吸毒者对移动医疗诊所的认知、感知和利用。
Awareness, perception and utilization of a mobile health clinic by people who use drugs.
机构信息
Department of Pediatrics, Center for Child and Community Health Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Baltimore City Health Department, Baltimore, MD, USA.
出版信息
Ann Med. 2022 Dec;54(1):138-149. doi: 10.1080/07853890.2021.2022188.
INTRODUCTION
People who use drugs (PWUD) face a multitude of barriers to accessing healthcare and other services. Mobile health clinics (MHC) are an innovative, cost-effective health care delivery approach that increases healthcare access to vulnerable populations and medically underserved areas. There is limited understanding, however, of how PWUD perceive and experience MHCs.
METHODS
Semi-structured interviews were conducted with 31 PWUD - 16 who had received care (clients) on an MHC (The Spot) and 15 who had not (non-clients) - to explore their perceptions and utilization of an MHC partnered with a mobile syringe services program in Baltimore, Maryland. Data analysis of the text was conducted using an iterative thematic constant comparison process informed by grounded theory.
RESULTS
Clients and non-clients, once aware of the MHC, had positive perceptions of The Spot and its benefits for their individual health as well as for the wellbeing of their community. These sentiments among clients were largely driven by access to low-barrier buprenorphine and service delivery without stigma around drug use. However, lack of general awareness of the spot and specific service offering were barriers to its use among non-clients.
DISCUSSION
MHCs provide an important opportunity to engage PWUD in healthcare and to expand buprenorphine use; however, even with accessibility near where PWUD access injection equipment, barriers to its use remain. Peer dissemination may be able to facilitate program information sharing and recruitment.KEY MESSAGESPeople who use drugs perceive a mobile health clinic in their neighbourhood as a benefit to their communities and themselves by improving access to healthcare services, providing access to low-threshold buprenorphine dispensation, and offering services without drug use stigma.People who use drugs learned about a mobile health clinic in their neighbourhood largely through word-of-mouth. As a result, people received limited information about the mobile health clinic services creating a barrier to its use.
简介
使用毒品的人（PWUD）在获得医疗保健和其他服务方面面临诸多障碍。移动医疗诊所（MHC）是一种创新的、具有成本效益的医疗保健提供方式，它增加了弱势人群和医疗服务不足地区获得医疗保健的机会。然而，对于 PWUD 如何看待和体验 MHC，人们的理解有限。
方法
对 31 名 PWUD 进行了半结构式访谈，其中 16 名曾在马里兰州巴尔的摩市的 MHC（The Spot）接受过护理（患者），15 名未曾接受过（非患者），以探讨他们对与移动注射器服务项目合作的 MHC 的看法和使用情况。对文本的数据进行了分析，使用迭代主题恒定性比较过程，并由扎根理论提供信息。
结果
一旦意识到 MHC，患者和非患者对 The Spot 及其对个人健康以及社区福祉的益处都有积极的看法。这些情绪在患者中主要是由于获得低门槛丁丙诺啡和无吸毒污名的服务提供推动的。然而，非患者对 MHC 的使用受到普遍缺乏对该场所的认识和特定服务提供的限制。
讨论
MHC 为接触 PWUD 提供了一个重要的医疗保健机会，并扩大了丁丙诺啡的使用；然而，即使在 PWUD 获得注射设备的地方具备可及性，使用 MHC 的障碍仍然存在。同伴传播可能能够促进项目信息共享和招募。
关键信息
使用毒品的人认为他们社区中的移动健康诊所对他们自己和他们的社区是有益的，因为它改善了医疗保健服务的可及性，提供了低门槛丁丙诺啡的配给，并提供了无吸毒污名的服务。使用毒品的人主要通过口口相传来了解他们社区中的移动健康诊所。因此，人们对移动健康诊所的服务了解有限，这就造成了使用该诊所的障碍。
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