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      Naloxone and the Inner City Youth Experience (NICYE): a community-based participatory research study examining young people’s perceptions of the BC take home naloxone program

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          Abstract

          Background

          Take home naloxone (THN) programs reduce mortality by training bystanders to respond to opioid overdoses. Clinical observation by the health care team at the Inner City Youth (ICY) program indicated that young adults appeared to enthusiastically participate in the THN program and developed improved relationships with staff after THN training. However, we found a dearth of literature exploring the experiences of young adults with THN programs. This study set out to address this gap and identify suggestions from the young adults for program improvement. The primary research question was “How do street-involved young people experience the THN Program in Vancouver, BC?”

          Methods

          The study was undertaken at the ICY Program. Two peer researchers with lived experience of THN were recruited from ICY and were involved in all phases of the study. The peer researchers and a graduate student facilitated two focus groups and five individual interviews with ICY program participants using a semi-structured interview guide. Audio recordings were transcribed verbatim. The cut-up-and-put-in-folders approach was used to identify emerging themes.

          Results

          The themes that emerged were perceptions of risk, altruism, strengthening relationship with staff, access to training, empowerment, and confidence in ability to respond, and suggestions for youth-friendly training. These themes were then situated within the framework of the health belief model to provide additional context. Participants viewed themselves as vulnerable to overdose and spoke of the importance of expanding access to THN training. Following training, participants reported an increase in internal locus of control, an improved sense of safety among the community of people who use drugs, improved self-esteem, and strengthened relationships with ICY staff. Overall, participants found THN training engaging, which appeared to enhance participation in other ICY programming.

          Conclusions

          Young people perceived THN training as a positive experience that improved relationships with staff. Participant recommendations for quality improvement were implemented within the provincial program.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12954-017-0160-3) contains supplementary material, which is available to authorized users.

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          Most cited references11

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          Interpretive description: a noncategorical qualitative alternative for developing nursing knowledge.

          Despite nursing's enthusiastic endorsement of the applicability of qualitative research approaches to answering relevant clinical questions, many nurse researchers have been hesitant to depart from traditional qualitative research methods. While various derivations of phenomenology, grounded theory, and ethnography have been popularized within qualitative nursing research, the methodological principles upon which these approaches are based reflect the foundations and objectives of disciplines whose aims are sometimes quite distinct from nursing's domain of inquiry. Thus, as many nurse researchers have discovered, nursing's unique knowledge mandate may not always be well served by strict adherence to traditional methods as the "gold standard" for qualitative nursing research. The authors present the point of view that a non-categorical description, drawing on principles grounded in nursing's epistemological mandate, may be an appropriate methodological alternative for credible research toward the development of nursing science. They propose a coherent set of strategies for conceptual orientation, sampling, data construction, analysis, and reporting by which nurses can use an interpretive descriptive approach to develop knowledge about human health and illness experience phenomena without sacrificing the theoretical or methodological integrity that the traditional qualitative approaches provide.
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            Are take‐home naloxone programmes effective? Systematic review utilizing application of the Bradford Hill criteria

            Abstract Background and Aims Fatal outcome of opioid overdose, once detected, is preventable through timely administration of the antidote naloxone. Take‐home naloxone provision directly to opioid users for emergency use has been implemented recently in more than 15 countries worldwide, albeit mainly as pilot schemes and without formal evaluation. This systematic review assesses the effectiveness of take‐home naloxone, with two specific aims: (1) to study the impact of take‐home naloxone distribution on overdose‐related mortality; and (2) to assess the safety of take‐home naloxone in terms of adverse events. Methods PubMed, MEDLINE and PsychINFO were searched for English‐language peer‐reviewed publications (randomized or observational trials) using the Boolean search query: (opioid OR opiate) AND overdose AND prevention. Evidence was evaluated using the nine Bradford Hill criteria for causation, devised to assess a potential causal relationship between public health interventions and clinical outcomes when only observational data are available. Results A total of 1397 records (1164 after removal of duplicates) were retrieved, with 22 observational studies meeting eligibility criteria. Due to variability in size and quality of the included studies, meta‐analysis was dismissed in favour of narrative synthesis. From eligible studies, we found take‐home naloxone met all nine Bradford Hill criteria. The additional five World Health Organization criteria were all either met partially (two) or fully (three). Even with take‐home naloxone administration, fatal outcome was reported in one in 123 overdose cases (0.8%; 95% confidence interval = 0.4, 1.2). Conclusions Take‐home naloxone programmes are found to reduce overdose mortality among programme participants and in the community and have a low rate of adverse events.
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              A quantitative and qualitative evaluation of the British Columbia Take Home Naloxone program

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                Author and article information

                Contributors
                kmitchell@providencehealth.bc.ca
                edurante@providencehealth.bc.ca
                kpellatt23@gmail.com
                chris.richardson@ubc.ca
                smathias@providencehealth.bc.ca
                Jane.buxton@bccdc.ca
                Journal
                Harm Reduct J
                Harm Reduct J
                Harm Reduction Journal
                BioMed Central (London )
                1477-7517
                7 June 2017
                7 June 2017
                2017
                : 14
                : 34
                Affiliations
                [1 ]Inner City Youth Program, 1260 Granville Street, Vancouver, BC V6Z 1M4 Canada
                [2 ]ISNI 0000 0001 2288 9830, GRID grid.17091.3e, School of Nursing, , University of British Columbia, ; Vancouver, Canada
                [3 ]ISNI 0000 0001 2288 9830, GRID grid.17091.3e, School of Population and Public Health, , University of British Columbia, ; 2206 East Mall, Vancouver, BC V6T 1Z3 Canada
                [4 ]ISNI 0000 0001 0352 641X, GRID grid.418246.d, , BC Centre for Disease Control, ; 655 West 12th Ave, Vancouver, BC V5Z 4R4 Canada
                Article
                160
                10.1186/s12954-017-0160-3
                5463299
                28592287
                f46ba745-7611-4a28-9e72-4b066cd52c34
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 23 March 2017
                : 24 May 2017
                Funding
                Funded by: Providence Health Care, Practice-based Research Challenge
                Funded by: BC Centre for Disease Control
                Categories
                Research
                Custom metadata
                © The Author(s) 2017

                Health & Social care
                naloxone,narcan,youth,young adult,take home naloxone,harm reduction,opioids,participatory research,mental health

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