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Mobile Syringe Service Programs: Meeting People Where They Are · Talking FACS

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  Welcome to Talking FACS, what you need to know about family,
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  food, finance, and fitness.
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  This nationally recognized, award-winning podcast is hosted by the University
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  of Kentucky Family and Consumer Sciences Extension Program.
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  Our educators share research knowledge with individuals, families,
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  and communities to improve quality of life.
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  Mobile syringe service programs can be complex and at times misunderstood,
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  but one that plays an important role in protecting public health and supporting
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  individuals and families impacted by substance use.
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  Hello and welcome to Talking FACS. I am your host, Mindy McCuLley,
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  Extension Specialist for Instructional Support.
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  The mobile syringe service programs are designed to reduce the spread of infectious
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  disease, connect individuals to vital health and recovery services,
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  and meet people where they are, literally and figuratively.
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  But what do they really look like in practice and how can communities better
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  understand their purpose and impact?
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  To help us explore this topic, my guest, Dr. Alex Elswick, Assistant Extension
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  Professor for Substance Use Prevention and Recovery.
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  We'll bring both research and real-world experience to this conversation,
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  helping us unpack the evidence,
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  address common concerns, and highlight the role Extension can play in educating
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  and supporting communities.
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  Welcome, Alex. Thank you, MinDY
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  First of all, let me just ask, what led you and your team to study mobile syringe
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  service programs in rural Appalachia here in Kentucky?
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  Yeah, it's a great place to start because it's really the why for what led us to do this research.
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  In Extension, we know better than anybody that rural communities are underserved.
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  It's part of the critical role that we play in Extension, that they're under-resourced.
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  We also know that in Kentucky, rural Appalachian residents face disproportionate risk factors.
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  So for things like HIV or hepatitis C, which are injection-related diseases.
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  And so Kentucky's made some major strides in establishing syringe service programs,
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  which we've talked about on previous Talking FACS podcast.
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  But not enough people have access to the brick and mortar sites.
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  They're typically located at health departments and in places like,
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  let's say, Pike County, which is geographically a really, really expansive county
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  with big transportation barriers.
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  It's really hard for people to get access. A mobile syringe service program
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  is a way of, like, I loved your introduction, a way of, you know,
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  we figuratively always say harm reduction is about meeting people where they are.
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  But this is an example of quite literally meeting people where they are.
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  So what are some of the major findings that you and your team have experienced?
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  Yes. And so this is worth saying that I was fortunate to lead this paper,
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  but this project was led by Dr. April Young and her team.
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  And in general, what we wanted to understand is what are rural Appalachian people
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  who use drugs, attitudes towards and their willingness to use a mobile syringe service program?
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  And so broadly, what we found was moderate willingness to use mobile syringe service program.
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  Our participants expressed, you know, that they thought that the convenience
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  and overcoming the transportation barriers could make it really useful.
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  But they also expressed a lot of privacy and confidentiality concerns,
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  things that people with substance use disorders experience stigma everywhere.
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  But we also know that in some rural communities, especially really small communities
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  where everyone knows everyone, you may not want to be seen going to a syringe
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  service program or something.
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  And so we also got some more specific feedback on who would you want to staff this?
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  What would you want the unit to look like? Where would you want it to park?
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  All those kinds of things to really get specific ideas of how to improve delivery.
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  Now that makes sense because you've got to build trust, right?
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  That's right. Were there any findings that surprised you?
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  Yes, there were a couple of findings that surprised me. First of all.
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  Most people in our study who are, again, rural Appalachian people who use drugs,
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  most of their preferences were more clinical in nature.
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  And what I mean by that is whether we were talking about who was staffing it or where it was located.
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  So, for instance, in terms of staffing, they really seem to prefer nurses and
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  traditional health care providers to certainly over law enforcement,
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  but also over social workers or even peers. So that surprised us.
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  And then also they reported a preference for the mobile units to be parked in,
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  like pharmacies or hospitals, more like clinical spaces and not in gas stations
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  or grocery stores or places like that.
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  And so that also surprised us a little bit because that didn't necessarily fit
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  with the idea of convenience, but that
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  might be where convenience and like confidentiality are a bit of tension.
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  Yeah, it makes sense to me. I mean, lots of people go to those places and so
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  you could do that for any number of reasons. Exactly right.
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  So why should extension agents and community leaders care about these findings? Yeah.
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  So as we, as we talked about, you know, extension plays such a critical role,
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  in every community, but, but especially in our rural underserved communities,
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  where, you know, you brought up trust and credibility.
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  We have so much trust and credibility in our communities.
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  And so when it comes to moving the needle on, no pun intended,
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  moving the needle on attitudes towards addiction or towards how to.
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  Help people using harm reduction, extension educators play a really important
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  role because people look to extension educators as thought leaders.
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  Understanding harm reduction is a good way for Extension educators to help reduce
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  stigma and increase the likelihood that people in their community will actually
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  engage with those, you know, life-saving measures.
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  What's a practical role you can expect to find at your Extension office?
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  That's a great question because for many people in the general public,
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  they might see substance use as kind of outside of the traditional work that Extension has done.
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  But we have a great many things that we offer.
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  The first would be to get accurate information. You know that you can go to
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  your extension office and get credible, trusted information.
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  The internet was supposed to democratize information, but now it's a scary place
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  where you're not really sure if what you're reading is true or not.
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  Your extension agents can really help with that, can help reduce stigma,
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  help connect members of the community to local resources that could be harm
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  reduction resources, or it could be more meeting basic needs,
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  all the needs that members of the community have related to nutrition or relationships or etc.
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  So I think extension offices is such a hub for all of the kind of resources
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  that build stability in terms of either substance use prevention or substance use recovery. perfect.
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  So, Alex, as we wrap up today, what's the biggest takeaway you hope that listeners
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  will remember from this study?
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  So one of the core tenets of harm reduction that's really important and a really
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  important thing that I thread through all of the work that I do is that everyone
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  deserves compassionate care. Everyone deserves love. Everyone deserves compassionate care.
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  You don't have to do anything. You don't have to be sober in order to be a deserving human being.
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  You know, we know that people in underserved rural communities deserve the same
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  access to care, but don't have it.
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  And harm reduction is fundamentally, you know, mobile syringe service programs
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  are just one example of the many ways that harm reduction is kind of a radical,
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  compassionate care that says, you know, regardless of whether or not I agree
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  with your behaviors, I think that you have a right to care.
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  And then lastly, I would just say, you know, communities are stronger when their
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  responses are rooted in evidence and in dignity.
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  Right. I love that. Evidence and dignity. Maybe that should be your tagline.
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  Alex, I love it when we talk because I always learn something and I have a new
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  perspective on the community that we serve.
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  Thank you so much for giving me the time. If you are just tuning in,
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  you're listening to Talking FACS, and we're available wherever you listen to
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  agent for Family and Consumer Sciences.
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