Dalla Lana School of Public Health, University of Toronto, 480 University Ave, Suite 300, Toronto, ON, M5G 1V2, Canada.
Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, ON, Canada.
Harm Reduct J. 2023 Nov 14;20(1):169. doi: 10.1186/s12954-023-00902-x.
The Canadian drug supply has significantly increased in toxicity over the past few years, resulting in the worsening of the overdose crisis. A key initiative implemented during this crisis has been data monitoring and reporting of substance use-related harms (SRH). This literature review aims to: (1) identify strategies used for the meaningful engagement of people who use drugs (PWUD) in local, provincial, and national SRH data system planning, reporting, and action and (2) describe data monitoring and reporting strategies and common indicators of SRH within those systems.
We searched three academic and five gray literature databases for relevant literature published between 2012 and 2022. Team members who identify as PWUD and a librarian at Public Health Ontario developed search strings collaboratively. Two reviewers screened all search results and applied the eligibility criteria. We used Microsoft Excel for data management.
Twenty-two articles met our eligibility criteria (peer-reviewed n = 10 and gray literature reports n = 12); most used qualitative methods and focused on the Canadian context (n = 20). There were few examples of PWUD engaged as authors of reports on SRH monitoring. Among information systems involving PWUD, we found two main strategies: (1) community-based strategies (e.g., word of mouth, through drug sellers, and through satellite workers) and (2) public health-based data monitoring and communication strategies (e.g., communicating drug quality and alerts to PWUD). Substance use-related mortality, hospitalizations, and emergency department visits were the indicators most commonly used in systems of SRH reporting that engaged PWUD.
This review demonstrates limited engagement of PWUD and silos of activity in existing SRH data monitoring and reporting strategies. Future work is needed to better engage PWUD in these processes in an equitable manner. Building SRH monitoring systems in partnership with PWUD may increase the potential impact of these systems to reduce harms in the community.
近年来，加拿大的毒品供应毒性显著增加，导致过量危机恶化。在这场危机中，一项关键举措是对与药物使用相关的伤害（SRH）进行数据监测和报告。本文献综述旨在：（1）确定在地方、省和国家 SRH 数据系统规划、报告和行动中，使吸毒者（PWUD）有意义地参与的策略；（2）描述这些系统中的数据监测和报告策略以及 SRH 的常见指标。
我们在三个学术数据库和五个灰色文献数据库中搜索了 2012 年至 2022 年期间发表的相关文献。公共卫生安大略省的一名自认为是 PWUD 的团队成员和一名图书管理员共同制定了搜索字符串。两名审查员筛选了所有搜索结果并应用了资格标准。我们使用 Microsoft Excel 进行数据管理。
22 篇文章符合我们的资格标准（同行评审 n=10 篇，灰色文献报告 n=12 篇）；大多数使用定性方法，且重点关注加拿大的情况（n=20）。很少有 PWUD 作为 SRH 监测报告的作者参与的例子。在涉及 PWUD 的信息系统中，我们发现了两种主要策略：（1）基于社区的策略（例如，通过毒品卖家和卫星工作人员的口口相传）和（2）基于公共卫生的数据监测和沟通策略（例如，向 PWUD 传达药物质量和警报）。在涉及 PWUD 的 SRH 报告系统中，使用最频繁的指标是药物使用相关的死亡率、住院率和急诊就诊率。
本综述表明，PWUD 的参与度有限，且现有 SRH 数据监测和报告策略存在活动孤立的情况。未来需要做更多工作，以公平的方式让 PWUD 更好地参与这些流程。与 PWUD 合作建立 SRH 监测系统，可能会增加这些系统在减少社区伤害方面的潜在影响。
