Kerman Nick, Manoni-Millar Stéphanie, Cormier Luc, Cahill Tali, Sylvestre John
School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Vanier Hall, Ottawa, Ontario, K1N 6N5, Canada.
School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Vanier Hall, Ottawa, Ontario, K1N 6N5, Canada.
Drug Alcohol Depend. 2020 Aug 1;213:108078. doi: 10.1016/j.drugalcdep.2020.108078. Epub 2020 May 23.
People who inject drugs are highly vulnerable to social determinants of health (SDOH) inequities, such as homelessness, food insecurity, lack of social support, and poor access to healthcare. Supervised consumption sites (SCSs) have been developed to reduce harms associated with injection drug use but their social impacts remain largely unknown. This study explored service users' experiences with SCSs and how their service use affected their SDOH.
A qualitative descriptive study design was used. Participants were recruited from an SCS in Ottawa, Canada. Data were collected using in-depth interviews (n = 21). Data analysis involved two cycles of coding that were visibly presented in an analytic matrix. Member checking of the findings was then completed using two focus groups (n = 7).
Five themes were identified with regard to how SCSs impacted the SDOH: (1) social connectedness and community, (2) emotional support and stress reduction, (3) safety and security, (4) current shelter statuses and search for housing, and (5) health service access and use. The perceived effects of SCSs in these domains were mostly positive, though the importance of being vigilant and cautious when using the services was also expressed by participants.
SCSs represent a potential downstream intervention to addressing some of the SDOH inequities experienced by people who inject drugs. In particular, the findings indicate that SCSs can be a bridge to rebuilding service users' connections with the healthcare system and an important service in efforts to prevent unsheltered homelessness.
注射吸毒者极易受到健康的社会决定因素（SDOH）不平等问题的影响，例如无家可归、粮食不安全、缺乏社会支持以及难以获得医疗保健服务。已设立监督下的消费场所（SCS）以减少与注射吸毒相关的危害，但其社会影响在很大程度上仍不为人知。本研究探讨了服务使用者在SCS的经历以及他们使用服务如何影响其SDOH。
采用定性描述性研究设计。参与者从加拿大渥太华的一个SCS招募。通过深度访谈（n = 21）收集数据。数据分析包括两个编码循环，这些编码在分析矩阵中清晰呈现。然后通过两个焦点小组（n = 7）完成对研究结果的成员核对。
就SCS如何影响SDOH确定了五个主题：（1）社会联系与社区，（2）情感支持与压力减轻，（3）安全保障，（4）当前的住房状况与寻找住房，以及（5）医疗服务的获取与使用。SCS在这些领域的感知效果大多是积极的，不过参与者也表示使用这些服务时保持警惕和谨慎很重要。
SCS是解决注射吸毒者所经历的一些SDOH不平等问题的潜在下游干预措施。特别是，研究结果表明SCS可以成为重建服务使用者与医疗保健系统联系的桥梁，并且是预防无家可归者露宿街头努力中的一项重要服务。
