Staying Alive in Little Five: Perceptions of Service Industry Workers Who Encounter and Respond to Opioid Overdose in Little Five Points, Atlanta Público
Febres-Cordero, Sarah (Summer 2021)
Abstract
Background: In Little Five Points (L5P), Atlanta, opioid overdose occurs, and service industry workers are often first responders by default. Little Five Points is an eclectic, primarily independent, commercial district comprised of service industry workers. Community members are implementing harm reduction strategies, including access to sterile syringes and free distribution of naloxone (opioid antidote) to those who are likely to encounter and respond to an opioid-induced overdose. These attributes make L5P an ideal location to identify strategies that can be implemented by laypeople, improve education regarding naloxone administration, and overdose management.
Purpose: The purpose of this study is to describe the perceptions of service industry workers who encounter and respond to opioid overdose in a community setting.
Methods: I conducted a qualitative descriptive study with elements of ethnography and phenomenology in an Atlanta commercial district that has been encountering and responding to opioid overdose in the community and practicing harm reduction since the 1990s. To explore potential strategies for layperson response to overdose, this qualitative descriptive study utilized participant observation, criterion, and snowball sampling, and led to an enrollment of 15 participants. One-on-one interviews employed a 13-question interview guide with semi-structured open-ended questions. Iterative analysis with constant comparison was employed with inductive reasoning. Internal validity was ensured by member checks, reflexivity, peer review, triangulation of methods, and archival research.
Findings: One-on-one interviews with 15 service industry workers yielded 13 hours of rich, descriptive data, and participant observations over seven months produced 44 hours of field data. Our inquiry uncovered the perceived invisible and hidden nature of opioid use and overdose, revealing three themes: hidden places of consumption, hidden by blending in, and hidden dangers.
Table of Contents
Introduction
Purpose of Study
Summary of Papers
Context of Inquiry
Service Industry Workers as First Responders
Naloxone, an Opioid Antagonist
Chapter 1: Blending Qualitative Methods: An Immersive Approach to Community Research
Abstract
Introduction
Risk for Human Subjects
Data Collection
Reflexivity and Ethics
Making Community Connections
Community Advisory Board
Member Checks
Sampling Strategy
Interdisciplinarity and Cross-Collaboration
Analysis
Analytic Strategy
Coding
Conclusion
Chapter 2: Service Industry Workers Perceptions of the hidden and invisible nature of opioid and heroin use in Little Five Points, Atlanta
Study Context
Harm Reduction
Stigma
Social Geography and Stigma
Method
Ethics
Results
Sample
Data collection
Analysis
Results
Theme 1: Places of Consumption
Theme 2: Hidden by Blending In
Intoxication and alcohol use
Counterculture and subculture appearance
Homelessness and untreated mental health problems
There is no Normal
Theme 3: Hidden Dangers
Disease transmission
Unintentional overdose: Fentanyl and Carfentanil and found drugs
Fear of perceived violence
Discussion
Concealability
Disruptiveness
Aesthetic Qualities
Peril
Limitations
Conclusion
Appendix, Tables and Figures
Appendix A
Table 1 Demographics
Figure 1 Theoretical Framework
Figure 2 Train kid in L5P. Photo by SFC
Chapter 3: Designing a Graphic Novel: Engaging Community, Arts, and Culture into Public Health Initiatives
Abstract
Background
Naloxone and Layperson Response to Opioid Overdose
Parent Study Methods
Emerging Study Findings
Why We Chose the Graphic Novel Format for Dissemination
Disseminating with Art in Little Five Points
Working with a Community Artist
Implications for Research and Cross-Collaboration
Figures and Images
Image 1
Image 2
Image 3
Figure 2
Figure 3
Figure 4
Figure 5
Conclusion
It takes a village
Why L5P?
Preliminary Work
Approach
Theoretical framework
Reflexivity and ethics
Stigma
Next Steps
References
About this Dissertation
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