Feasibility and acceptability of inserts promoting virtual overdose monitoring services (VOMS) in naloxone kits: a qualitative study.

BACKGROUND: In response to the ongoing opioid epidemic, there have been efforts to develop novel harm reduction strategies alongside scaling of currently implemented programs. Virtual overdose monitoring services (VOMS) are a novel intervention which aims to reduce substance-related mortality through technology for those who are out of reach of current supervised consumption sites. Scaling of naloxone programs presents a unique opportunity to promote VOMS to people at risk of substance-related mortality. This study aims to explore the feasibility and acceptability of naloxone kit inserts in promoting awareness of VOMS. METHOD: We used purposive and snowball sampling to recruit 52 key informants, including people who use drugs (PWUD) with experience using VOMS (n = 16), PWUD with no prior experience using VOMS (n = 9), family members of PWUD (n = 5), healthcare and emergency services professionals (n = 10), community-based harm reduction organizations (n = 6), and VOMS administrators/peer support workers (n = 6). Two evaluators completed semi-structured interviews. Interview transcripts were analyzed using thematic analysis informed to identify key themes. RESULTS: Four key interrelated themes emerged, including the acceptability of naloxone kit inserts to promote VOMS, best practices for implementation, key messaging to include within promotional materials and facilitators to dissemination of harm reduction material. Participants highlighted that messaging should be promoted both inside and outside the kits, should be concise, provide basic information about VOMS and can be facilitated through current distribution streams. Messaging could further be used to draw attention to local harm reduction services and could be promoted on other supplies, including lighters and safer consumption supplies. CONCLUSION: Findings demonstrate that it is acceptable to promote VOMS within naloxone kits and highlight interviewees preferred ways to do so. Key themes that emerged from interviewees can be used to inform the dissemination of harm reduction information, including VOMS and bolster current strategies for reducing illicit drug overdose.

Patient Opinion of Visiting Therapy Dogs in a Hospital Emergency Department.

To date there have been no studies examining whether patients want emergency department (ED) therapy dog programs. This patient-oriented study examined the opinions of patients about whether they would want to be visited by a therapy dog in the Royal University Hospital ED. Cross-sectional survey data were collected over a six week period from a convenience sample of 100 adult patients who had not been visited by a therapy dog in the ED. Most (80%) indicated they would want a visit by a therapy dog as an ED patient. A higher proportion of individuals who currently have a pet dog (95%) or identify as having lots of experience with dogs (71%) were more likely to indicate this want compared to those without a dog (90%) or little to no experience with dogs (62%). The majority were also of the opinion that patients may want to visit a therapy dog in the ED to reduce anxiety (92%) and frustration (87%) as well as to increase comfort (90%) and satisfaction (90%) and to a lesser extent to reduce pain (59%). There was no significant difference in findings by gender or age, other than a higher proportion of older adults and females identifying cultural background and tradition as a possible reason that patients may not want to be visited by a therapy dog. The findings of this study can help guide considerations for future ED therapy dog programs.

A scoping study of cultural interventions to treat addictions in Indigenous populations: methods, strategies and insights from a Two-Eyed Seeing approach.

BACKGROUND: This paper describes the methods, strategies and insights gained from a scoping study using a "Two-Eyed Seeing" approach. An evolving technique, Two-Eyed Seeing respects and integrates the strengths of Indigenous knowledge and Western sciences, often "weaving back and forth" between the two worldviews. The scoping study was used to inform a tool for measuring the impact of culturally based addictions treatment services on wellness in Indigenous populations. It formed part of a three-year study, Honouring Our Strengths: Indigenous Culture as Intervention in Addictions Treatment. The scoping study identified and mapped literature on cultural interventions in addictions treatment, and described the nature, extent and gaps in literature. METHODS: Using a Two-Eyed Seeing approach, we adapted, applied and enhanced a common framework of scoping studies. In the end stage of the scoping review process, an Ad Hoc Review Group, led by our project Elder, reviewed and interpreted Indigenous and Western understandings within the mapped information. Elements of the scoping study were joined with results from community focus groups with staff at treatment centres. RESULTS: Two-Eyed Seeing contributed differently at each stage of the scoping study. In early stages, it clarified team expertise and potential contributions. At the mid-point, it influenced our shift from a systematic to a scoping review. Near the end, it incorporated Western and Indigenous knowledge to interpret and synthesize evidence from multiple sources. CONCLUSIONS: This paper adds to the collective work on augmenting the methodology of scoping studies. Despite the challenges of a Two-Eyed Seeing approach, it enables researchers using scoping studies to develop knowledge that is better able to translate into meaningful findings for Indigenous communities.

"I Got to Know Them in a New Way": Rela(y/t)ing Rhizomes and Community-Based Knowledge (Brokers') Transformation of Western and Indigenous Knowledge.

Drawing on three culturally specific research projects, this paper examines how community-based knowledge brokers' engagement in brokering knowledge shaped the projects' processes. Informed by Deleuze and Guattari's (1987) conceptualization of the "rhizome," we discuss how community knowledge brokers' engagement in open research-creation practices embrace the relational foundation of Indigenous research paradigms in contrast to mainstream Western research practices that are engaged as linear, objective, and outcome-oriented activities. In turn, we offer propositions for building team environments where open research-creation practices can unfold, informing a periphery of shared space for Indigenous and Western paradigms.