Date of Award
8-2024
Document Type
Campus Access Dissertation
Degree Name
Doctor of Philosophy (PhD)
Department
Nursing
First Advisor
Lingling Zhang
Second Advisor
Sun S. Kim
Third Advisor
Akwasi Duah
Abstract
The opioid crisis in the United States has emerged as a critical public health issue, with urban areas like Boston experiencing a significant rise in opioid overdose deaths. This dissertation addressed this complex challenge through three interrelated manuscripts, each contributing unique insights and strategies for opioid overdose prevention. The first manuscript conducted a policy analysis of the Opioid-Overdose Reduction Continuum of Care Approach (ORCCA) Practice Guide, using Russell and Fawcett's conceptual model of nursing and health policy. This analysis evaluated the guide's alignment with nursing practices and health policies, highlighting its potential to enhance nursing interventions in opioid crisis management. The second manuscript employed a descriptive qualitative design to explore the perspectives of 15 stakeholders, including healthcare providers, law enforcement officials, policymakers, and community leaders. Using MAXQDA software was utilized for data management and analysis, six key themes were identified: Community Empowerment and Collaborative Action, Barriers and Equity in Access, Innovative and Educational Strategies, Policy and Systemic Solutions for Socioeconomic Challenges, Integrated Mental Health and Substance Use Services, and Integrated Community Safety and Technological Recovery Solutions. These themes underscored the necessity of a holistic public health approach, emphasizing the integration of mental health services and the importance of community engagement and law enforcement collaboration. The third manuscript built on these insights by conducting a stakeholder analysis using the Agency for Healthcare Research and Quality's Stakeholder Analysis Tool. This analysis examined various stakeholders' roles, interactions, and potential influence, providing a detailed understanding of their contributions and the dynamics of collaboration. The findings highlighted the importance of multi-stakeholder engagement and systemic policy changes in enhancing opioid overdose prevention efforts. An integrated framework for opioid overdose prevention was developed from the combined insights of these analyses, providing a comprehensive, adaptable model for public health officials. Together, these manuscripts offered a comprehensive approach to addressing the opioid crisis in Boston, emphasizing the need for integrated, evidence-based strategies and collaborative efforts. This dissertation significantly contributed to the field of public health by providing actionable insights and recommendations for more effective and inclusive opioid overdose prevention strategies.
Recommended Citation
Kyei, Evans F., "Unraveling the Opioid Crisis in Urban Centers: Policy Approaches and Community Strategies to Address Overdose Deaths in Boston, MA" (2024). Graduate Doctoral Dissertations. 983.
https://scholarworks.umb.edu/doctoral_dissertations/983
Comments
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