Persons Using Drugs Seeking Care at a Mobile Health Van: Preliminary Results on Perceptions of Care Needs and Implications for Future "Street" Research

Background and Purpose: Opioid deaths are one of the leading and most preventable causes of death in the United States. Access to care, particularly harm reduction services, remain one of the leading strategies to stop this growing health disparity; however most PWUD report low levels of care due to systems of care that are difficult to navigate, high levels of stigma experiences, and lower levels of health literacy (e.g. perception of need). A small, albeit growing, body of research suggests mobile health vans can act as safety nets for the most vulnerable of populations, particularly PWUD, and minimize experiences of stigma and increase access to medication assisted treatment. Currently, there is sparse research exploring perception of care needs among PWUD, particularly among historically oppressed populations. This qualitative study aims to fill a gap in research to better understand perceptions of care and help seeking behavior among a sample of PWUD seeking care at a mobile health van in Chicago.

Methods: This oral presentation reviews preliminary results of an ongoing qualitative study among a sample of PWUD seeking medical care at a mobile health van at two neighborhoods hardest hit by overdose deaths in the Chicago area (n=25). Participants were asked ten semi-structured questions to understand 1) social identities, 2) experiences with care 3) facilitators and barriers to care, and 4) messages to the public regarding their substance use. An a priori preliminary analysis of existing interviews was conducted to identify general themes across the four interview domains.

Results: The average consumer was 46.46 years old (SD=10.23), identifies as male (n=15; 60%), Black or African American (n= 14, 56%), and reports heroin/opiates as their primary drug of choice (n=23, 92%). Most consumers have a history of incarceration (n=23, 92%) and were 18.84 years old (SD=5.44) when they first started using illicit drugs. Almost all consumers agreed treatment was needed for drug use, but there were differing opinions on what components of treatment were most needed that generally reflected readiness for change. Most consumers reported accessing care at the mobile health vans because of the convenience and rapport with the staff. Consumers largely reported that access to peer recovery support was integral to treatment along with a place to stay. The most common barriers to care included discharging without a place to stay or being denied intake due to positive urinalysis. Finally, the most resounding message from consumers to society about (their) drug use was to tell others to “just say no” and voiced statements speaking to their dignity and worth as a person and the ubiquity of addiction.

Conclusions and Implications: The preliminary results identify key factors to help-seeking among PWUD seeking care at a Chicago-based mobile health van. Next steps for analysis will be discussed, including attention to discourse and language by social identities. The project results will be used to inform future health literacy, particularly among those recently incarcerated. Recommendations for community outreach and/or mobile site (“street”) research will be highlighted.