Strengths & limitations
overdose, fatigue
EVENTS, RECRUITMENT
Results of this study fill a gap in the literature regarding naloxone experiences of PWUD in rural Appalachian communities. Furthermore, our study explored the ways that PWUD discuss naloxone with their social networks, before, during, and after overdose events. This focus area yielded rich data, providing meaningful context to the existing body of literature. The application of the R-REF as the guiding framework for our study is a key strength of this study, missing from other studies that explore naloxone experiences in rural environments. This framework helps us to contextualize findings in relation to a long-standing body of scholarly work [Among the limitations of this study is missing perspectives. Our sample was skewed toward participants with sustained engagement in the intervention. We lack perspectives of people who were re-incarcerated or otherwise disengaged from the program during our recruitment period. Furthermore, our sample was largely comprised of white participants, meaning that we lack important perspectives of rural people of color. Our sample was also solely comprised of participants with criminal-legal system involvement. Individuals who had not been recently involved in this system might have expressed less concern about police response to finding naloxone during a search.During data collection, some interviews were impacted by poor cellular/internet connection. While the researchers took steps to mitigate disruption (e.g., arranging office space/computers for participants to use, supplementing transcripts with detailed notes), transcripts still reflect some inaudible moments.Another limitation is that naloxone experiences were not the sole focus of the interview guide. Furthermore, the naloxone questions were placed toward the end of the guide. While this structure allowed the interviewer to build trust and rapport with participants before discussing naloxone experiences, it also increased risk of participant fatigue.Regarding positionality, the primary interviewer is not from a rural Appalachian community. While the interviewer strived to build rapport and avoid stigmatizing language, she may have been perceived as an outsider by participants. However, having third party distinct from the C2H REHNS conducting interviews was a methodological strength as it enabled participants to openly share their experiences.