Thesis (Ph.D.)--University of Illinois at Urbana-Champaign, 2006. / Adviser: William T. Trent. Includes bibliographical references.

Despite thirty published evaluation reports citing the effectiveness of Vancouver’s safe injection site (Small 2008), the Canadian federal government refuses to endorse safe injection sites as a health service option available to injection drug users (IDUs). Insite’ s evaluation results are undergoing debate, because two communicative spheres of knowledge, each with a unique authoritative language, are conflicting as each is attempting to gain moral authority over the right to recontextualize drug users. Drawing on a literature review of two harm reduction programs in Vancouver, Insite and Sheway, and expert interviews with evaluators, I show that what constitutes “evidence” is in fact subjective, determined by spheres of communicability that are built upon social, professional and political contexts. To confront the problematic nature of this issue, I suggest that evaluators and overseers need to treat program evaluation as a process of negotiation, best approached in a fluid manner. By obscuring multiple user experiences in the evaluation of harm reduction programs, evaluators and overseers risk imposing their communicative ideologies on what it means to be a drug user.

Despite thirty published evaluation reports citing the effectiveness of Vancouver’s safe injection site (Small 2008), the Canadian federal government refuses to endorse safe injection sites as a health service option available to injection drug users (IDUs). Insite’ s evaluation results are undergoing debate, because two communicative spheres of knowledge, each with a unique authoritative language, are conflicting as each is attempting to gain moral authority over the right to recontextualize drug users. Drawing on a literature review of two harm reduction programs in Vancouver, Insite and Sheway, and expert interviews with evaluators, I show that what constitutes “evidence” is in fact subjective, determined by spheres of communicability that are built upon social, professional and political contexts. To confront the problematic nature of this issue, I suggest that evaluators and overseers need to treat program evaluation as a process of negotiation, best approached in a fluid manner. By obscuring multiple user experiences in the evaluation of harm reduction programs, evaluators and overseers risk imposing their communicative ideologies on what it means to be a drug user.

No description available.

Vapour products (e-cigarettes) have rapidly grown in sales. While competing claims about the effects of vaping are fiercely debated within the public health community, no studies have examined the claims accepted in the regulatory arena. In the first article of this manuscript-based dissertation, my co-authors and I utilized narrative policy framework to identify the claims about vapour devices in legislation recommendation reports from Queensland Australia, Canada, and the European Union, and the United States. The vast majority of claims represented vapour devices as a threat, while the potential benefits were very rarely presented, resulting in bans and strict regulations. Evidence on two claims, youth vaping as a risk for nicotine dependence, and vapour products as a cessation aid, was evaluated with systematic reviews. For the youth claim, we retrieved population surveys on (1) the first product used, (2) non-nicotine vaping, (3) the prevalence of infrequent users among past-30-day users, and (4) cannabis vaping. Surveys indicated that a near majority of students who were past-30-day users vaped only once or twice a month, and an appreciable number, 25% and more, reported consuming non-nicotine liquids. Furthermore, 80% to 90% of ever-users tried cigarettes first. Far fewer youth are at a risk for nicotine addiction than indicated by any past-30-day use. On the other hand, vaping as a mode of administration of other drugs has received little attention, and presents an unknown risk to youth. We evaluated the claims about cessation with a review of systematic reviews (umbrella review). Three reviews, Hartmann-Boyce et al. (2016), Malas et al. (2016) and El-Dib et al. (2017) received the better quality ratings. They were unable to reach a definitive conclusion due to the limited number of randomized controlled trials and the low quality of most of the studies. We considered the reviewers’ tentative statements on their findings, the findings of the quality cohort studies, the potential underestimation of effectiveness in the studies, and the improved nicotine delivery of newer models. The weight of the evidence allowed us to state our optimism that vapour products have potential as a cessation aid. In the jurisdictions studied in this dissertation, vapour products have been claimed to be a threat by leading youth to smoking and impeding cessation. Does the evidence support the claims? The possible risk of youth becoming dependent on nicotine from vaping is substantially lower than indicated by the metric of any past-30-day use. There is reasonable evidence that vapour products may be an effective cessation aid. With a better understanding of these two claims, we in public health should revisit the regulations, policies, and interventions for vapour products so that they are in line with the evidence, not unsupported claims. / Graduate / 2019-04-02

Despite thirty published evaluation reports citing the effectiveness of Vancouver’s safe injection site (Small 2008), the Canadian federal government refuses to endorse safe injection sites as a health service option available to injection drug users (IDUs). Insite’ s evaluation results are undergoing debate, because two communicative spheres of knowledge, each with a unique authoritative language, are conflicting as each is attempting to gain moral authority over the right to recontextualize drug users. Drawing on a literature review of two harm reduction programs in Vancouver, Insite and Sheway, and expert interviews with evaluators, I show that what constitutes “evidence” is in fact subjective, determined by spheres of communicability that are built upon social, professional and political contexts. To confront the problematic nature of this issue, I suggest that evaluators and overseers need to treat program evaluation as a process of negotiation, best approached in a fluid manner. By obscuring multiple user experiences in the evaluation of harm reduction programs, evaluators and overseers risk imposing their communicative ideologies on what it means to be a drug user. / Arts, Faculty of / Anthropology, Department of / Graduate

Syftet med studien var att undersöka hur personer med ett injektionsmissbruk, som medverkade i sprututbytesverksamhet i Sverige, upplevde att deras livskvalitet blivit annorlunda. Vidare undersöktes också vilka insatser de blivit erbjudna och om de upplevde att de hade ett minskat riskbeteende. Frågeställningarna som användes i studien för att undersöka detta var:  Vilka insatser inom sprututbytesverksamheten erbjuds personer med injektionsmissbruk att ta del av?  Hur använder sig personer som medverkar i sprututbytesverksamhet av den kunskap de erhåller om hur de ska minska sitt riskbeteende?  Hur upplever personerna som deltar i sprututbytesverksamheten att deras livskvalitet blivit annorlunda? För att kunna svara på frågeställningarna användes en enkät som skickades till sprututbytesverksamheter i Sverige. De centrala begrepp som går att återfinna i studien är harm reduction och livskvalitet och dessa begrepp är väsentliga när det gäller konstruktionen av enkäten i relation till syfte och frågeställningar. Slutligen inkom 15 stycken enkäter av de 60 stycken som hade skickats ut, vilket gjorde att resultatet som kom fram inte gick att generalisera. Enkäterna behandlades i datorprogrammet SPSS för att kunna ge en tydlig bild av hur respondenterna svarat. Det som framkom i resultatet var att respondenterna främst använde sig av insatser som byte av sprutor, vaccinationer och att testa sig för sjukdomar. Smittskydd och smittspridning var de områden där respondenterna uppgav att de erbjöds mest information, vilket också var de områden de ansåg sig ha bäst kunskap om. Det framkom även att respondenterna ansåg att deras livskvalitet hade blivit bättre sedan de började i sprututbytesverksamheten. Insatser som syftade till att personerna som deltog skulle avsluta sitt narkotikamissbruk var inte något som det angavs att det erbjöds speciellt mycket av. Slutsatsen som drogs av studien var att de insatser som erbjöds på sprututbytesverksamheten i första hand syftade till att minska riskbeteende och smittspridning av HIV

Thesis (M.A.)--Bowling Green State University, 2009. / Document formatted into pages; contains vii, 71 p. Includes bibliographical references.

Thesis (M.S.), Wellness Management--University of Central Oklahoma, 2008. / Includes bibliographical references (leaves 56-58).

Thesis (M.S.), Wellness Management--University of Central Oklahoma, 2008. / Includes bibliographical references (leaves 56-58).