Implementing a Community Needs Assessment for Naloxone Vending Machines with Leaders with Lived Experience


Author: Jordan Akerley, Joanne Kay

Theme: Epidemiology & Public Health Research Year: 2023

Background: End Hep C SF (EHCSF) is a multi-sector collective impact initiative that works toward hepatitis C (HCV) elimination. Since 2018, EHCSF’s CN program has supported and trained people with lived experience with HCV and substance use to advocate for others living with and at risk of HCV. The program is increasingly taking a syndemic approach to HCV elimination.

In 2021, San Francisco reported 625 deaths attributable to unintentional overdose, and naloxone was used by emergency responders and community partners to reverse thousands of overdoses. The San Francisco Department of Public Health’s (SFDPH) Office of Overdose Prevention proposed a collaboration with EHCSF’s Community Navigator (CN) Program to conduct a needs analysis of potential locations for naloxone vending machines to increase access in high-risk settings and lower-resourced, priority neighborhoods.

Methods: Drawing on the expertise of CNs’ lived experience, and supplementing this expertise with skills-specific training on survey methods, EHCSF supported CNs to conduct surveys in four neighborhoods with high overdose rates. CNs and survey respondents were incentivized to participate.

Results: 15 CNs participated in survey training and 11 of this cohort conducted 250 surveys that included quantitative and qualitative questions. CNs shared about their experience at a feedback session. The quality and resonance of the survey tool was improved by the CN’s recommendations to change language, content and sequence. CNs lent credibility to this survey about sensitive and personal topics and recorded candid perspectives about the city’s response to overdose.

Conclusion: Partnering with navigators enabled SFDPH and EHCSF to better understand community knowledge, attitudes, and considerations that will affect the installation of naloxone vending machines in San Francisco. The project strengthened the relationship between community and the public health experts leading San Francisco’s overdose response. EHCSF and SFDPH will complete a process evaluation of the project.

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