changing policy to change lives
TRANSCRIPT
Changing Policy to Change Lives
University of North Carolina at Chapel Hill
HBEH 730: Theoretical Foundations of Behavioral & Social Science, Fall 2015
Shauna Ayres, Bridget Hochwalt, Tom Joseph, & Elizabeth Orlan
Rates of Acute Hep. C per 100,000 residents
2007
2014
INTRODUCTION Policy Campaign Program Timeline Summary
HARM REDUCTION
POLICY
West Virginia Legislature
PROGRAM
Injection Drug Users
Dua
l A
ppro
ach
Introduction POLICY Campaign Program Timeline Summary
Proposed Bill for West Virginia
•County mandated & appropriated Needle Exchange Programs
• Surveillance for Hepatitis C
• Needle disposal
• Addiction treatment
• Naloxone & Suboxone
• Good Samaritan Law
• Evidence-based education added to school curriculum
Introduction POLICY Campaign Program Timeline Summary
BILL SPONSOR,
Delegate
Dr. Chris
Stansbury
of Kanawha
County
NEPs by State
• Kentucky SB 192 is a comprehensive harm reduction package
Prevention
• Good Samaritan
• NEP
• Education
Treatment
• Naloxone
• Suboxone
• Counseling
32 STATES+ District of Columbia & Puerto Rico
Introduction POLICY Campaign Program Timeline Summary
Cost
$0
$20,000
$40,000
$60,000
$80,000
$100,000
$120,000
$140,000
$160,000
1 HCV Tx 1 NEP
Introduction POLICY Campaign Program Timeline Summary
Cabell County NEP Pilot Program
SUCCESSES
Community acceptance
8 other counties are interested
Started September 2015
Free needle exchange program
with educational components, counseling, & testing
Serving 305 individuals,
21-35 years old, 60% males
Goal: 1-1 exchange
LIMITATIONSBudget
Meeting demandTransportation
Introduction POLICY Campaign Program Timeline Summary
Passing HB
1001
Federal Gov.
Legislature
State & Local Gov.
Civil Society
Media
Constituents
Sta
keho
lder
Ma
pp
ing
Introduction POLICY Campaign Program Timeline Summary
Crushing the Competition
Allies Coalition Opponents
Introduction POLICY Campaign Program Timeline Summary
BILL SPONSOR,
Del. Chris Stansbury
House
Speaker
Tim
Armstead
Rep.
Hal
Rogers
(R-KY)
Patrick
Morrissey-
AG
Sen.
Joe
Manchin
(D-WV)
Gov.
Earl Ray
Tomblin
Sen.
Shelley
Capito
(R-WV)
Diffusion of Innovations
ConfirmationImplementationDecisionPersuasionAwareness
Introduction Policy CAMPAIGN Program Timeline Summary
“…It is literally touching every
community around this state…
If you don’t think it’s your problem now,
it soon will be.”
--Delegate Dr. Chris Stansbury of Kanawha County & BILL SPONSOR
Introduction Policy CAMPAIGN Program Timeline Summary
HARM REDUCTION
POLICY
West Virginia Legislature
PROGRAM
Injection Drug Users
Dua
l A
ppro
ach
Introduction Policy Campaign PROGRAM Timeline Summary
Program Summary
• County-Wide
• Individualized Service Delivery
• Suite of Services• Needle disposal
• Addiction treatment
• Infectious disease testing
• Harm reduction education
• Naloxone & Suboxone
Introduction Policy Campaign PROGRAM Timeline Summary
Social Networks
Homophily Centrality Reciprocity
Introduction Policy Campaign PROGRAM Timeline Summary
Word of Mouth
Most Cabell County’s NEP patrons are referred by word of mouth.
Introduction Policy Campaign PROGRAM Timeline Summary
Mobile AppHomophily
Centrality
Reciprocity
Mob
ile A
pp
Homophily
Centrality
Reciprocity
Introduction Policy Campaign PROGRAM Timeline Summary
Outcome Evaluation
Introduction Policy Campaign PROGRAM Timeline Summary
NEP
State PolicyNEP
↓Use of
dirty needles among IDUs
↓Use of
dirty needles among IDUs’
peers
↓Hep C &
other infectious diseases
HARM REDUCTION
Educational Material
& Resources
Testing & Treatment
Take Home Points
• Hepatitis C is an immediate & growing public health threat
Lack of funding from government
• Strong evidence that NEPs are a solution
• Clear cost-benefit
• Widespread community support
Introduction Policy Campaign Program Timeline SUMMARY
NEEDLE EXCHANGE PROGRAMS SAVE LIVES
Dr. Donna Evon Dr. Kurt Ribisl
Claire Brennan Dirk Davis
Tim Hazelett, Cabell County Health Administrator
Dr. Michael Kilkenny, Cabell County Health Director
Philip McDaniel, GIS Librarian, UNC-CH
Daniel Raymond, Policy Director, Harm Reduction Coalition, NYC
Looking Glass Café
Thank You!
“We hope to put ourselves out of business in the Harm Reduction Program.”
-Tim Hazelett, Cabell County Health Administrator