Syringe Service Programs' (SSP) User Experiences

Attachment 2e: SSP Staff In-Depth Interview Guide

RURAL EXPERIENCE AND ACCESS STUDY

SSP Staff or Stakeholder Interview Guide

Form Approved

OMB No: 0920-1091

Exp. Date: 09/30/2021

This information is collected under the authority of the Public Health Service Act, Section 301, "Research and Investigation," (42 U.S.C. 241); and Sections 304, 306 and 308(d) which discuss authority to maintain data and provide privacy for health research and related activities (42 U.S.C. 242 b, k, and m(d)). This information is also being collected in conjunction with the provisions of the Government Paperwork Elimination Act and the Paperwork Reduction Act (PRA). This information will only be used by the Centers for Disease Control and Prevention (CDC) staff to evaluate Syringe Service Programs’ (SSP) User Experiences.

Public reporting burden of this collection of information is estimated to average 60 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; Attn: OMB-PRA (0920-1091)

Date: ___________

Study identification number: _________

Interviewer Three Digit Initials: ________

Start Time: ___:___AM/PM

Introduction and Interview Purpose

[Interviewer Note: Interviewer instructions appear in all caps and should not be read verbatim]

Welcome and thank you again for agreeing to participate in this study. My name is ________, and I am part of a research team working to understand different perspectives on Syringe Service Programs like [name of SSP]. During our discussion today, we will be talking about syringe service programs, HIV, hepatitis B and C, drug use, and related topics. There are no right or wrong answers to these questions. I want to hear, in your own words, your thoughts, experiences and opinions about the topics we will be discussing.

First, here is a form that explains the study in more detail. Would you like to read it yourself, or would you prefer for me to read it to you?”

ACCORDING TO RESPONDENT's ANSWER, LET RESPONDENT READ IT OR READ IT TO RESPONDENT.

“We would like to record the interview today. The recording will ensure that our notes of today’s conversation are complete and accurate. We will destroy the recording at the end of the study. Do you have any questions before you sign?”

ANSWER ANY QUESTIONS, AND WITNESS RESPONDENT SIGNING.

“Thank you. Here is a copy of the consent form for you to keep. As a reminder, your participation is voluntary. If there are any questions that you prefer not to answer, please tell me, and I'll move on to the next question.” As a reminder, this interview is confidential and your responses will not be linked to your name or any identifying information.

HAND COPY TO RESPONDENT.

TURN ON TAPE RECORDERS AND SAY: “Now that I have the recorders on, may I also have your verbal permission to record our interview?”

Section A. SSP Background

I would like to talk about your role with [name SSP], the services [name SSP] offers its clients, and the barriers and facilitators to those services, especially for clients that reside in rural areas.

1. Tell me about your relationship with [name SSP].

2. Tell me about the services [name SSP] offers. How do the services differ between locations, if you have multiple locations?

3. Which services would you say are the most used? Which are the least used? Why?

PROBE: What are some of the main barriers that prevent clients from using all of the services offered?

4. Are there any services not offered at [name SSP] that you think would benefit the clients?

PROBE: What are some of the barriers to offering these services?

5. How do clients learn about the services offered at [name SSP]?

PROBE:

How might the [name SSP} better market services?

6. Think about your clients that live in rural areas compared to those who live in more urban areas. How do they differ in terms of what services they access, the barriers they face, or the services they need but [name SSP] is not able to provide?

Section B. Infectious Diseases

These next questions are about HIV, Hepatitis C and Hepatitis B.

First, I would like to ask you a few questions about HIV.

7. Thinking about your clients who live in rural areas, how interested do you think they are in HIV testing. Why?

8. Does [name SSP] offer HIV testing? [IF NO], do you make referrals for HIV testing?

PROBE:

(a) Who do you typically offer or refer for HIV testing?

(b) How do you assess clients’ risk for HIV?

(c) Thinking of the clients offered HIV testing, approximately what proportion of clients get tested?

9. How concerned are you about your rural clients getting HIV, or transmitting HIV to others?

10. Tell me about linking HIV positive clients to HIV care. Is it standard practice for [name SSP] to link all people living with HIV to medical services?

PROBE:

(a) How do you follow up to see if they attend their medical appointments?

(b) Are there differences in HIV testing and linkage to care services for your rural clients compared to the clients who live in urban areas?

11. Does [name SSP] offer or make referral for pre-exposure prophylaxis or PrEP, also called Truvada, a daily pill used to prevent HIV, to its clients? Do you offer or refer out?

Now let us talk about Hepatitis C.

12. Describe the Hepatitis C testing offered to your clients.

PROBE:

(a) Where are they tested?

(b) Do you know which tests are given?

(c) Is a confirmatory (RNA) test offered at [name SSP]? If not, how does [name SSP] facilitate obtaining a confirmatory test for clients, particularly rural clients?

13. Thinking about your clients who live in rural areas, how interested do you think they are in Hepatitis C testing. Why or why not?

14. What role does [name SSP] play in Hepatitis C treatment and care, if any?

Now I would now like to ask you about vaccinations for Hepatitis A and B.

15. Does [name SSP] offer vaccinations for Hepatitis A? How about Hepatitis B? Why or why not?

PROBE:

(a) Who gets vaccinated for Hepatitis A? Who gets vaccinated for Hepatitis B?

(b) Does [name SSP] refer clients to get a vaccination somewhere else?

Section C. Treatment

These next few questions are about preventing drug overdoses and substance use treatment.

16. Tell me about your experience at [name SSP] with Narcan, also called Naloxone.

PROBE:

(a) Does [name SSP] offer Narcan? Why or why not?

(b) How do the rural clients receive or access Narcan?

(c) What are the barriers, if any, that prevent rural clients from obtaining an adequate supply of Narcan?

(d) What could be done to get more people to use Narcan?

(e) Have you been trained to use Narcan?

I would like to talk about substance abuse treatments available for those who want it. These therapies may use counseling (e.g. harm reduction) alone or combine them with medications like methadone, Suboxone (also called buprenorphine) or naltrexone. They also can include self-help programs like 12 Step (e.g. Narcotics Anonymous, Alcoholics Anonymous), moderation management programs, residential or outpatient treatments, and detox programs.

17. Tell me about substance use treatments available to your clients who live in rural areas.

PROBE:

(a) Are they readily accessible or is there a wait?

(b) Describe the role [name SSP] plays in getting people into treatment.

(c) Which types of treatment are [name SSP] clients offered or referred?

(d) Does [name SSP] encourage any one type of treatment over others?

(e) What are the barriers, if any, that prevent clients from following through on treatment referrals or treatment itself?

Section D. Community

Finally, I would like to ask you some questions about your experience and your community.

18. What is your personal experience with people who inject drugs?

19. Tell me how [name SSP] has affected individuals who live in nearby rural areas.

20. What is the community perception of [name SSP]?

21. Are there any particular barriers that affect the SSP’s operations?

22. Are there other concerns or needs facing people who live in rural areas and inject drugs that we have not discussed?

Section E. Closing

Is there anything else that you think we should know?

Thank you again for participating. I’m going to turn off the recorders and pay you your XX for participating.

End time: ___:____ AM/PM