Syringe Services Program (SSP) Implementation in Indigenous Communities

Syringe Services Program Implementation in Indigenous Communities will explore the factors that facilitated the successful implementation of Indigenous-centered syringe services programs that integrate harm reduction, allopathic “western,” and traditional Indigenous approaches to health and healing. 

Background

Indigenous Peoples have the highest rate of prescription opioid misuse of any sociodemographic group in the United States (US). Increasing rates of opioid misuse have led to increased prevalence of injection drug use (IDU) and concomitant overdose and infectious disease morbidity and mortality. Infectious disease inequities are driven in part by inadequate access to sterile injection equipment. IDU-associated harms are one of many drivers of Indigenous Peoples having the lowest life expectancy of all racial and ethnic groups. Despite sustained health inequities among Indigenous Peoples, very few Federally recognized tribes in the US have implemented syringe services programs (SSPs). This scarcity is driven in part by the fact that SSPs – which reflect harm reduction and, often, allopathic “western” approaches to health and well-being – must be combined with traditional Indigenous approaches for healing. While these three approaches are not incompatible, their combining can be challenging. Understanding factors that facilitated the successful implementation of Indigenous-centered SSPs that provide access to harm reduction, allopathic “western,” and traditional Indigenous approaches to health and well-being warrants exploration since these programs are essential for mitigating IDU-associated harms. 

Study Goals:  

AIM 1 

Through this Project, we will identify the roles of cultural factors, community contexts, and policy during the implementation of SSPs that combine multiple approaches (i.e., harm reduction, allopathic “western,” and traditional Indigenous) to health and well-being in three diverse Indigenous communities through key informant interviews with persons who played a role during implementation. 

AIM 2 

We will also determine the contexts and mechanisms by which cultural, social, and structural factors affect attitudes and beliefs about the utilization of SSPs that combine multiple approaches among Indigenous-SSP clients and Indigenous non-clients. 

AIM 3 

Finally, we will examine how patterns of knowledge and attitudes about multiple approaches to health and well-being and SSPs that combine them are associated with sociocultural factors (e.g., cultural identification, stigma) through audience segmentation research among Indigenous-serving members of the public health and healthcare workforce. 




Contact Information

Mr. Clinton Alexander, Project Co-Lead  

Dr. Sean Allen, Project Lead 

Dr. Melissa Walls, Co-Investigator 

Dr. Donald Warne, Co-Investigator 

Dr. Kristin Schneider 

Dr. Suzanne Grieb