School of Health and Social Care, Edinburgh Napier University, Edinburgh, United Kingdom.
Faculty of Social Sciences, University of Stirling, Stirling, United Kingdom.
J Med Internet Res. 2024 Sep 24;26:e52345. doi: 10.2196/52345.
Globally, drug-related deaths (DRDs) are increasing, posing a significant challenge. Scotland has the highest DRD rate in Europe and one of the highest globally. The Scottish Government launched the Digital Lifelines Scotland (DLS) program to increase the provision of digital technology in harm reduction services and other support services. Digital technology responses to DRDs can include education through digital platforms, improved access to treatment and support via telehealth and mobile apps, analysis of data to identify risk factors, and the use of digital tools for naloxone distribution. However, digital technology should be integrated into a comprehensive approach that increases access to services and addresses underlying causes. Digital transformation could enhance harm reduction service and support, but challenges must be addressed for successful implementation. The DLS program aims to enhance digital inclusion and improve health outcomes for people who use or are affected by drug use to reduce the risk of DRDs.
This study aims to explore the role of digital technology as an enabler and supporter in enhancing existing services and innovating new solutions, rather than being a stand-alone solution. Specifically focusing on individuals who use drugs, the research investigates the potential of digital inclusion and technology provision for preventing DRDs within the context of the DLS program.
Semistructured interviews were conducted with 47 people: 21 (45%) service users, 14 (30%) service providers, and 12 (26%) program staff who were all involved in DLS. Interviews were audio recorded, transcribed, and then coded. Analysis was done in three phases: (1) thematic analysis of interview data to identify the benefits of digital technologies in this sector; (2) identification of the challenges and enablers of using digital technologies using the Technology, People, Organizations, and Macroenvironment conceptual framework; and (3) mapping digital technology provision to services offered to understand the extent of digital transformation of the field.
Participants identified increased connectivity, enhanced access to services, and improved well-being as key benefits. Digital devices facilitated social connections, alleviated loneliness, and fostered a sense of community. Devices enabled engagement with services and support workers, providing better access to resources. In addition, digital technology was perceived as a preventive measure to reduce harmful drug use. Lack of technical knowledge, organizational constraints, and usability challenges, including device preferences and security issues, were identified.
The study found that digital inclusion through the provision of devices and connections has the potential to enhance support in the harm reduction sector. However, it highlighted the limitations of existing digital inclusion programs in achieving comprehensive digital transformation. To progress, there is a need for sustained engagement, cultural change, and economic considerations to overcome barriers.
全球范围内，与药物相关的死亡（DRD）正在增加，这构成了一个重大挑战。苏格兰的 DRD 发生率在欧洲最高，在全球也位居前列。苏格兰政府推出了苏格兰数字生命线（DLS）计划，以增加减少伤害服务和其他支持服务中数字技术的提供。针对 DRD 的数字技术应对措施包括通过数字平台进行教育、通过远程医疗和移动应用程序改善治疗和支持的可及性、通过数据分析识别风险因素，以及使用数字工具分发纳洛酮。然而，数字技术应该被整合到一个全面的方法中，以增加服务的可及性并解决根本原因。数字转型可以增强减少伤害服务和支持，但为了成功实施，必须解决挑战。DLS 计划旨在增强数字包容性，并改善使用或受药物使用影响的人的健康结果，以降低 DRD 的风险。
本研究旨在探索数字技术作为增强现有服务和创新新解决方案的推动者和支持者的作用，而不是作为一个独立的解决方案。研究特别关注药物使用者，调查数字包容和技术提供在 DLS 计划背景下预防 DRD 的潜力。
对 47 人进行了半结构化访谈：21 人（45%）为服务使用者，14 人（30%）为服务提供者，12 人（26%）为项目工作人员，他们都参与了 DLS。对访谈进行了录音、转录和编码。分析分三个阶段进行：（1）对访谈数据进行主题分析，以确定该部门数字技术的优势；（2）使用技术、人员、组织和宏观环境概念框架确定使用数字技术的挑战和推动者；（3）映射数字技术的提供情况以了解该领域数字化转型的程度。
参与者确定了增强的连接性、更好的服务可及性和提高的幸福感是关键优势。数字设备促进了社交联系，减轻了孤独感，并培养了社区感。设备使人们能够与服务和支持人员互动，更方便地获得资源。此外，数字技术被视为减少有害药物使用的预防措施。参与者还确定了缺乏技术知识、组织限制以及可用性挑战，包括设备偏好和安全问题。
研究发现，通过提供设备和连接实现的数字包容有潜力增强减少伤害部门的支持。然而，它也强调了现有的数字包容计划在实现全面数字化转型方面的局限性。为了取得进展，需要持续参与、文化变革和经济考虑，以克服障碍。
