The acceptability of overdose alert and response technologies: introducing the TPOM-ODART framework

Area of Science:

• Public Health
• Digital Health
• Sociology

Background:

• Opioid overdoses (OD) cause significant global mortality, yet are reversible with naloxone hydrochloride.
• Many fatal overdoses occur when individuals use opioids alone, highlighting the need for technological interventions.
• The acceptability of overdose response technologies to people who use opioids (PWUO) is a critical concern for effective implementation.

Purpose of the Study:

• To explore the acceptability of overdose response technologies among PWUO.
• To identify key factors influencing the adoption of harm reduction technologies for opioid overdose.
• To integrate primary research data with the Technology People Organisations Macroenvironment (TPOM) framework.

Main Methods:

• A qualitative study employing focus group methodology with PWUO, affected family members, and service providers.
• Data analysis involved a multi-stage thematic analysis using both inductive and deductive approaches.
• The study drew upon the Technology People Organisations Macroenvironment (TPOM) framework to analyze acceptability factors.

Main Results:

• Three major themes emerged: 'Trust-in technologies, systems and people,' 'Balancing harm reduction, safety and ambivalence,' and 'Readiness-a double bind.'
• Trust was closely linked to data security, privacy, and confidentiality concerns.
• Participant groups perceived that those most at risk might be least able to engage with new interventions.

Conclusions:

• Effective digital strategies for preventing fatal overdoses require sensitivity to technological, social, organizational, and environmental factors.
• Trust, readiness, and performance are central to technology acceptability for PWUO.
• An augmented TPOM framework, the TPOM-ODART, was developed to guide the design of these interventions.