Literature Collection

Background: Jails in Massachusetts are among the first nationwide to provide correctional populations with medications to treat opioid use disorder (MOUD). The COVID-19 pandemic caused jails to pivot and adapt MOUD programming. We aimed to identify adaptations and barriers to MOUD access that COVID-19 exacerbated or created, and document new elements that staff wish to sustain as COVID-19 recedes. Methods: We conducted semi-structured in-depth interviews and focus groups in 2020-2021 with 29 jail staff who implement MOUD programming in two Massachusetts jails. We conducted qualitative data analysis in Atlas.ti 8 using an inductive approach. Results: Participants shared that access to MOUD among correctional populations is understood by jail staff to be an essential health service. Thus, to facilitate continued access to MOUD, both during incarceration and also at community reentry, jail staff quickly implemented changes in MOUD regulations and dosing protocols and established telehealth capacity. Despite these program adaptations, participants identified how COVID-19 increased health and social needs among correctional populations, reduced availability of community-based healthcare and recovery-supportive services, and introduced new factors that could undermine recovery. Innovations that participants wished to sustain as COVID-19 receded included telehealth capacity, smaller-sized therapeutic groups, and application of a public health approach to treat opioid use disorder among correctional populations. Conclusions: During disruptive events, jails can adapt MOUD programming to ensure access for people living in jail and upon release. Findings identify factors for understanding the outcomes of jail-based MOUD programming during COVID-19 and highlight opportunities to improve service delivery after COVID-19.

Crystal methamphetamine ("meth") use is on the rise in the USA, having devastating effects on individuals and communities. Innovative prevention strategies are therefore critical. Through an exploratory qualitative study, we examined the perspectives and experiences of teenagers and parents around meth prevention messaging formats and strategies. Teens and adults were recruited through middle and high schools, libraries, local sporting events, and word of mouth in three communities in North Idaho, May-September 2016. Guided by the theoretical framework of the Extended Parallel Process Model, we conducted focus groups and small group interviews (three teen; two adults). Using a deductive content analytic approach, we developed teen- and adult-specific codebooks, analyzed the transcripts with NVivo 12-Plus, and identified themes. Teens and adults were all acutely aware of meth use in their communities, personally knowing people who were addicted to meth, and all understood the oral ("meth mouth") and physical ("crank bugs") consequences of meth use. Three primary themes were identified, which focused on the effects of, addiction to, and messaging around crystal meth use. For teens and adults, images illustrating the effects of meth were least effective if they appeared unrealistic or comical. Teens resonated most with messages focusing on pain and vanity (bad teeth and breath), and there was consensus that showing teens images simulating changes in their appearance over time as a result of meth use in a clinical setting would be an effective prevention strategy. Teens and adults who had exposure to meth addiction in North Idaho felt that prevention messages focused on meth are imperative, given its high prevalence and deleterious effects. Future work will entail developing and testing a communication-based meth prevention strategy along with tailored messaging that can be used with teens in dental settings.