Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO, 63110, USA.
Department of Psychological Sciences, University of Missouri, St. Louis, MO, USA.
BMC Public Health. 2024 Aug 5;24(1):2103. doi: 10.1186/s12889-024-19541-3.
Black individuals in the U.S. face increasing racial disparities in drug overdose related to social determinants of health, including place-based features. Mobile outreach efforts work to mitigate social determinants by servicing geographic areas with low drug treatment and overdose prevention access but are often limited by convenience-based targets. Geographic information systems (GIS) are often used to characterize and visualize the overdose crisis and could be translated to community to guide mobile outreach services. The current study examines the initial acceptability and appropriateness of GIS to facilitate data-driven outreach for reducing overdose inequities facing Black individuals.
We convened a focus group of stakeholders (N = 8) in leadership roles at organizations conducting mobile outreach in predominantly Black neighborhoods of St. Louis, MO. Organizations represented provided adult mental health and substance use treatment or harm reduction services. Participants were prompted to discuss current outreach strategies and provided feedback on preliminary GIS-derived maps displaying regional overdose epidemiology. A reflexive approach to thematic analysis was used to extract themes.
Four themes were identified that contextualize the acceptability and utility of an overdose visualization tool to mobile service providers in Black communities. They were: 1) importance of considering broader community context; 2) potential for awareness, engagement, and community collaboration; 3) ensuring data relevance to the affected community; and 4) data manipulation and validity concerns.
There are several perceived benefits of using GIS to map overdose among mobile providers serving Black communities that are overburdened by the overdose crisis but under resourced. Perceived potential benefits included informing location-based targets for services as well as improving awareness of the overdose crisis and facilitating collaboration, advocacy, and resource allocation. However, as GIS-enabled visualization of drug overdose grows in science, public health, and community settings, stakeholders must consider concerns undermining community trust and benefits, particularly for Black communities facing historical inequities and ongoing disparities.
在美国，由于健康的社会决定因素，包括基于地点的特征，黑人面临着与药物过量相关的日益严重的种族差异。流动外展工作旨在通过为药物治疗和过量预防服务机会较低的地区提供服务来缓解社会决定因素，但往往受到基于便利性的目标的限制。地理信息系统（GIS）常用于描述和可视化药物过量危机，并且可以转化为社区，以指导流动外展服务。本研究考察了 GIS 的初始可接受性和适宜性，以促进数据驱动的外展工作，减少黑人面临的药物过量不平等问题。
我们召集了来自密苏里州圣路易斯市主要黑人社区从事流动外展工作的组织的利益相关者（N=8）进行焦点小组讨论。代表组织提供成人心理健康和物质使用治疗或减少伤害服务。参与者被要求讨论当前的外展策略，并对显示区域药物过量流行病学的初步 GIS 衍生地图提供反馈。采用反思性主题分析方法提取主题。
确定了四个主题，这些主题使流动服务提供者在黑人社区中接受和使用药物过量可视化工具的情况具有背景和实用性。它们是：1）考虑更广泛的社区背景的重要性；2）意识、参与和社区合作的潜力；3）确保数据与受影响社区相关；4）数据操纵和有效性问题。
对于服务负担过重但资源不足的黑人社区的移动服务提供商来说，使用 GIS 绘制药物过量地图有几个被认为是有益的。潜在的好处包括为服务提供基于位置的目标，以及提高对药物过量危机的认识，促进合作、宣传和资源分配。然而，随着 GIS 增强的药物过量可视化在科学、公共卫生和社区环境中的发展，利益相关者必须考虑破坏社区信任和利益的问题，特别是对于面临历史不平等和持续差距的黑人社区。
