Methods
overdose, OUD, opioid overdose, abscess
ABSCESS
We draw upon semi-structured interviews conducted with people receiving ED-based care who were part of a larger randomized control trial. The larger trial compared the effectiveness of peer recovery specialists and ED-based social workers on treatment uptake, future opioid overdose rates, and ED utilization for opioid overdose in Rhode Island [Between September 2019 and March 2020, semi-structured interviews were conducted with 19 participants from the parent trial to assess their ED care experiences across intervention type (i.e., clinical social worker or peer recovery specialist). Participants were eligible if they were: at least 18 years of age; able to conduct the study in English; and presenting for an opioid overdose in the ED or deemed to be at high risk for an opioid overdose. High overdose risk categorization included currently being treated in the ED for an opioid overdose; had an opioid overdose in the prior 12 months; were receiving treatment for opioid withdrawal; or were receiving treatment for an injection-related outcome (e.g., abscess, soft tissue injection) [Participants from the parent study who had agreed to be contacted for a qualitative interview during the informed consent process (Participant recruitmentA total of 44 trial participants were reached, with the remainder unable to be contacted. The research assistant explained the qualitative sub-study and 24 participants agreed to participate (see Fig. Participants were interviewed in private rooms in the study site by one of two women research assistants who had been trained in qualitative research methods (EN, YA). Verbal informed consent was obtained prior to starting the interviews and interviewers briefly shared their interest in the study topic with participants. Interviews were facilitated using a semi-structured interview guide developed by members of the study team and informed by the study’s aims, relevant literature, and ED clinical expertise of two study team members. Topics included experiences within ED settings (e.g., discrimination, facilitators to care, services discussed with providers), experiences with the treatment arm randomized to (e.g., peer navigator, social worker) including pre- and post- ED visit, perceptions of behavioral counseling received, and ED-based harm reduction resources (e.g., naloxone, medications for OUD). Interviews ranged from 25 to 60 min, were audio-recorded, and transcribed verbatim by a professional transcription company. All transcripts were reviewed for accuracy by the study RAs. All participants received a $50 gift card honorarium. The study team met weekly to discuss and reflect on emerging findings during the study period, including data saturation.Data were coded and analyzed thematically in NVivo12 using inductive and deductive approaches [