Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth College, 46 Centerra Parkway, Lebanon, NH 03766, USA.
Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth College, 46 Centerra Parkway, Lebanon, NH 03766, USA.
Int J Drug Policy. 2021 Sep;95:103259. doi: 10.1016/j.drugpo.2021.103259. Epub 2021 Apr 29.
New Hampshire (NH) ranked first for fentanyl- and all opioid-related overdose deaths per capita from 2014 to 2016 and third in 2017 with no rate reduction from the previous year relative to all other states in the US. In response to the opioid crisis in NH, Manchester Fire Department (MFD), the state's largest city fire department, launched the Safe Station program in 2016 in partnership with other community organizations. This community-based response to the crisis-described as a connection to recovery-focuses on reducing barriers to accessing resources for people with substance use and related problems. The study aim is to characterize the multi-organizational partnerships and workflow of the Safe Station model and identify key components that are engaging, effective, replicable, and sustainable.
A mixed-methods design included: semi-structured qualitative interviews conducted with 110 stakeholders from six groups of community partners (Safe Station clients, MFD staff and leadership, and local emergency department, ambulance, and treatment partner staff); implementation and sustainability surveys (completed by MFD stakeholders); and ethnographic observations conducted at MFD. Qualitative data were content analyzed and coded using the Consolidated Framework for Implementation Research. Survey subscales were scored and evaluated to corroborate the qualitative findings.
Community partners identified key program characteristics including firefighter compassion, low-threshold access, and immediacy of service linkage. Implementation and sustainability survey data corroborate the qualitative interview and observation data in these areas. All participants agreed that community partnerships are key to the program's success. There were mixed evaluations of the quality of communication among the organizations.
Safe Station is a novel response to the opioid crisis in New Hampshire that offers immediate, non-judgmental access to services for persons with opioid use disorders requiring community-wide engagement and communication. Data convergence provides guidance to the sustainability and replicability of the program.
新罕布什尔州（NH）在 2014 年至 2016 年期间人均芬太尼和所有阿片类药物相关过量死亡人数排名第一，2017 年排名第三，与美国其他所有州相比，前一年的死亡率没有下降。为应对 NH 的阿片类药物危机，曼彻斯特消防局（MFD），该州最大的城市消防局，于 2016 年与其他社区组织合作推出了安全站计划。该计划作为对危机的一种基于社区的反应——被描述为与康复的联系——侧重于减少有药物使用和相关问题的人获取资源的障碍。本研究旨在描述安全站模式的多组织伙伴关系和工作流程，并确定具有吸引力、有效性、可复制性和可持续性的关键组成部分。
混合方法设计包括：对来自六个社区合作伙伴群体（安全站客户、MFD 工作人员和领导层以及当地急诊室、救护车和治疗合作伙伴工作人员）的 110 名利益相关者进行半结构式定性访谈；实施和可持续性调查（由 MFD 利益相关者完成）；以及在 MFD 进行的民族志观察。使用实施研究综合框架对定性数据进行内容分析和编码。对调查子量表进行评分和评估，以佐证定性发现。
社区合作伙伴确定了关键计划特征，包括消防员的同情心、低门槛准入和服务联系的即时性。实施和可持续性调查数据在这些方面与定性访谈和观察数据相吻合。所有参与者都认为社区伙伴关系是该计划成功的关键。对于组织之间沟通质量的评价存在差异。
安全站是对新罕布什尔州阿片类药物危机的一种新颖反应，为需要社区广泛参与和沟通的阿片类药物使用障碍患者提供了即时、非评判性的服务获取途径。数据的一致性为该计划的可持续性和可复制性提供了指导。
