Wilson J Deanna, Klipp Stephanie P, Leon Kelsey, Liebschutz Jane M, Merlin Jessica, Murray-Krezan Cristina, Nolette Sommer, Phillips Kristina T, Stein Michael, Weinstock Nate, Hamm Megan
Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, 51 N 39th Street, Philadelphia, PA, 19104, USA.
Prevention Point, Philadelphia, PA, USA.
Harm Reduct J. 2025 Jun 18;22(Suppl 1):108. doi: 10.1186/s12954-025-01210-2.
People who use drugs (PWUD) continue to experience not only high overdose rates but also growing infectious complications. In response, there has been a growing focus on increasing access to harm reduction resources, particularly among hospitalized PWUD. However, there is limited data on how best to integrate harm reduction into hospital settings. We describe using a Design Sprint, a human-centered design process, to co-create an intervention with people who have lived experience (PWLE) focused on improving access and adoption of harm reduction behaviors for hospitalized PWUD.
We recruited a sample of PWLE from Pittsburgh, Pennsylvania. We recruited a total of 14 participants over a 3-week period from March to April 2024. There were four Design Sprint sessions, two-hours in length, delivered via HIPAA-compliant zoom. Participants identified intervention components, sketched the intervention, and prototyped the planned intervention process. Sessions were recorded and transcribed verbatim. The team identified intervention components and key themes using thematic analysis.
There were 14 PWLE (mean age 40.4 years; majority white) who participated in at least one Design Sprint session. Participants conceptualized an intervention delivered by a THRIVE navigator who establishes rapport, identifies what if any goals the participant may have, offers information from a menu of harm reduction topics, and helps participants create a Wellness Plan focused on achieving their goals and overcoming likely barriers. The THRIVE navigator will then follow-up via weekly text messages. There were four additional themes that informed intervention content and implementation. These were related to the hospital being experienced as a hostile environment to PWUD; the value of health information being delivered by PWLE who can speak authentically; the importance of creating a flexible participant-led intervention offering a range of content; and the importance of neutrality to building authenticity and attaining participant buy-in.
The Design Sprint process allowed for rich input from PWLE on the design, scope, content, and implementation of the THRIVE intervention. Findings highlight the importance of a peer navigator role to embody relational harm reduction and guide THRIVE participants in education and goal setting around a host of wellness-related behaviors.
吸毒者不仅继续面临高过量用药率，还面临越来越多的感染并发症。作为回应，人们越来越关注增加获得减少伤害资源的机会，特别是在住院吸毒者中。然而，关于如何最好地将减少伤害纳入医院环境的数据有限。我们描述了如何使用设计冲刺（一种以人为本的设计过程），与有生活经验的人共同创建一种干预措施，重点是改善住院吸毒者获得和采用减少伤害行为的情况。
我们从宾夕法尼亚州匹兹堡招募了有生活经验的人的样本。在2024年3月至4月的3周时间里，我们共招募了14名参与者。通过符合健康保险流通与责任法案（HIPAA）的Zoom平台进行了四次时长两小时的设计冲刺会议。参与者确定干预组成部分，勾勒干预措施，并为计划中的干预过程制作原型。会议进行了录音并逐字转录。团队使用主题分析确定了干预组成部分和关键主题。
有14名有生活经验的人（平均年龄40.4岁；大多数为白人）参加了至少一次设计冲刺会议。参与者构思了一种由“茁壮成长”导航员提供的干预措施，该导航员建立融洽关系，确定参与者可能有的任何目标，从一系列减少伤害主题的菜单中提供信息，并帮助参与者制定一份侧重于实现其目标和克服可能障碍的健康计划。然后，“茁壮成长”导航员将通过每周短信进行跟进。还有另外四个主题为干预内容和实施提供了信息。这些主题与医院被视为对吸毒者充满敌意的环境有关；有生活经验的人传递的健康信息的价值，他们能够真实地表达；创建一个灵活的、由参与者主导的干预措施并提供一系列内容的重要性；以及中立性对建立真实性和获得参与者认可的重要性。
设计冲刺过程使有生活经验的人能够就“茁壮成长”干预措施的设计、范围、内容和实施提供丰富的意见。研究结果突出了同伴导航员角色在体现关系性减少伤害以及指导“茁壮成长”参与者围绕一系列与健康相关行为进行教育和目标设定方面的重要性。
