectives. SCS implementation began in the 1980s, and today, there are at least 200 known SCSs operating in over twelve countries. While a growing literature supports their effectiveness as a harm reduction strategy, there is limited information on contextual factors that may support or hinder SCS implementation and sustainability. We aimed to fill this gap in knowledge by reviewing existing qualitative studies on SCSs. Methods We conducted a systematic review and thematic synthesis of qualitative studies. We identified all peer-reviewed, English-language qualitative studies on SCSs containing original data in PubMed, Web of Science, Google Scholar, and Science Direct as of September 23, 2019. Two authors independently screened, abstracted, and coded content relating to SCS implementation and sustainment aligned with the Exploration, Preparation, Implementation, Sustainment (EPIS) implementation science framework. Results After removing duplicates, we identified 765 unique records, of which ten qualitative studies met inclusion criteria for our synthesis. Across these ten studies, 236 total interviews were conducted. Overall, studies described how SCSs can (1) keep drug use out of public view while fostering a sense of inclusion for participants, (2) support sustainment by enhancing external communities’ acceptability of SCSs, and (3) encourage PWUD utilization. Most studies also described how involving PWUD and peer workers (i.e., those with lived experience) in SCS operation supported implementation and sustainability. Discussion Our thematic synthesis of qualitative literature identified engagement of PWUD and additional factors that appear to support SCS planning and operations and are critical to implementation success. However, the existing qualitative literature largely lacked perspectives of SCS staff and other community members who might be able to provide additional insight into factors influencing the implementation and sustainability of this promising public health intervention.https://doi.org/10.1186/s12954-022-00655-zImplementation scienceHarm reductionSafe consumption sitesSupervised consumption sitesDrug consumption roomsQualitative |
| spellingShingle | Grace H. Yoon Timothy W. Levengood Melissa J. Davoust Shannon N. Ogden Alex H. Kral Sean R. Cahill Angela R. Bazzi Implementation and sustainability of safe consumption sites: a qualitative systematic review and thematic synthesis Harm Reduction Journal Implementation science Harm reduction Safe consumption sites Supervised consumption sites Drug consumption rooms Qualitative |
| title | Implementation and sustainability of safe consumption sites: a qualitative systematic review and thematic synthesis |
| title_full | Implementation and sustainability of safe consumption sites: a qualitative systematic review and thematic synthesis |
| title_fullStr | Implementation and sustainability of safe consumption sites: a qualitative systematic review and thematic synthesis |
| title_full_unstemmed | Implementation and sustainability of safe consumption sites: a qualitative systematic review and thematic synthesis |
| title_short | Implementation and sustainability of safe consumption sites: a qualitative systematic review and thematic synthesis |
| title_sort | implementation and sustainability of safe consumption sites a qualitative systematic review and thematic synthesis |
| topic | Implementation science Harm reduction Safe consumption sites Supervised consumption sites Drug consumption rooms Qualitative |
| url | https://doi.org/10.1186/s12954-022-00655-z |
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