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      Factors that help injecting drug users to access and benefit from services: A qualitative study

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          Abstract

          Background

          International research shows that injecting drug users (IDUs) can encounter many barriers when they try to access drug treatment and other services. However, the existing literature is mostly quantitative and does not consider the kinds of factors that injectors themselves identify as enabling them to access and benefit from services. Responding to this gap in knowledge, our paper explores IDUs' own suggestions for improving service engagement and their reports of other factors enabling them to seek help.

          Methods

          Semi-structured qualitative interviews were conducted with 75 current illicit drug injectors in three geographically diverse areas of West Yorkshire, England. Recruitment was through needle exchange programmes, with additional snowball sampling to ensure inclusivity of gender, ethnicity and primary drug injected. Transcribed data were analysed thematically using Framework.

          Results

          Although participants were often satisfied with current access to services, they made three broad suggestions for improving engagement. These were: providing more services (more providers and more forms of support); better operation of existing services (including better communication systems and more flexibility around individual needs); and staffing-related improvements (particularly, less judgemental and more understanding staff attitudes). Other factors identified as important enablers of help seeking were: having supporting relationships (particularly with family members); personal circumstances/life events (especially becoming a parent); and an injector's state of mind (such as feeling motivated and positive).

          Conclusion

          A range of practical suggestions for improving IDUs' access to drug treatment and other services are identified.

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          Most cited references52

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          Qualitative data analysis for applied policy research

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            In search of how people change. Applications to addictive behaviors.

            How people intentionally change addictive behaviors with and without treatment is not well understood by behavioral scientists. This article summarizes research on self-initiated and professionally facilitated change of addictive behaviors using the key trans-theoretical constructs of stages and processes of change. Modification of addictive behaviors involves progression through five stages--pre-contemplation, contemplation, preparation, action, and maintenance--and individuals typically recycle through these stages several times before termination of the addiction. Multiple studies provide strong support for these stages as well as for a finite and common set of change processes used to progress through the stages. Research to date supports a trans-theoretical model of change that systematically integrates the stages with processes of change from diverse theories of psychotherapy.
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              Relation of the therapeutic alliance with outcome and other variables: A meta-analytic review.

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                Author and article information

                Journal
                Subst Abuse Treat Prev Policy
                Substance Abuse Treatment, Prevention, and Policy
                BioMed Central
                1747-597X
                2007
                30 October 2007
                : 2
                : 31
                Affiliations
                [1 ]Professor of Public Health, Oxford Brookes University, Oxford, UK
                [2 ]Research Fellow, Leeds West Primary Care Trust, Leeds, UK
                Article
                1747-597X-2-31
                10.1186/1747-597X-2-31
                2169215
                17971204
                dcf79a0e-adca-4af4-9707-320ba994a47e
                Copyright © 2007 Neale et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 13 July 2007
                : 30 October 2007
                Categories
                Research

                Health & Social care
                Health & Social care

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