Kentucky Outreach Service Kiosk (KyOSK) Study Protocol: a Community-level, Controlled Quasi-experimental, Type 1 Hybrid Effectiveness Study to Assess Implementation, Effectiveness and Cost-effectiveness of a Community-tailored Harm Reduction Kiosk...

Overview

Journal BMJ Open

Specialty General Medicine

Date 2024 Mar 2

PMID 38431295

Authors

April M Young

Jennifer R Havens

Hannah L F Cooper

Amanda Fallin-Bennett

Laura Fanucchi

Patricia R Freeman

Hannah Knudsen

Melvin D Livingston

Kathryn E McCollister

Jack Stone

Peter Vickerman

Edward Freeman

Tasfia Jahangir

Elizabeth Larimore

Carol R White

Chelsi Cheatom

KyOSK Community Staff

KyOSK Design Team

Affiliations

Soon will be listed here.

Abstract

Introduction: Many rural communities bear a disproportionate share of drug-related harms. Innovative harm reduction service models, such as vending machines or kiosks, can expand access to services that reduce drug-related harms. However, few kiosks operate in the USA, and their implementation, impact and cost-effectiveness have not been adequately evaluated in rural settings. This paper describes the Kentucky Outreach Service Kiosk (KyOSK) Study protocol to test the effectiveness, implementation outcomes and cost-effectiveness of a community-tailored, harm reduction kiosk in reducing HIV, hepatitis C and overdose risk in rural Appalachia.

Methods And Analysis: KyOSK is a community-level, controlled quasi-experimental, non-randomised trial. KyOSK involves two cohorts of people who use drugs, one in an intervention county (n=425) and one in a control county (n=325). People who are 18 years or older, are community-dwelling residents in the target counties and have used drugs to get high in the past 6 months are eligible. The trial compares the effectiveness of a fixed-site, staffed syringe service programme (standard of care) with the standard of care supplemented with a kiosk. The kiosk will contain various harm reduction supplies accessible to participants upon valid code entry, allowing dispensing data to be linked to participant survey data. The kiosk will include a call-back feature that allows participants to select needed services and receive linkage-to-care services from a peer recovery coach. The cohorts complete follow-up surveys every 6 months for 36 months (three preceding kiosk implementation and four post-implementation). The study will test the effectiveness of the kiosk on reducing risk behaviours associated with overdose, HIV and hepatitis C, as well as implementation outcomes and cost-effectiveness.

Ethics And Dissemination: The University of Kentucky Institutional Review Board approved the protocol. Results will be disseminated in academic conferences and peer-reviewed journals, online and print media, and community meetings.

Trial Registration Number: NCT05657106.

Citing Articles

Likelihood of using a harm reduction vending machine among rural people who inject drugs in Appalachian Kentucky.

Young A, Jahangir T, Belton I, Freeman E, Livingston M Int J Drug Policy. 2025; 137:104709.

PMID: 39842394 PMC: 11875871. DOI: 10.1016/j.drugpo.2025.104709.

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