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Against the Odds: Syringe Exchange Policy Implementation in Indiana.
Beth E Meyerson1, Carrie A Lawrence2, Laura Miller2
1Rural Center for AIDS/STD Prevention, Indiana University School of Public Health-Bloomington, 1025 E. 7th Street, Bloomington, IN, USA. bmeyerso@indiana.edu.
AIDS and Behavior
|January 22, 2017
Summary
Indiana counties rapidly adopted syringe exchange policies but faced ambiguity and resource issues. Emerging health commons networks offered solutions, but state barriers hindered implementation and population health improvements.
Area of Science:
- Public Health
- Health Policy
- Implementation Science
Background:
- Syringe exchange programming (SEP) is proven effective for public health.
- Limited research exists on policy adoption and implementation of SEP.
- Indiana's new legislation enabled local SEP establishment.
Purpose of the Study:
- To document the experiences of Indiana counties establishing SEP.
- To identify challenges and facilitators in policy adoption and implementation.
- To explore the role of health commons in resource-scarce environments.
Main Methods:
- Mixed-method, qualitative, exploratory case study.
- Data collected from 24 Indiana counties (May 2015 - April 2016).
- Focused on policy adoption and implementation processes.
Main Results:
- Observed rapid policy adoption interest across counties.
- Counties reported significant policy ambiguity and resource capacity issues.
- Health commons emerged, facilitating information and resource sharing, but faced state structural barriers.
Conclusions:
- Health commons can be crucial for SEP success by creating efficiencies.
- Overcoming state structural barriers is vital for effective policy implementation.
- Recommendations are offered to improve SEP adoption and population health outcomes.
