#VP21: Sustainable Harm Reduction: Evaluation Of Cardboard Fitkits Dispensed From Automatic Dispensing Machines

Author: Brennan Geiger Edmund Silins Nick Rich Phillip Read

Theme: Epidemiology and Public Health Research Year: 2021

Background: Health care contributes approximately 7% of Australia’s total carbon emissions. The Kirketon Road Centre Needle & Syringe Program (NSP) dispenses over 54,000 Polypropylene Fitpacks® annually. Fitpacks® cannot be recycled, taking hundreds of years to slowly decompose. KRC piloted a sustainable harm reduction initiative to replace plastic Fitpacks® with cardboard Fitkits and reduce the environmental footprint of our program. Methods: Project evaluation employed a mixed method study design. Face-to-face structured interviews with clients assessed client sentiment and risks surrounding the project. Consumer surveys, service level, and needle pick-up surveillance data informed quantitative evaluation of consumer behaviour and project impact. Results: Respondents rated cardboard packaging on a five-point Likert scale ranging from one (It’s a dud) to five (It’s sweet). Cardboard packaging was rated highly by participants with half of respondents scoring it four or five (median=4.0, IQR=2). Almost all (90%) participants rated cardboard Fitkit packaging better or much better for the environment than plastic Fitpacks® (median=5.0, IQR=1). Three-quarters (73.3%) of respondents indicated their disposal method had not changed as a result of cardboard Fitkits. We found no significant difference in the quantity of discarded sharps in the community before and after project implementation (before: Mean (M)=461.42, standard deviation (SD)=221.50; after: M=361.67, SD=130.80; t(22)=1.34, p=.19, MD=99.75), suggesting that replacing plastic Fitpacks® with cardboard Fitkits was not associated with an increase in unsafely disposed sharps in the community. Conclusion: This evaluation found no evidence of detrimental impacts on drug user’s injecting practice, nor public amenity associated with changed packaging. The use of cardboard Fitkits reduces the environmental impact of NSP operations, which is both valued by clients, and offers packaging cost savings which can be used to support Free-Vend and increase in NSP distribution. Harm reduction programs for drug user health should include environmental impact when assessing overall health outcomes for clients. Disclosure of Interest: PR has received research funding from Gilead Sciences, as well as institutional and individual honoraria from Gilead Sciences, Abbvie and MSD.

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