Beaugard Corinne A, Formica Scott W, Cummins Emily R, Bagley Sarah M, Beletsky Leo, Green Traci C, Murray Stephen P, Yan Shapei, Xuan Ziming, Walley Alexander Y, Carroll Jennifer J
Boston University School of Social Work, 264 Bay State Road, Boston MA 02215, United States.
Social Science Research and Evaluation, Inc., 84 Mill St., Lincoln, MA 01773, United States.
Int J Drug Policy. 2024 Feb;124:104310. doi: 10.1016/j.drugpo.2023.104310. Epub 2024 Jan 4.
Public health-public safety partnerships for post-overdose outreach have emerged in many communities to prevent future overdose events. These efforts often identify overdose survivors through emergency call data and seek to link them with relevant services. The aim of this study was to describe how post-overdose outreach programs in Massachusetts manage the confidentiality of identifiable information and privacy of survivors.
In 2019, 138 Massachusetts programs completed surveys eliciting responses to questions about program operations. Descriptive statistics were calculated from the closed-ended survey responses. Thirty-eight interviews were conducted among outreach staff members during 2019-2020. Interview transcripts and open-ended survey responses were thematically analyzed using deductive and inductive approaches.
Of programs that completed the survey, 90 % (n = 124/138) reported acting to protect the privacy of survivors following overdose events, and 84 % (n = 114/135) reported implementing a protocol to maintain the confidentiality of personal information. Interviews with outreach team members indicated substantial variation in practice. Outreach programs regularly employed discretion in determining actions in the field, sometimes undermining survivor privacy and confidentiality (e.g., by disclosing the overdose event to family members). Programs aiming to prioritize privacy and confidentiality attempted to make initial contact with survivors by phone, limited or concealed materials left behind when no one was home, and/or limited the number of contact attempts.
Despite the establishment of privacy and confidentiality protocols within most post-overdose outreach programs, application of these procedures was varied, discretionary, and at times viewed by staff as competing with engagement efforts. Individual outreach overdose teams should prioritize privacy and confidentiality during outreach to protect overdose survivors from undesired exposure. In addition to individual program changes, access to overdose survivor information could be changed across all programs to bolster privacy and confidentiality protocols. For example, transitioning the management of overdose-related information to non-law enforcement agencies would limit officers' ability to disseminate such information at their discretion.
许多社区已出现公共卫生-公共安全伙伴关系，以开展过量用药后外联工作，防止未来发生过量用药事件。这些工作通常通过紧急呼叫数据识别过量用药幸存者，并设法将他们与相关服务联系起来。本研究的目的是描述马萨诸塞州的过量用药后外联项目如何管理可识别信息的保密性和幸存者的隐私。
2019年，138个马萨诸塞州的项目完成了调查，以获取有关项目运作问题的答复。根据封闭式调查答复计算描述性统计数据。2019年至2020年期间，对外联工作人员进行了38次访谈。使用演绎和归纳方法对访谈记录和开放式调查答复进行了主题分析。
在完成调查的项目中，90%（n = 124/138）报告在过量用药事件后采取行动保护幸存者隐私，84%（n = 114/135）报告实施了维护个人信息保密性的方案。对外联团队成员的访谈表明，实际做法存在很大差异。外联项目在确定现场行动时经常自行决定，有时会损害幸存者的隐私和保密性（例如，向家庭成员透露过量用药事件）。旨在优先考虑隐私和保密性的项目试图通过电话与幸存者进行首次联系，在无人在家时留下的材料有限或予以隐瞒，和/或限制联系尝试的次数。
尽管大多数过量用药后外联项目都制定了隐私和保密方案，但这些程序的应用各不相同，具有随意性，工作人员有时认为这与参与工作相冲突。个别外联过量用药团队在开展外联工作时应优先考虑隐私和保密性，以保护过量用药幸存者免受不必要的曝光。除了个别项目的改变外，所有项目获取过量用药幸存者信息的方式都可以改变，以加强隐私和保密方案。例如，将与过量用药相关信息的管理移交给非执法机构，将限制官员自行传播此类信息的能力。
