NIDA IRP Technology Development Initiative Featured Paper

The acceptability of overdose alert and response technologies: introducing the TPOM-ODART framework

Published in Harm Reduction Journal (2023)

Authors

Josh Dumbrell, Hadi Daneshvar, Alberto Oteo, Alexander Baldacchino, Catriona Matheson

Paper presented by Dr. Agnieszka Sulima and selected by the NIDA TDI Paper of the Month Committee

Publication Brief Description

The development of overdose alert and response technologies (ODART) that can detect overdose (OD) and alert first responders in a timely manner can be an effective way to reduce the number of drug-related deaths (DRDs). The available literature indicates that there is also a willingness to use these technologies by people who use drugs and affected communities.

Dumbrell at al. conducted a qualitative study using a focus group methodology to explore which factors are important for the acceptability of such technologies to people who use opioids (PWUO) in Scotland. The analysis uncovered several challenges faced by developers and implementation teams related to creating acceptable products that can feasibly support fatal OD prevention. Trust in technology, system and people were viewed as central to the acceptability of ODART and were closely linked to data security, privacy and confidentiality.

Furthermore, balancing harm reduction, safety and ambivalence was identified as an important factor that developers and implementation teams must consider for OD interventions to be acceptable to PWUO. Homelessness was negatively associated with willingness to use ODART posing a significant challenge for implementation as this is the most vulnerable group of people who use drugs and they are at high risk of OD. The authors concluded that effective ODART preventions will need to be sensitive to the complex relationship between technological, social/human, organizational and wider macroenvironment factors to maximize their use. Findings from this work can help to better understand areas for potential improvements and solutions to the challenges presented for ODART developers.

Dumbrell, Josh; Daneshvar, Hadi; Oteo, Alberto; Baldacchino, Alexander; Matheson, Catriona

The acceptability of overdose alert and response technologies: introducing the TPOM-ODART framework Journal Article

In: Harm Reduct J, vol. 20, no. 1, pp. 40, 2023, ISSN: 1477-7517.

Abstract | Links

@article{pmid36967388,

title = {The acceptability of overdose alert and response technologies: introducing the TPOM-ODART framework},

author = {Josh Dumbrell and Hadi Daneshvar and Alberto Oteo and Alexander Baldacchino and Catriona Matheson},

url = {https://pubmed.ncbi.nlm.nih.gov/36967388/},

doi = {10.1186/s12954-023-00763-4},

issn = {1477-7517},

year  = {2023},

date = {2023-03-01},

urldate = {2023-03-01},

journal = {Harm Reduct J},

volume = {20},

number = {1},

pages = {40},

abstract = {BACKGROUND: Opioids were implicated in approximately 88,000 fatal overdoses (OD) globally. However, in principle all opioid OD are reversible with the timely administration of naloxone hydrochloride. Despite the widespread availability of naloxone among people who use opioids (PWUO), many who suffer fatal OD use alone, without others present to administer the reversal agent. Recognising this key aspect of the challenge calls for innovations, a number of technological approaches have emerged which aim to connect OD victims with naloxone. However, the acceptability of OD response technologies to PWUO is of key concern.nnMETHODS: Drawing on the Technology People Organisations Macroenvironment (TPOM) framework, this study sought to integrate acceptability-related findings in this space with primary research data from PWUO, affected family members and service providers to understand the factors involved in harm reduction technology acceptability. A qualitative study using a focus group methodology was conducted. The participant groups were people with lived experience of problem opioid use, affected family members and service providers. Data analysis followed a multi-stage approach to thematic analysis and utilised both inductive and deductive methods.nnRESULTS: Thirty individuals participated in one of six focus groups between November 2021 and September 2022. The analysis generated six major themes, three of which are reported in this article-selected for their close relevance to PWUO and their importance to developers of digital technologies for this group. 'Trust-in technologies, systems and people' was a major theme and was closely linked to data security, privacy and confidentiality. 'Balancing harm reduction, safety and ambivalence' reflects the delicate balance technological solutions must achieve to be acceptable to PWUO. Lastly, 'readiness-a double bind' encapsulates the perception shared across participant groups, that those at the highest risk, may be the least able to engage with interventions.nnCONCLUSION: Effective digital strategies to prevent fatal OD must be sensitive to the complex relationships between technological, social/human, organisational and wider macroenvironmental factors which can enable or impede intervention delivery. Trust, readiness and performance are central to technology acceptability for PWUO. An augmented TPOM was developed (the TPOM-ODART).},

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pubstate = {published},

tppubtype = {article}

}

BACKGROUND: Opioids were implicated in approximately 88,000 fatal overdoses (OD) globally. However, in principle all opioid OD are reversible with the timely administration of naloxone hydrochloride. Despite the widespread availability of naloxone among people who use opioids (PWUO), many who suffer fatal OD use alone, without others present to administer the reversal agent. Recognising this key aspect of the challenge calls for innovations, a number of technological approaches have emerged which aim to connect OD victims with naloxone. However, the acceptability of OD response technologies to PWUO is of key concern.nnMETHODS: Drawing on the Technology People Organisations Macroenvironment (TPOM) framework, this study sought to integrate acceptability-related findings in this space with primary research data from PWUO, affected family members and service providers to understand the factors involved in harm reduction technology acceptability. A qualitative study using a focus group methodology was conducted. The participant groups were people with lived experience of problem opioid use, affected family members and service providers. Data analysis followed a multi-stage approach to thematic analysis and utilised both inductive and deductive methods.nnRESULTS: Thirty individuals participated in one of six focus groups between November 2021 and September 2022. The analysis generated six major themes, three of which are reported in this article-selected for their close relevance to PWUO and their importance to developers of digital technologies for this group. 'Trust-in technologies, systems and people' was a major theme and was closely linked to data security, privacy and confidentiality. 'Balancing harm reduction, safety and ambivalence' reflects the delicate balance technological solutions must achieve to be acceptable to PWUO. Lastly, 'readiness-a double bind' encapsulates the perception shared across participant groups, that those at the highest risk, may be the least able to engage with interventions.nnCONCLUSION: Effective digital strategies to prevent fatal OD must be sensitive to the complex relationships between technological, social/human, organisational and wider macroenvironmental factors which can enable or impede intervention delivery. Trust, readiness and performance are central to technology acceptability for PWUO. An augmented TPOM was developed (the TPOM-ODART).