Digital transformation of the harm reduction sector — “Here4UScotland” a case study of a virtual supervised consumption

Objective

This study explores the potential of digital technologies in reducing drug-related deaths through virtual supervised drug consumption. It assesses barriers, enablers, and strategies for adopting a remote supervision service app, Here4UScotland, fostering user engagement and ownership.

Methods

A mixed-methods evaluation was undertaken, using semi-structured interviews, focus groups, and quantitative data. Interviews and focus groups were undertaken with 26 participants. The Technology, People, Organizations, and Macro-environmental framework guided data collection and analysis, while the Transformative Technology Integration in Health conceptual model enabled analysis of the relationship between digital technology and service delivery. Qualitative data were thematically analyzed.

Results

The app was piloted in Aberdeen (Scotland) from January to December 2023. Twenty-five users received smartphones and logged 74 calls. Qualitative findings identified user concerns about privacy versus the need for real-time support, challenges in integrating new features, and the impact of police involvement on trust in digital services. The app's functionality and user engagement highlighted the need for ongoing support and improved system integration. Interviews highlighted the importance of relationships, training, and strategic outreach in successfully delivering digital harm reduction services. Technological features, such as location tracking, offer real-time support but raise privacy concerns.

Conclusion

Organizational and macroeconomic factors, including marketing, outreach, and law enforcement involvement, may impact service effectiveness and should be considered in future app implementations. Despite challenges, digital tools have enhanced accessibility and support in overdose prevention. Future research should explore cultural differences in digital adoption and improve communication strategies to maximize user engagement.