Co-design of harm reduction materials for people who inject drugs to implement research findings

Abstract

Background Equipment used by people who inject drugs (PWID) either has a needle which is fixed to the syringe or can be detached and replaced. Detachable low dead space syringes (LDSS) have been developed, with less space between the needle and plunger (referred to as dead space) than traditional detachable equipment. This equipment can help protect PWID from harm of infection as less blood is transferred if equipment is shared. Our previous research found that detachable LDSS are likely to be acceptable to PWID, and we produced recommendations for their introduction in needle and syringe programmes (NSP) in the United Kingdom (UK). We held a national stakeholder meeting to discuss how to accelerate the pace and scale of the rollout and uptake of detachable LDSS. This commentary reflects on the involvement of PWID as co-designers of harm reduction materials to implement these research findings in a way that supports the uptake of LDSS equipment by NSP and service users. We present the user-centred design process, peer reflections on the project, and lessons learnt by the team working with the peers. Main body Peers and stakeholders translated the research into easy to understand messages following a consultation with NSP across the UK. Working with Linnell Publications over three workshops, peers selected their preferred design style and informed the language, messages, and overall look of the designs. The peers ensured the designs avoided images and language with negative connotations, humour, and unequivocal language. Peers said that they found the process enjoyable and informative—leading to increased awareness of harm reduction practices. The facilitators took steps to ensure the views of the peers were heard throughout. They reflected on the importance of involving PWID meaningfully throughout the project. Without the peers, the designs would be less effective and engaging to their target audience. Conclusion We conclude that placing peers at the heart of this research implementation project was essential to ensure the materials are appropriate and engaging and do not stigmatise or alienate the intended audience unintentionally. We recommend that others planning similar work include peers within the entire project to support their meaningful contribution.

A two-component intervention to improve hand hygiene practices and promote alcohol-based hand rub use among people who inject drugs: a mixed-methods evaluation

“…The fact that the intervention was co-designed with field workers and PWID peers may have contributed to its success in meeting PWID needs. We support previous suggestions advocating the inclusion of peers in the development and evaluation of HR interventions [ 47 ]. No specific hand hygiene product is currently present in injecting kits accessible in France.…”

Using the Person-Based Approach to develop a tailored intervention to prevent bacterial skin and soft tissue infections among people who inject drugs: A participatory study

“…Using the PBA strengthened understanding of the psychosocial context of those using the intervention and the behaviours to be addressed [27]. The bene cial impact of this co-production, involvement and iterative prototyping for public health interventions has been demonstrated in another study in this eld [54]. Our study strengthens this evidence base and provides a blueprint for the process.…”

“I felt like a TRIO champion”: end-user perspectives on their role as co-designers of multi-purpose technologies

“…As experts of their own lives, end-users should be offered an opportunity to influence the design processes of products being development for them ( Giroux et al , 2019 ; Hussey et al , 2019 ), and working collaboratively can optimize the eventual acceptability of the interventions. Results from our study indicate that the women appreciated the respect accorded to them and the recognition that they as end-users and researchers must work hand in hand for the successful development of prevention products.…”

“…Ideas from potential end-users better match the needs of the actual end-user than the ideas generated by professional developers or researchers ( Kristensson & Magnusson, 2010 ). By engaging local knowledge, the quality and validity of the research is improved ( Hussey et al , 2019 ). Thus, it is important to recognize the symbiotic relationship between product developers who understand what is technologically feasible and end-users who experience the product and therefore know what is best for them.…”