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Measuring the Impact: A RE-AIM Framework for Evaluation of a Needle Exchange Program

Background: Needle exchange programs (NEPs) have been widely documented over the past three decades as an effective and economic approach to controlling human immunodeficiency virus (HIV). As of July 1st, 2016, these programs have been legalized in North Carolina. Purpose: To perform stage 1 of an evaluation of a needle exchange program in North Carolina by utilizing a public health framework: the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM). Methods: First, the RE-AIM framework was used to create a plan for a program evaluation of a local NEP. Then, the first stage of the evaluation was completed. NEP program participants were interviewed to discuss their motivations, barriers, and use of the program’s services. Additionally, a survey was distributed to local law enforcement officers to assess their experiences, knowledge and attitudes of needle exchange and the laws governing it in North Carolina. Results: Generally, program participants believe the NEP provides a non-judgmental atmosphere and a sense of community. They also wish for alternate hours and more advertising regarding programs that are offered. Twenty three percent of area police incorrectly believe possession of syringes and other supplies from a needle exchange is illegal. Conclusions: The NEP should concentrate on increasing awareness of the programs they offer and investigate providing alternate hours of operation. Furthermore, local area police may need additional training regarding the legality of needle exchange in this area, including how to respond to scenarios that impact drug users. Implications for Practice: The RE-AIM framework was provided to the NEP for further evaluation. Offering training for local area police may increase their knowledge of the law and improve relations with participants of the NEP. More flexible hours at the NEP site may make their services more accessible to a variety of people.
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