Roth Alexis M, D'Angelo Ally K, Gordon David, Cocchiaro Benjamin, Lingamoorthy Anush, Laurano Rose, Salzman Matthew, Brenner Jacob S, Baston Cameron
Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, 3215 Market Street, Philadelphia, PA, 19104, United States, 1 2154330457.
Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States.
J Med Internet Res. 2025 Jul 28;27:e73566. doi: 10.2196/73566.
For over a decade, drug overdose has been the leading cause of injury and accidental death in the United States. Most fatal overdoses involve opioids and occur during solitary drug use events when no one is available to initiate lifesaving responses (eg, naloxone). While there is a growing interest in devices providing early overdose detection and automated responses, little research has engaged end users in a device design process.
This study aimed to describe user experience, perceived harms and benefits, and the acceptability of a shoulder-mounted wearable sensor among people who inject drugs who wore a device prototype for 7 days and to explore real-time responses that could be incorporated into a next-generation sensor.
Individuals aged ≥18 years reporting past week injection drug use were recruited from a walk-in substance use disorder clinic in Camden, New Jersey. Participants completed a brief survey assessing sociodemographics and recent drug use and were assigned a sensor prototype that they were asked to wear near-continuously for 7 days. At endline, they completed semistructured interviews exploring acceptability, usability, and form and function preferences for next-generation devices with integrated automated response options. Structured field notes and transcripts were analyzed to identify key themes and design considerations.
Participants (n=23) had a median age of 41 years. Most were primarily non-Hispanic White (65%) males (61%), experiencing homelessness (57%) who reported daily injection drug use (74%) within 3 months and receipt of opioid use disorder medication within a month (74%). A total of 16 people completed an exit interview. They found the concept of a shoulder-mounted overdose detection device acceptable and unanimously endorsed the need for long-lasting discreet devices. They emphasized the importance of having multiple response options that wearers could tailor to their individual circumstances and preferences, noting some might prefer an automatic call to emergency services, while others might prefer to alert a peer. Participants expressed a preference for solutions that alert first responders over automated biomedical solutions, such as naloxone injection, because of concerns about device error (eg, false positives) leading to precipitated withdrawal.
After wearing a shoulder-mounted prototype, this small group of participants found the idea acceptable and provided feedback to improve usability and design. Data suggest that a variety of devices with differing functions, sizes, and capacities will be needed to meet user needs and increase the likelihood of adoption once devices come to market.
十多年来，药物过量一直是美国伤害和意外死亡的主要原因。大多数致命的药物过量涉及阿片类药物，且发生在单独使用毒品的情况下，此时无人可启动救生反应（如注射纳洛酮）。虽然人们对提供早期药物过量检测和自动反应的设备兴趣日益浓厚，但很少有研究让终端用户参与设备设计过程。
本研究旨在描述注射毒品者佩戴设备原型7天期间对肩戴式可穿戴传感器的用户体验、感知到的危害和益处以及可接受性，并探索可纳入下一代传感器的实时反应。
从新泽西州卡姆登的一家随到随诊物质使用障碍诊所招募年龄≥18岁且报告过去一周有注射吸毒行为的个体。参与者完成一份简短调查，评估社会人口统计学和近期吸毒情况，并被分配一个传感器原型，要求他们几乎持续佩戴7天。在研究结束时，他们完成半结构化访谈，探讨对具有集成自动反应选项的下一代设备的可接受性、可用性以及形式和功能偏好。对结构化现场记录和访谈记录进行分析，以确定关键主题和设计考量因素。
参与者（n = 23）的中位年龄为41岁。大多数人主要是非西班牙裔白人（65%）男性（61%），经历无家可归（57%），报告在3个月内每日注射吸毒（74%）且在一个月内接受阿片类物质使用障碍药物治疗（74%）。共有16人完成了退出访谈。他们认为肩戴式药物过量检测设备的概念是可接受的，并一致认可需要持久且不显眼的设备。他们强调拥有多种反应选项的重要性，佩戴者可以根据个人情况和偏好进行调整，指出有些人可能更喜欢自动呼叫紧急服务，而另一些人可能更喜欢提醒同伴。由于担心设备错误（如误报）导致戒断反应加剧，参与者表示比起自动生物医学解决方案（如注射纳洛酮），他们更倾向于能提醒急救人员的解决方案。
在佩戴肩戴式原型设备后，这一小群参与者认为该想法是可接受的，并提供了反馈以改善可用性和设计。数据表明，需要各种功能、尺寸和容量不同 的设备来满足用户需求，并增加设备上市后被采用的可能性。
