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从设计到行动:参与式方法满足当地过量用药应对计划的能力建设需求。

From design to action: participatory approach to capacity building needs for local overdose response plans.

机构信息

Health Design Studio, OCAD University, Toronto, ON, M5T 1W1, Canada.

Institute for Safe Medication Practices Canada (ISMP Canada), Toronto, ON, M2N6K8, Canada.

出版信息

BMC Public Health. 2023 Apr 27;23(1):774. doi: 10.1186/s12889-023-15414-3.

Abstract

BACKGROUND

In response to the rise in opioid-related deaths, communities across Ontario have developed opioid or overdose response plans to address issues at the local level. Public Health Ontario (PHO) leads the Community Opioid / Overdose Capacity Building (COM-CAP) project, which aims to reduce overdose-related harms at the community level by working with communities to identify, develop, and evaluate capacity building supports for local needs around overdose planning. The 'From Design to Action' co-design workshop used a participatory design approach to engage communities in identifying the requirements for capacity building support.

METHODS

A participatory approach (co-design) provided opportunity for collaborative discussion around capacity building needs at the community level. The co-design workshop included three structured collaborative activities to 1) prioritize scenarios that illustrated various challenges associated with community overdose response planning, 2) prioritize the challenges within each scenario and 3) prioritize the supports to address each of these challenges. It was conducted with fifty-two participants involved in opioid/overdose-related response plans in Ontario. Participatory materials were informed by the results of a situational assessment (SA) data gathering process, including survey, interview, and focus group data. A voting system, including dot stickers and discussion notes, was applied to identify priority supports and delivery mechanisms.

RESULTS

At the workshop, key challenges and top-priority supports were identified, for development and implementation. The prioritized challenges were organized into five categories of capacity building supports addressing: 1) stigma & equity; 2) trust-based relationships, consensus building & on-going communication; 3) knowledge development & on-going access to information and data; 4) tailored strategies and plan adaptation to changing structures and local context; and 5) structural enablers and responsive governance.

CONCLUSION

Using a participatory approach, the workshop provided an opportunity for sharing, generating, and mobilizing knowledge to address research-practice gaps at the community level for opioid response planning. The application of health design methods such as the 'From Design to Action' co-design workshop supports teams to gain a deeper understanding of needs for capacity building as well as illustrating the application of participatory approaches in identifying capacity building needs for complex public health issues such as the overdose crisis.

摘要

背景

为应对阿片类药物相关死亡人数的上升,安大略省各地社区已制定阿片类药物或过量用药应对计划,以解决当地的问题。安大略省公共卫生局(PHO)领导社区阿片类药物/过量用药能力建设(COM-CAP)项目,该项目旨在通过与社区合作,确定、制定和评估针对当地过量用药规划需求的能力建设支持,从而减少社区层面与过量用药相关的伤害。“从设计到行动”合作设计研讨会采用参与式设计方法,让社区参与确定能力建设支持的需求。

方法

参与式方法(合作设计)为社区层面的能力建设需求提供了协作讨论的机会。合作设计研讨会包括三个结构化的协作活动,以 1)优先考虑说明与社区过量用药应对规划相关的各种挑战的情景,2)优先考虑每个情景中的挑战,以及 3)优先考虑解决这些挑战的支持。该研讨会有 52 名参与安大略省阿片类药物/过量用药相关应对计划的人员参加。参与性材料由情景评估(SA)数据收集过程的结果提供信息,包括调查、访谈和焦点小组数据。投票系统(包括点贴纸和讨论笔记)用于确定优先支持和交付机制。

结果

在研讨会上,确定了关键挑战和首要支持,以进行开发和实施。确定优先级的挑战被组织成五个能力建设支持类别,以解决:1)耻辱感和公平性;2)基于信任的关系、共识建立和持续沟通;3)知识发展和持续获取信息和数据;4)量身定制的策略和计划适应不断变化的结构和当地环境;以及 5)结构促进因素和响应性治理。

结论

通过采用参与式方法,研讨会为分享、生成和调动知识提供了机会,以解决社区层面阿片类药物应对规划中的研究与实践差距。应用健康设计方法,如“从设计到行动”合作设计研讨会,支持团队更深入地了解能力建设需求,并说明在确定复杂公共卫生问题(如过量用药危机)的能力建设需求方面采用参与式方法的应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c50/10134559/7f523439f896/12889_2023_15414_Fig1_HTML.jpg

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