Spike on a bike: mobile harm reduction in action

Area of Science:

• Public Health
• Sociology
• Addiction Studies

Background:

• Rural areas face significant barriers to accessing harm reduction services for people who use drugs.
• The COVID-19 pandemic exacerbated declining service use, prompting innovative solutions.
• Spike on a Bike (SOAB) is a mobile, peer-led intervention developed to deliver harm reduction supplies and support directly to remote communities.

Purpose of the Study:

• To evaluate the effectiveness of the mobile harm reduction intervention, Spike on a Bike (SOAB).
• To assess SOAB's impact on service access, user engagement, and experiences in rural West Wales.
• To identify areas for improvement in mobile harm reduction service delivery.

Main Methods:

• A mixed-methods evaluation combining quantitative (service uptake, demographics) and qualitative (interviews, surveys, observations) data.
• Data collection occurred between May 2022 and June 2024.
• The evaluation involved collaboration with academic institutions and public health bodies.

Main Results:

• SOAB significantly enhanced access to harm reduction support in rural West Wales.
• The intervention reached diverse age groups and engaged a notable proportion of female clients (36%).
• Service users reported improved access and reduced stigma, but uptake of blood-borne virus testing and steroid harm reduction kits was low.

Conclusions:

• Mobile harm reduction services are a viable model for overcoming service exclusion in rural settings.
• Tailoring services to local contexts and reducing barriers (transport, stigma, visibility) is key to reaching underserved populations.
• SOAB's approach offers valuable insights for developing future, community-informed harm reduction strategies.