C Strike1, M Rotondi2, G Kolla3, É Roy4, N K Rotondi5, K Rudzinski6, R Balian7, T Guimond3, R Penn3, R B Silver7, M Millson3, K Sirois7, J Altenberg7, N Hunt8. 1. Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada; Social and Epidemiological Research Department, Centre for Addiction and Mental Health (CAMH), 33 Russell Street, Toronto, ON M5S 2S1, Canada. Electronic address: carol.strike@utoronto.ca. 2. School of Kinesiology and Health Science, Faculty of Health, York University, 4700 Keele Street, Toronto, ON M3J 1P3, Canada. 3. Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada. 4. Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Campus Longueuil 1111, rue St-Charles Ouest, Longueuil, QC J4K 5G4, Canada. 5. Social and Epidemiological Research Department, Centre for Addiction and Mental Health (CAMH), 33 Russell Street, Toronto, ON M5S 2S1, Canada. 6. Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada; Social and Epidemiological Research Department, Centre for Addiction and Mental Health (CAMH), 33 Russell Street, Toronto, ON M5S 2S1, Canada. 7. South Riverdale Community Health Centre, 955 Queen Street East, Toronto, ON M4M 3P3, Canada. 8. Centre for Research on Drugs and Health Behaviour, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, United Kingdom.
Abstract
BACKGROUND: Injection drug use is a skill learned in social settings. Change the Cycle (CTC), a peer-delivered, one-session intervention, is designed to reduce among people who inject drugs (PIDs) injection initiation-related behaviours (i.e., speaking positively about injecting to non-injectors, injecting in front of non-injectors, explaining or showing a non-injector how to inject) and initiation of non-injectors. We hypothesized that participation in CTC would lead to reductions in initiation-related behaviours six months later. METHODS: Using respondent driven sampling (RDS), 98 PIDs were recruited in Toronto, Canada to participate in pilot testing of CTC. The baseline session consisted of a structured interview, the peer-delivered CTC intervention, instructions regarding RDS coupon distribution, and an invitation to return in six months for a follow-up interview. For the 84 PIDs completing the six-month interview, we compared initiation-related behaviours at baseline with six-month follow-up. RESULTS: The proportion of PIDs offering to initiate a non-injector was reduced from 8.4% (95% CI: 2.5, 15.9) at baseline to 1.59% (95% CI: 0.4, 3.7) at 6-month follow-up. The prevalence of speaking positively about injection to non-injectors also decreased significantly. The proportion of PIDs who helped a non-injector with a first injection at baseline was 6.2% (95% CI: 2.1, 11.3) and at follow-up was 3.5% (95% CI: 0.8, 7.1). Paired analyses of initiator baseline versus follow-up data showed a 72.7% reduction in initiation (95%CI: 47.7, 83.1). CONCLUSIONS: While further refinements remain to be tested, pilot study results suggest that CTC holds promise as a prevention intervention.
BACKGROUND: Injection drug use is a skill learned in social settings. Change the Cycle (CTC), a peer-delivered, one-session intervention, is designed to reduce among people who inject drugs (PIDs) injection initiation-related behaviours (i.e., speaking positively about injecting to non-injectors, injecting in front of non-injectors, explaining or showing a non-injector how to inject) and initiation of non-injectors. We hypothesized that participation in CTC would lead to reductions in initiation-related behaviours six months later. METHODS: Using respondent driven sampling (RDS), 98 PIDs were recruited in Toronto, Canada to participate in pilot testing of CTC. The baseline session consisted of a structured interview, the peer-delivered CTC intervention, instructions regarding RDS coupon distribution, and an invitation to return in six months for a follow-up interview. For the 84 PIDs completing the six-month interview, we compared initiation-related behaviours at baseline with six-month follow-up. RESULTS: The proportion of PIDs offering to initiate a non-injector was reduced from 8.4% (95% CI: 2.5, 15.9) at baseline to 1.59% (95% CI: 0.4, 3.7) at 6-month follow-up. The prevalence of speaking positively about injection to non-injectors also decreased significantly. The proportion of PIDs who helped a non-injector with a first injection at baseline was 6.2% (95% CI: 2.1, 11.3) and at follow-up was 3.5% (95% CI: 0.8, 7.1). Paired analyses of initiator baseline versus follow-up data showed a 72.7% reduction in initiation (95%CI: 47.7, 83.1). CONCLUSIONS: While further refinements remain to be tested, pilot study results suggest that CTC holds promise as a prevention intervention.
Authors: Ricky N Bluthenthal; Lynn Wenger; Daniel Chu; Philippe Bourgois; Alex H Kral Journal: Drug Alcohol Depend Date: 2017-04-19 Impact factor: 4.492
Authors: Stephanie Navarro; Alex H Kral; Carol S Strike; Kelsey Simpson; Lynn Wenger; Ricky N Bluthenthal Journal: Subst Use Misuse Date: 2019-05-03 Impact factor: 2.164
Authors: Kelsey A Simpson; Alex H Kral; Jesse L Goldshear; Lynn Wenger; Carol S Strike; Ricky N Bluthenthal Journal: Drug Alcohol Depend Date: 2020-02-05 Impact factor: 4.492
Authors: Anneli Uusküla; David M Barnes; Mait Raag; Ave Talu; Susan Tross; Don C Des Jarlais Journal: Drug Alcohol Depend Date: 2018-05-08 Impact factor: 4.492